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NEUROLOGY 1990;40:423
© 1990 American Academy of Neurology

Progressive aphasia

A precursor of global dementia?

J. Green, MD, J. C. Morris, MD, J. Sandson, PhD, D. W. McKeel, Jr., MD and J. W. Miller, MD, PhD

Departments of Neurology and Neurological Surgery (Neurology) (Drs. Green, Morris, Sandson, and Miller), and Pathology (Drs. Morris and McKeel), and the Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO.

We studied 8 subjects longitudinally in whom isolated language dysfunction had developed gradually at a mean age of 62.8 years. The language deficits initially displayed by the subjects were characteristic of the syndrome of "progressive aphasia without dementia." By 5 years after onset of progressive aphasia, however, 7 of the 8 subjects additionally had developed mild dementia as diagnosed by clinical means, and the remaining subject demonstrated declining performance in both verbal and nonverbal psychometric measures. Thus, generalized cognitive impairment occurred in all. Neuropathologic evidence of a diffuse dementing disorder was present in the 2 subjects studied postmortem. One had Alzheimer's disease with disproportionate involvement of the left inferior parietal cortex, and the other displayed widespread neocortical neuronal loss and microvacuolation in the absence of specific histopathologic markers. In this series, progressive aphasia was a precursor of global dementia.

Address correspondence and reprint requests to Dr. John C. Morris, Department of Neurology, Box 8111, Washington University School of Medicine, 660 S. Euclid Avenue, St. Louis, MO 63110.

Supported in part by NIA grants AGO5681 and AG03991.

Presented in part at the 40th annual meeting of the American Academy of Neurology, Cincinnati, OH, April 1988.

Received June 14,1989. Accepted for publication in final form August 9,1989.






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