Abstract Details

Title Loss of speech and functional impairment in Alzheimer’s disease-related primary progressive aphasia: predictive factors of decline

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P7 - Poster Session 7 (8:00 AM-9:00 AM)

Poster/Presentation
Number 3-003

Objective To identify features associated with different disease courses in Alzheimer’s disease (AD)-related primary progressive aphasia (PPA).

Background AD-related PPA includes patients with established Alzheimer’s pathology and linguistic features extending from logogenic PPA to mixed-PPA with impairment in naming, repetition and agrammatism. Patients in this group show different trajectories of linguistic deficits and nonverbal features.

Design/Methods 23 patients diagnosed with AD-related PPA were included. All patients underwent neuropsychological evaluation, ¹⁸F-Fluorodeoxyglucose-PET brain scan, CSF biomarker measurement and APOE genotype analysis at baseline and underwent neurological follow-up for a mean time of 2.94 (3.97) years. Outcome variables were progression to total loss of speech (TLoS) ability and loss of functional autonomy (LoFA) in daily life.

Results At follow-up, 11 patients progressed to TLoS (TLoS⁺). TLoS⁺patients had greater impairment in writing (0.00 [1.00] vs. 1.00 [0.00], p=0.032, η²=0.27) and higher median t-tau concentration (531.00 [560.00] vs. 1069.00 [423.00], p=0.049, η²=0.21) as compared to TLoS^–patients. A cut-off value of 955 pg/mL was found to discriminate TLoS⁺ and TLoS^– patients with an accuracy of 76.19% (95% C.I.=59.15-93.23). TLoS⁺patients had hypometabolism in middle and superior temporal gyrus, precuneus and paracentral lobule. Eleven patients who progressed to LoFAhad greater impairment in single-word comprehension as compared to patients who maintained autonomy in self-care (0.50 [0.50] vs. 0.00 [0.50], p=0.001, η²=0.49).

Conclusions

AD-related PPA patients who will progress to total loss of speech may be detected at baseline according to linguistic profile, CSF t-tau and brain metabolic pattern. Impairment in single-word comprehension may be used to identify patients who will need assistance in self-care over a three-year period. These features could be useful tools both for caregivers, to prepare sufficient resources for the future need of patient care, both for clinicians to select patients to be eligible for disease modifying therapies and future clinical trials on AD.

Authors/Disclosures
Salvatore Mazzeo (Policlinico San Donato S.p.A.) PRESENTER	Mr. Mazzeo has nothing to disclose.
	No disclosure on file
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	No disclosure on file
Giulia Giacomucci, MD	Ms. Giacomucci has nothing to disclose.
	No disclosure on file
	No disclosure on file
Benedetta Nacmias	Benedetta Nacmias has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier.
Sandro Sorbi	Sandro Sorbi has nothing to disclose.
	No disclosure on file

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