The relationship between behavioural changes, cognitive symptoms, and functional disability in primary progressive aphasia: A longitudinal study

C. M. O'Connor, L. Clemson, E. Flanagan, C. Kaizik, H. Brodaty, J. R. Hodges, O. Piguet, E. Mioshi

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Abstract

Background: The contribution of behavioural changes to functional decline is yet to be explored in primary progressive aphasia (PPA).

Objectives: (1) investigate functional changes in two PPA variants [semantic (svPPA) and non-fluent (nfvPPA)], at baseline and after 12 months; (2) investigate baseline differences in behavioural changes between groups, and (3) explore predictors of functional decline after a 12-month period.

Methods: A longitudinal study involving 29 people with PPA (18 svPPA; 11 nfvPPA) seen annually in Sydney/Australia was conducted. A total of 114 functional and behavioural assessments were included for within-group (repeated-measures ANOVA; annual rate of change; multiple regression analyses) and between-group analyses (pairwise comparisons).

Results: Functional profiles in svPPA and nfvPPA were similar in people with up to 5 years of disease duration. Behavioural changes were marked in svPPA patients (stereotypical behaviour and apathy) but did not predict annual rate of change of functional abilities; global cognitive scores at baseline did. Despite mild behavioural changes in nfvPPA (disinhibition, apathy), these were significant predictors of annual rate of functional change.

Conclusions: The presentation and interplay of behavioural changes and functional disability differ in svPPA and nfvPPA. These varying factors should be taken into account when considering prognosis, disease management, and selection of outcome measures for interventions.
Original languageEnglish
Pages (from-to)215-226
Number of pages12
JournalDementia and Geriatric Cognitive Disorders
Volume42
Issue number3-4
Early online date30 Sept 2016
DOIs
Publication statusPublished - Oct 2016

Keywords

  • primary progressive aphasia
  • frontotemporal dementia
  • activities of daily living
  • functional impairment
  • behavior

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