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

We aimed to identify features associated with different disease trajectories in Alzheimer's disease (AD)related primary progressive aphasia (PPA). We considered 23 patients diagnosed with AD-related PPA. All patients underwent neuropsychological evaluation, 18 F-Fluorodeoxyglucose-PET brain scan, CSF biomarkers measurement and APOE genotype analysis at baseline and underwent neurological follow-up for a mean time of 3 years. Patients who progressed to total loss of speech (TLoS + ) had greater impairment in writing and higher t-tau concentration as compared to TLoS - patients. Patients who progressed to loss of functional autonomy (LoFA + ) had greater impairment in single-word comprehension as compared to patients who maintained autonomy in self-care. Furthermore, 18 F-FDG-PET SPM analyses revealed different brain metabolic patterns between TLoS + and TLoS - and between LoFA + and LoFA -. In conclusion, linguistic profile, CSF t-tau and brain metabolic pattern might be useful tools to predict progression to total loss of speech and loss of functional autonomy in AD-related PPA patients.(c) 2022 Elsevier Inc. All rights reserved.