A thesis submitted in partial fulfilment of - Queen Margaret University

Studies have not always found age to be a prognostic factor (Basso, 1992;
Poeck, Huber and Willmes, 1989). Basso (1992) also states that if there were
clear age differences in recovery it would only indicate that changes occur with
age, without suggesting the possible causes of these changes. However
Alexander (1994) advises that on the whole older people present with a worse
functional outcome than younger people. Pedersen et al. (1995) found the
influence of age on recovery was significant but minimal. Pedersen, Vinter and
Olsen (2004) found an age difference between Broca’s and Wernicke’s aphasia
one year after stroke but not in the initial acute stages. They suggested that the
‘true’ aphasia is initially masked by diaschisis and felt that age was not a
predictor of recovery. De Riesthal and Wertz (2004) advise that many studies
vary in terms of communication measures used (impairment-based or functional)
and method of measuring amount of change or improvement. Nakayama,
Jørgensen, Raaschou and Olsen (1994) advise that age does not independently
influence stroke outcome neurologically but rather in aspects of activities of daily
living, suggesting a poorer compensatory ability in elderly stroke patients.
2.6.1.2 Years of education
As discussed, the acquisition of skills and information contributes to the
complexity of neuronal connections in the brain (see section 2.5.2) therefore the
more education that a person experiences, the greater the complexity and
number of neuronal patterns are present in the language areas of the brain
(Jacobs, Schall and Scheibel, 1993). Education refers not only to the formal
education system but also to the long-term intellectual experiences resulting
from that education (Jacobs et al., 1993). Jacobs et al. (1993) found that the
more education that an individual experienced the more complex and
interconnected neural connections they possessed compared to less educated
individuals. While it was not possible to prove whether the more complex
number of neurones existed as a result of attending university, or whether
participants were more predisposed to attending higher education because of an
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