Douglas Joanne T
The University of Alabama at Birmingham, USA.
Dementia (London). 2025 Apr;24(3):353-367. doi: 10.1177/14713012241281006. Epub 2024 Aug 30.
Primary progressive aphasia (PPA) is a neurodegenerative brain disorder characterized by declining language ability. It is a rare, often young-onset dementia with a devastating impact on the work and personal activities of those affected. At present there is no cure or disease-modifying therapy for PPA nor any way to arrest or slow the underlying progressive brain degeneration. Throughout the course of the condition any treatment must therefore be palliative-designed to manage symptoms and improve the quality of life of the affected person. The majority of those affected receive little or no follow-up care after diagnosis, particularly in the early stage of the disease. There is very little information in the medical literature about person-centered care designed to improve the quality of life of people with PPA written from the perspective of those living with this condition. I received an early and accurate clinical diagnosis of the nonfluent/agrammatic variant of PPA, supported by imaging. I am fortunate to have benefited from exemplary individualized care from a multidisciplinary medical team from the onset of my difficulties with language. In this paper, I discuss my lived experience of all aspects of this personalized and person-centered care, describing how it was founded on shared decision-making and a holistic, dementia-inclusive approach encompassing the physical, mental, emotional, psychosocial and spiritual dimensions of living with an incurable neurodegenerative disease.
原发性进行性失语(PPA)是一种神经退行性脑部疾病,其特征是语言能力逐渐下降。它是一种罕见的、通常在年轻时发病的痴呆症,对患者的工作和个人活动产生毁灭性影响。目前,尚无针对PPA的治愈方法或疾病改善疗法,也没有任何方法可以阻止或减缓潜在的进行性脑退化。因此,在整个病程中,任何治疗都必须是姑息性的——旨在控制症状并提高患者的生活质量。大多数患者在确诊后很少或根本没有接受后续护理,尤其是在疾病的早期阶段。医学文献中几乎没有从PPA患者的角度撰写的关于以患者为中心的护理以提高PPA患者生活质量的信息。我通过影像学检查获得了早期且准确的临床诊断,确诊为非流利/语法缺失型PPA。从语言出现问题开始,我就有幸受益于多学科医疗团队提供的模范个性化护理。在本文中,我将讨论这种个性化和以患者为中心的护理各个方面的亲身经历,描述它是如何建立在共同决策以及涵盖患有无法治愈的神经退行性疾病生活的身体、心理、情感、社会心理和精神层面的整体、包含痴呆症的方法之上的。