%C England
%L discovery10191781
%J European Journal of Neurology
%O This work is licensed under a Creative Commons Attribution 4.0 International License. The images
or other third-party material in this article are included in the Creative Commons license,
unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license,
users will need to obtain permission from the license holder to reproduce the material. To view a copy of this
license, visit http://creativecommons.org/licenses/by/4.0/
%D 2024
%K Alzheimer's disease, logopenic, primary progressive aphasia, staging
%T Symptom-based staging for logopenic variant primary progressive aphasia
%X Background and purpose: Logopenic 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. Methods: An 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. Results: Six 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. Conclusions: This 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.
%A CJD Hardy
%A C Taylor-Rubin
%A B Taylor
%A E Harding
%A AS Gonzalez
%A J Jiang
%A L Thompson
%A R Kingma
%A A Chokesuwattanaskul
%A F Walker
%A S Barker
%A E Brotherhood
%A C Waddington
%A O Wood
%A N Zimmermann
%A N Kupeli
%A KXX Yong
%A PM Camic
%A J Stott
%A CR Marshall
%A NP Oxtoby
%A JD Rohrer
%A F O'Shea
%A A Volkmer
%A SJ Crutch
%A JD Warren
%I Wiley