Alzheimers Disease, Dementia & Ageing

Rafael Aranguiz Loyola has completed his medical studies in the University of Chile and PhD Neurology in the University of Valparaíso. He is currently director of the Memory Disorders Unit in Clinica Davila and neurologist of the Psychogeriatric Unit in Instituto Nacional de Geriatria.

Introduction: Primary Progressive Aphasia (PPA) is a syndrome resulting from a neurodegenerative disease such as frontotemporal lobar degeneration or Alzheimers disease, characterized by a prominent language deficit, insidious beginning and gradually progressive evolution. This syndrome can be classified in three variants or subtypes: Non fluent/agrammatic, logopenic and/or semantic. Patients with PAA may develop neuropsychiatric symptoms with a variable pattern of presentation according to each aphasia subtype. The importance of these symptoms lies on their high prevalence, association with higher mortality, quality of life deterioration, care giver overload, institutionalization and excessive health costs.\r\n\r\nrnrnMethodology: The objective of the present study was to characterize the patients with PPA diagnosed in our center, Instituto Nacional de Geriatria, between January 2017 and September 2018, in order to assess the prevalence of neuropsychiatric symptoms in this group (measured with NPI Q-scale), the distribution by each variant and to estimate the association between scholarity level and age of PPA onset. There has been excluded patients with records of vascular lesions or other medical conditions that could explain the cognitive impairment and/or language disorder, as well as patients with clinical history of neuropsychiatric diseases. The study design was descriptive cross-sectional. Non parametric statistics has been applied using stata software. \r\n\r\nrnrnResults: 38 subjects were included, 3 of them were finally excluded because a non-degenerative etiology was suspected. We observed an average age at time of diagnosis of 75.88 +/- 6,11 years (SD), with predominance of female sex (60%) and average scholarity of 8.08 years. 34.28% of subjects were diagnosed as semantic variant PPA, logopenic PPA 28.57%, mixed PPA 28.57%, and agrammatic PPA in 8.57%. (Figure 1). A statistically significant difference was observed in age of onset according to scholarity level, being lower in patients with eight or more years of schooling (p=0.04). The most prevalent neuropsychiatric symptoms were apathy (83%), followed by depression (65.71%), irritability (60%) and aberrant motor activity (54.28%). We observed a significant difference on anxiety symptoms depending on PPA variant, being more prevalent in semantic variant (p=0.05). Regarding to others neuropsychiatric symptoms and average scores of NPI Q between variants there was no significant difference between groups.\r\n\r\nrnrnDiscussion: Prevalence of general neuropsychiatric symptoms and its distribution according to PPA subtype were not different than previous published studies. However, considering that INGER is a tertiary national reference center for dementia, it’s necessary to highlight the low prevalence of PPA in addition to the low proportion of agrammatic PPA subtype. Further studies are required to explain these findings.