Alzheimer's & dementia (New York, N. Y.) · 2026
Person-centered intervention response in primary progressive aphasia: A secondary analysis of the Communication Bridge-2 randomized clinical trial.
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Rogalski Emily, Fegter Ollie, Roberts Angela C, Bona Matthew, Cummings Emily, Esparza Marisa, Polley Eric, Rademaker Alfred
Аннотация
INTRODUCTION: Person-centered outcomes that capture clinically meaningful change are essential to non-pharmacological intervention research for Alzheimer's disease and related dementias. Primary progressive aphasia (PPA) is a neurodegenerative syndrome characterized by progressive language impairment. The Communication Bridge-2 (CB2) randomized controlled trial previously demonstrated the efficacy of a personalized, participation-focused speech-language intervention on Goal Attainment Scaling (GAS), a person-centered communication participation outcome. This secondary responder analysis characterized meaningful participant- and goal-level response following intervention and at 12 months after enrollment to inform clinical translation and future appropriate use criteria.
METHODS: Fifty participants with mild to moderate PPA in the CB2 experimental arm, each with three individualized communication participation goals (N = 150 goals), were included. Prespecified responder thresholds were defined as GAS ≥1 following each intervention block and GAS ≥0 at 12 months, reflecting improvement or maintenance relative to baseline in a progressive condition. Descriptive analyses examined responder patterns across time points, participants, baseline severity, PPA subtypes, and goal characteristics.
RESULTS: All participants met responder criteria at one or more evaluation time points. At 12 months, 79% of goals met responder criteria, and 60% of participants met responder criteria across all three goals. More than half of the goals (51.3%) met responder criteria at all three evaluation time points. Meaningful response was observed across PPA subtypes, baseline severity levels, and diverse goal characteristics. Exploratory patterns suggested higher 12-month responder rates for goals targeting speech, familiar communication partners, and familiar communication contexts.
DISCUSSION: This secondary responder analysis demonstrates that a person-centered, participation-focused speech-language intervention was associated with meaningful goal-level improvement or maintenance across a heterogeneous PPA population, with many responses sustained over 12 months. These findings support the value of GAS as a pragmatic, person-centered outcome for capturing meaningful response in progressive neurodegenerative disease and provide translational evidence to inform future appropriate use criteria and individualized dementia care.
METHODS: Fifty participants with mild to moderate PPA in the CB2 experimental arm, each with three individualized communication participation goals (N = 150 goals), were included. Prespecified responder thresholds were defined as GAS ≥1 following each intervention block and GAS ≥0 at 12 months, reflecting improvement or maintenance relative to baseline in a progressive condition. Descriptive analyses examined responder patterns across time points, participants, baseline severity, PPA subtypes, and goal characteristics.
RESULTS: All participants met responder criteria at one or more evaluation time points. At 12 months, 79% of goals met responder criteria, and 60% of participants met responder criteria across all three goals. More than half of the goals (51.3%) met responder criteria at all three evaluation time points. Meaningful response was observed across PPA subtypes, baseline severity levels, and diverse goal characteristics. Exploratory patterns suggested higher 12-month responder rates for goals targeting speech, familiar communication partners, and familiar communication contexts.
DISCUSSION: This secondary responder analysis demonstrates that a person-centered, participation-focused speech-language intervention was associated with meaningful goal-level improvement or maintenance across a heterogeneous PPA population, with many responses sustained over 12 months. These findings support the value of GAS as a pragmatic, person-centered outcome for capturing meaningful response in progressive neurodegenerative disease and provide translational evidence to inform future appropriate use criteria and individualized dementia care.