A Spanish version of the Progressive Aphasia Severity Scale (PASS) for assessing Primary Progressive Aphasia?s variants

ZAMORA, DOLORES JAZMÍN; STEEB, BRENDA; GERALDINE, BOROVINSKY; MARTÍNEZ-CUITIÑO, MACARENA

Conferencia; Alzherimer´s Association Satellite Symposium; 2018

PPA-L patients show a mild (56%) and moderate (25%) performance in Syntax and grammar. Fluency is mildly (87%) or moderately (13%) affected. On the contrary, Single-word comprehension is preserved (44%) or mildly impaired (44%). In PPA-S patients, Single-word comprehension is always affected. This outcome can be associated with the gradual loss of semantic concepts and lexical labels. On the other hand, PPA-S patient´s fluency is preserved (89%) and they either do not have syntax difficulties (33%) or they show only a mild impairment (56%). Sample: 30 PPA patients were divided into three groups according their PPA variant (PPA-G, PPA-L and PPA-S) with no statistically significant differences in age (F (2,27) = 2.942; p =.070). Instrument: These three groups were evaluated through both a language assessment and the ESAPP. Analysis: As in the original study (Sapolsky et al., 2014), Fluency, Syntax and grammar, and Single-word comprehension were the three ESAPP domains selected to identify whether the diagnosed PPA variant is in consonance with the patient´s performance. A five-point scale from "normal" (0), to "questionable/very mild" (0,5), "mild" (1), "moderate" (2), or "severe" (3) was used to rate each domain. Percentages of each score in the three language domains were calculated for each PPA variant. Primary Progressive Aphasia (PPA) is a neurodegenerative disease characterized by an isolated language impairment in the first years of the illness. Gorno-Tempini et al. (2011) classify PPA into agrammatic (PPA-G), semantic (PPA-S), and logopenic (PPA-L) variants, which can be inferred from neuroanatomic studies together with a formal language assessment. However, information about patients´ everyday communication skills must be obtained by means of other instruments. Sapolsky et al. (2014) created the Progressive Aphasia Severity Scale (PASS), a structured questionnaire in which the principal caregiver provides information about the patient´s performance in thirteen language domains: articulation, fluency, syntax and grammar, word retrieval and expression, repetition, auditory comprehension, single-word comprehension, reading, writing, functional communication, initiation of communication, turn-taking and generation of language. In order to rate the presence and severity of the impairment in each domain, the clinician considers both the caregiver´s questionnaire and the formal language assessment results. In 2015, Borovinsky et al. introduced the ESAPP (Escala de Severidad de la Afasia Progresiva Primaria), an adaptation into Spanish of the original version. From that moment, the ESAPP questionnaire is distributed among caregivers at the Institute of Cognitive Neurology (Instituto de Neurología Cognitiva, INECO). The aim of this presentation is to determine if the linguistic aspects assessed in the ESAPP match the PPA variant diagnosed in the formal language assessment. Accurate PPA variant´s diagnosis is crucial in early stages of the illness because it determines which language skills are preserved and which are impaired. Thus, early diagnosis results in an improved treatment design and permits to outline various communicational guidelines for family members and caregivers. These results demonstrate that the ESAPP establishes communicational profiles that agree with the main linguistic difficulties detailed in the formal assessment and the diagnosed PPA variant. Consequently, the ESAPP constitutes an useful instrument to complement standardized measures with information from the patient´s everyday life performance. The ESAPP is a novel assessment resource for Spanish-speaking patients and contributes to the process of diagnosing the PPA variant. It is also helpful in determining therapy goals and monitoring patients´ evolution during their treatment. In future studies, we expect to extend the sample, assess other ESAPP domains and compare patients´ performance in different languages