Functional decline in the aphasic variant of Alzheimer's disease

Introduction Primary progressive aphasia (PPA) is a clinical dementia syndrome associated with frontotemporal lobar degeneration (FTLD) or Alzheimer's disease (AD). Impairment in activities of daily living is essential for dementia diagnosis, yet less is known about the neuropathologic impact on functional decline in PPA, especially over time. Methods Activities of Daily Living Questionnaire (ADLQ) ratings were compared by suspected underlying pathology between 17 PPA(A beta+) and 11 PPA(A beta-) participants at 6-month intervals for 2 years using a linear mixed-effects model. A general linear model examined associations between functional decline and cortical thickness at baseline. Results Groups did not differ in demographics or aphasia severity at baseline, yet overall and subdomain scores of the ADLQ were significantly worse for PPA(A beta+) compared to PPA(A beta-) (P = .015) at each interval across 18 months. Discussion Functional decline appears more pronounced and disrupts more aspects of life activities for individuals with non-semantic PPA with suspected AD versus non-AD neuropathology.