APHASIA TYPE, AGE AND CEREBRAL INFARCT LOCALIZATION

Stroke patients with nonfluent aphasia tend to be younger than fluent aphasics. We investigated whether this difference was due to an age-re lated change in the anatomico-functional organisation of language area s or to an age-dependent variation on the distribution of infarct loca lisation. From a hospital prospective stroke database we selected thos e patients who suffered an ischaemic stroke with at least one non-lacu nar infarct demonstrated by computed tomography (n = 423 patients). We retrieved information on language disturbance in the acute phase (no aphasia, non-fluent aphasia, fluent aphasia) and on infarct localisati on by CT. Non-fluent aphasia predominated in young (aged < 51 years) p atients while in elderly patients (aged > 70 years) the opposite was f ound (chi(2) = 8.03; P = 0.005). Posterior infarcts were also more fre quent in elderly patients (chi(2) = 9.9; P = 0.002). There were 27 aty pical cases (patients with lesions on language areas without aphasia) and 14 aphasics with atypical infarct localisation (9 fluent aphasics with anterior lesions and 5 non-fluent aphasics with posterior lesions ). The proportions of atypical cases, their infarct location or fluenc y type were not influenced by age. It was concluded that the predomina nce of fluent aphasia in older patients was related to the higher prop ortion of posterior infarcts in these patients. The hypothesis of age- related changes in the anatomico-functional organisation of language a reas was not supported by the present data.