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Symptom‐based staging for logopenic variant primary progressive aphasia

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Title: Symptom‐based staging for logopenic variant primary progressive aphasia
Authors: Chris Hardy, Cathleen Taylor‐Rubin, Beatrice Taylor, Emma Harding, Aida Suárez‐González, Jessica Jiang, Laura M. Thompson, Rachel Kingma, Anthipa Chokesuwattanaskul, Ffion Walker, Steve Barker, Emilie Brotherhood, Claire Waddington, Olivia Wood, Nikki Zimmermann, Nuriye Kupeli, Keir Yong, Paul M. Camic, Joshua Stott, Charles R. Marshall, Neil P. Oxtoby, Jonathan D. Rohrer, Frankie O'Shea, Anna Volkmer, Sebastian J. Crutch, Jason D. Warren
Source: Eur J Neurol
Publisher Information: Wiley, 2024.
Publication Year: 2024
Subject Terms: Male, History, Physiology, Severity of Illness Index, Cohort Studies, 0302 clinical medicine, Mechanisms of Alzheimer's Disease, Pathology, Disease, 10. No inequality, Aged, 80 and over, Psychiatry, Cohort, Life Sciences, Alzheimer's disease, Middle Aged, Diagnosis and Management of Alzheimer's Disease, FOS: Philosophy, ethics and religion, 3. Good health, Psychiatry and Mental health, Caregivers, Archaeology, Dementia and Cognitive Disorders, Disease Progression, Medicine, Female, Primary progressive aphasia, Comprehension, Frontotemporal dementia, Cognitive Neuroscience, Milestone, 03 medical and health sciences, Alzheimer Disease, Health Sciences, Aphasia, Humans, Aged, Neural Mechanisms of Language Processing, logopenic, Australia, Linguistics, staging, Philosophy, Aphasia, Primary Progressive, FOS: Biological sciences, FOS: Languages and literature, primary progressive aphasia, Dementia, Gerontology, Neuroscience
Description: Background and purposeLogopenic variant primary progressive aphasia (lvPPA) is a major variant presentation of Alzheimer's disease (AD) that signals the importance of communication dysfunction across AD phenotypes. A clinical staging system is lacking for the evolution of AD‐associated communication difficulties that could guide diagnosis and care planning. Our aim was to create a symptom‐based staging scheme for lvPPA, identifying functional milestones relevant to the broader AD spectrum.MethodsAn international lvPPA caregiver cohort was surveyed on symptom development under an ‘exploratory’ survey (34 UK caregivers). Feedback from this survey informed the development of a ‘consolidation’ survey (27 UK, 10 Australian caregivers) in which caregivers were presented with six provisional clinical stages and feedback was analysed using a mixed‐methods approach.ResultsSix clinical stages were endorsed. Early symptoms included word‐finding difficulty, with loss of message comprehension and speech intelligibility signalling later‐stage progression. Additionally, problems with hearing in noise, memory and route‐finding were prominent early non‐verbal symptoms. ‘Milestone’ symptoms were identified that anticipate daily‐life functional transitions and care needs.ConclusionsThis work introduces a new symptom‐based staging scheme for lvPPA, and highlights milestone symptoms that could inform future clinical scales for anticipating and managing communication dysfunction across the AD spectrum.
Document Type: Article
Other literature type
Language: English
ISSN: 1468-1331
1351-5101
DOI: 10.1111/ene.16304
DOI: 10.60692/c1qnb-fw772
DOI: 10.60692/ambag-kxd87
Access URL: https://pubmed.ncbi.nlm.nih.gov/38666798
https://discovery-pp.ucl.ac.uk/id/eprint/10191781/
Rights: CC BY
Accession Number: edsair.doi.dedup.....07d7e6cd6d8b9e858f04592dfbb4e87c
Database: OpenAIRE
Description
Abstract:Background and purposeLogopenic variant primary progressive aphasia (lvPPA) is a major variant presentation of Alzheimer's disease (AD) that signals the importance of communication dysfunction across AD phenotypes. A clinical staging system is lacking for the evolution of AD‐associated communication difficulties that could guide diagnosis and care planning. Our aim was to create a symptom‐based staging scheme for lvPPA, identifying functional milestones relevant to the broader AD spectrum.MethodsAn international lvPPA caregiver cohort was surveyed on symptom development under an ‘exploratory’ survey (34 UK caregivers). Feedback from this survey informed the development of a ‘consolidation’ survey (27 UK, 10 Australian caregivers) in which caregivers were presented with six provisional clinical stages and feedback was analysed using a mixed‐methods approach.ResultsSix clinical stages were endorsed. Early symptoms included word‐finding difficulty, with loss of message comprehension and speech intelligibility signalling later‐stage progression. Additionally, problems with hearing in noise, memory and route‐finding were prominent early non‐verbal symptoms. ‘Milestone’ symptoms were identified that anticipate daily‐life functional transitions and care needs.ConclusionsThis work introduces a new symptom‐based staging scheme for lvPPA, and highlights milestone symptoms that could inform future clinical scales for anticipating and managing communication dysfunction across the AD spectrum.
ISSN:14681331
13515101
DOI:10.1111/ene.16304