Applicability and Correlates of a Symptom-Led Staging System for Primary Progressive Aphasia

Area of Science:

• Neurology
• Clinical Linguistics
• Gerontology

Background:

• Primary progressive aphasia (PPA) requires effective staging for patient management.
• Assessing the applicability of symptom-led staging systems is crucial for clinical utility.

Purpose of the Study:

• To evaluate the feasibility of the PPA Progression Planning Aid (PPA-Squared) system for staging PPA patients retrospectively.
• To explore demographic and clinical correlates of PPA staging.
• To investigate the PPA-Squared system's predictive capability for survival.

Main Methods:

• Retrospective staging of 75 PPA patients using the PPA-Squared system across three axes: Communication, Non-Verbal Thinking/Personality, and Personal Care/Well-Being.
• Calculation of successful staging percentage.
• Non-parametric tests to assess associations between PPA-Squared scores and clinical/demographic data.
• Mantel-Cox test for survival prediction analysis.

Main Results:

• The PPA-Squared system successfully staged 89.3% of patients from retrospective records.
• PPA-Squared scores significantly correlated with Mini-Mental State Examination (MMSE), Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL) scores.
• Associations were found with various cognitive domains including attention, executive functions, language, memory, and visuo-spatial abilities.

Conclusions:

• The PPA-Squared system is a feasible tool for staging PPA patients.
• The system demonstrates clinical validity by correlating with cognitive and functional assessments.
• The PPA-Squared system's utility is confirmed for assessing PPA patient status based on cognitive and functional profiles.