Muddles and puzzles: Metaphor use associated with disease progression in Primary Progressive Aphasia.
Anna Volkmer, Jade Cartwright, Leanne Ruggero and 3 others
PMID 38708057WHAT IT FOUND
People with Primary Progressive Aphasia and their families use specific metaphors that shift with disease progression and variant.
For example, logopenic variant speakers moved from describing 'jumbles' to 'ghosts' as the condition advanced. Therapists should listen for these terms to gauge severity.
Key findings
01Metaphor use varies by PPA variant and changes over time, with terms becoming more emotive as the disease progresses.
02Care partners and people with PPA use metaphors like 'guide' or 'roadmap' to describe the role of speech and language therapy, often contrasting with the clinical view of therapy as a 'toolbag'.
03Only 14 metaphors were generated by people with PPA compared to 116 by care partners, likely due to the small number of participants with PPA and the focus group format.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size of people with PPA was very small (n=7), resulting in few metaphors generated by them (n=14). The focus group format may have suppressed contributions from people with PPA compared to care partners. The study did not collect a full range of socio-demographic characteristics. Participants were from English-speaking backgrounds in the UK, so findings may be culturally skewed. The analysis was secondary, relying on transcripts from studies not originally designed to investigate metaphor.
Declared interests
The study was part of the Rare Dementia Support Impact Study. AV is funded by this study. No other specific conflicts of interest are declared in the provided text.
The easy way to misread this
Do not assume these metaphor patterns are diagnostic tools or universal across all PPA variants and individuals. The findings are based on a very small sample of people with PPA (n=7), and the metaphors were drawn from secondary analysis of focus groups not designed for this purpose. Treat these as illustrative examples of lived experience rather than evidence of a reliable clinical marker.