The COVID-19 pandemic brought into the spotlight the technological needs of carers together with accessibility and availability of disease-related web-based services. Athens Alzheimer Association undertook the cultural adaptation of the platform iSupport in Greece. The process included multiple methodological steps based on Ecological Validity Model, and the platform was pilot tested to 15 carers of people with dementia. The duration of this project lasted for one year (April 2020-March 2021). Today more than 160 carers in Greece have registered on the platform. All 23 lessons are easily accessible by the isupportdementia-greece website.
Primary Progressive Aphasia (PPA) is a degenerative condition characterized by the progressive loss of language function. In PPA, aphasia is the most prominent deficit at onset. On the other hand, memory deficits are the hallmark of Alzheimer's disease (AD). The first aim of the study was to establish differences on neuropsychological testing and connected speech production between Greek-speaking individuals with AD and PPA. The second aim was to investigate the executive deficit involvement in the two conditions. Ten individuals with PPA and 9 individuals with AD took part in a comprehensive cognitive-linguistic evaluation. Fifteen demographically matched neurologically healthy adults served as controls. Participants were evaluated using a battery of neuropsychological measures. Quantitative production analysis and acoustic analysis were performed to calculate narrative and temporal measures of the participants' speech. Participants with PPA differed significantly from participants with AD on linguistic measures. They performed worse on the long frequent sentences' subtest of the Sentence Repetition Test and they produced fewer narrative and unique words in picture description. They also produced shorter, less elaborated sentences, and made more phonological errors. The two groups did not differ significantly on memory, executive, visuospatial and semantic composite measures. Compared to neurotypical adults, participants with AD were impaired in memory, and executive function. They also exhibited lexical retrieval difficulties, as well as difficulties in linguistic tasks with an increased processing load. Participants with PPA performed within normal limits on the delay conditions of episodic memory measures. However, they too were impaired in executive tasks, especially for short-term memory and verbal fluency. The production of phonological errors, difficulty in repeating long frequent sentences, and the production of simple and short sentences has differentiated participants PPA not only from neurotypical controls but also from participants with AD. No single measure could differentiate the AD group from the other two groups. These findings should be interpreted with caution considering the small sample size.
There is a growing body of research on language impairment in bilingual speakers with neurodegenerative diseases. Evidence as to which language is better preserved is rather inconclusive. Various factors seem to influence language performance, most notably age of acquisition, level of proficiency, immersion and degree of exposure to each language. The present study examined fluency, lexical, discourse and grammatical abilities of a Greek-French late bilingual man with the non-fluent/agrammatic variant of primary progressive aphasia (nfvPPA). Speech samples derived from three different narrative tasks in both languages were analyzed using quantitative production analysis (QPA) and fluency measures. The first aim of the study was to compare the participant's connected speech production to that of Greek-speaking normal controls. The second aim was to determine whether Greek (L1) and French (L2) were differentially impaired. To our knowledge, this is the first report of connected speech deficits in a Greek-speaking patient with PPA and the first study which uses QPA to compare L1 and L2 narratives in a bilingual speaker with PPA. Compared to neurologically healthy controls, our participant was impaired in lexical, discourse and grammatical productivity measures, but did not differ in measures of grammatical accuracy. The presence of dysfluencies, reduced speech rate and simplified syntax is consistent with the pattern of impairment reported for the nfvPPA. Results showed that narrative production measures did not differ significantly between languages. However, they suggest a slightly worse performance in his second, non-dominant, language despite a similar pattern of impairment in both languages. Lengthy exposure to L2 and regular activation of L2 through daily use may explain the preservation of discourse abilities in his non-dominant language. This study calls attention to factors such as language dominance, proficiency, patterns of use, and exposure to a language. These factors play a key role in assessing bilingual individuals with PPA and making clinical decisions.
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