Delivering a Remote Proactive and Neuro-Cognitive Individualized Program in Primary Progressive Aphasia During Covid-19 Pandemic

Abstract

We present a remote protocol for the linguistic management of the Logopenic variant of Primary Progressive Aphasia (Lv-PPA) in a Moroccan patient. The intervention was designed to anticipate and mitigate neurocognitive and linguistic deterioration through a proactive person-centered approach. This single-case study implemented a culturally adapted version of Rogers’ (2000) proactive management protocol, which is organized into three progressive phases—early, mid, and late—centered on prediction, preparedness, and anticipation. The adapted protocol was applied to Mrs. R, a 78-year-old right-handed women . MRI scans revealed left parietal atrophy, while both hippocampi remained structurally preserved. Neuropsychological assessments indicated a general cognitive decline and progressive language impairment from 2015 up to the beginning of the study (MoCA: 20/30 in 2019), and further decline at the post-intervention assessment (13/30 in 2020), along with additional deficits in reading, praxis, and calculation. While some Mini Linguistic State Examination (MLSE) subdomains (notably syntax and reading) declined, others remained stable or showed slight improvement. Additionally, caregiver-reported outcomes (FROM-16) reflected a reduction in emotional and social burden, suggesting a positive impact on Mrs. R’s well-being and that of her family. Overall, the intervention supported the maintenance of functional communication and social participation, enhancing resilience in the face of progressive neurodegeneration and the added challenges of the COVID-19 pandemic.