A-109: Lexical Retrieval Deficits, Language, and Culture in Logopenic Aphasia: An Egyptian Arabic-Speaking Case

Abstract

Objective: A biopsychosocial framework guided diagnostic formulation of an Egyptian Arabic–speaking patient with suspected logopenic aphasia. This case highlights the complexity of assessing language in a bilingual individual, and the role of cultural and caregiver considerations in differential diagnosis of neurodegenerative disease. Method/Data Selection: A 71-year-old Egyptian Arabic–speaking woman with twelve years of education in Egypt presented with progressive cognitive decline characterized by memory, word-finding, and concentration difficulties. Neurocognitive screening (VASLUMS) indicated impairment, and neuroimaging revealed mild volume loss. Presentation was notable for anomia, memory retrieval difficulties, and reduced attention. Assessment was conducted in English and Egyptian Arabic with an interpreter, an Arabic-speaking neuropsychology fellow, culturally appropriate and adapted language measures; results were considered valid. Results/Data Synthesis: Testing in both languages revealed a prominent language profile with severe anomia, impaired sentence repetition, and phonological errors, alongside weaknesses in memory retrieval, executive functioning, and attention. Grammar, single-word comprehension, motor speech, and object knowledge were relatively preserved in both languages as demonstrated by adapted language measures. Mild ideomotor apraxia was observed. Behavioral observations included reduced insight and increased reliance on family for instrumental support, including assistance with medication and appointment management. Conclusions: Findings were most consistent with logopenic variant primary progressive aphasia, likely associated with Alzheimer’s disease pathology, with possible vascular contributions. Prominent anomia and impaired repetition across languages supported diagnostic differentiation in a bilingual context. Reduced insight may have contributed to underreporting of functional decline, making the incorporation of caregiver involvement critical to symptom interpretation and appropriate functional support.