Primary progressive aphasia
What is primary progressive aphasia?
Primary progressive aphasia (PPA) is a type of aphasia caused by dementia. It is considered a neurogenerative disease. This means there is a loss of brain tissue and symptoms get worse over time.
Speech and language are the areas that are most affected in the early stages of PPA. In later stages, other symptoms related to dementia may appear, such as memory loss. Sometimes, trouble with speaking and understanding are the first signs that you have dementia.
PPA is different from other types of aphasia, which are usually caused by stroke or brain injury.
Symptoms
What are the symptoms of primary progressive aphasia?
At first, PPA usually looks like a mild speech or language impairment. Symptoms can vary depending on which areas of the brain have been affected.
Common symptoms of early PPA include:
- Speech that is halting or has an atypical rhythm or intonation (non-fluent)
- Using fewer words when speaking
- Trouble finding the right word
- Trouble understanding others
At later stages, a person with PPA may experience:
- Inability to speak (produce verbal language)
- Memory loss
Causes
What causes primary progressive aphasia?
Primary progressive aphasia is caused by dementia, which is a decline in a person’s mental abilities.
Dementia is a term used to describe the symptoms of different underlying conditions. These underlying conditions include:
- Frontotemporal Dementia
- Alzheimer’s Disease
- Vascular dementia
- Lewy Body Dementia
PPA is most commonly caused by frontotemporal dementia, but other types of dementia can also cause aphasia.
When a person has dementia, certain areas of the brain will shrink, or atrophy. PPA is caused by atrophy in the left side of the brain, where the language centers are located.
Dementia is progressive, which means the symptoms will get worse as time goes on.
Which part of the brain is affected?
PPA is caused by shrinking of the areas of the brain responsible for language. These are usually on the left side (hemisphere) of the brain, and are usually the frontal, temporal, and parietal lobes.
Diagnosis
How is primary progressive aphasia diagnosed?
There is not a single test to diagnose PPA. A medical team, usually including a neurologist and speech-language pathologist, will do a series of tests. They will evaluate your medical history, test your speech and language abilities, and do neurological tests. Your team will likely also order brain imaging (MRI or PET scans) to see which parts of the brain are affected.
Treatment
How is primary progressive aphasia treated?
Treating PPA will focus on helping you manage the condition as it progresses. Most people with PPA will work with a speech-language pathologist to find ways to support communication. This may include learning to use augmentative and altnerative communication (AAC), such as speech devices.
Care partners, friends, family, and loved ones can also support a patient with PPA.
Recovery and prevention
Can primary progressive aphasia improve?
There is no cure for primary progressive aphasia. Because it is a progressive condition, your symptoms will likely get worse over time. Most people with PPA focus on managing the condition with their speech-language pathologist and care partners.
Doctors and SLPs research dementia and PPA to work to find supportive therapies. There may be experimental research available, including new therapies.
Can primary progressive aphasia be prevented?
There’s no real way to prevent primary progressive aphasia. Doctors recommend finding ways to support your brain health. Some recommendations may include:
- Use your brain and keep it active (learn new skills, engage in hobbies)
- Connect with your social circle (friends, family, loved ones)
- Follow a healthy lifestyle (good sleep, good nutrition, low stress)
- Keep up with regular doctors visits and check ups
It’s best to talk with your medical team to find management and treatment strategies to keep your brain healthy.
Living with primary progressive aphasia
What is it like to live with Broca’s aphasia?
Primary progressive aphasia tends to move slowly and can start in middle age. Many people with primary progressive aphasia find that PPA is the first symptom of dementia.
It can become harder to communicate as PPA progresses. Finding early supportive strategies, like AAC and speech therapy, can help.
People with PPA also benefit from strong social support through friends, family, and care partners.
What emotional or psychological effects can occur?
PPA can be stressful. Being unable to communicate as clearly or quickly as you used to can make you feel frustrated or embarrassed. Many people with PPA report feeling depressed or anxious. Some say they feel apathetic.
Dementia can cause other emotional issues, such as anger or confusion, that may worsen as the condition progresses.
Finding a good social circle, continuing to engage in hobbies, and keeping up with friends and family can help. Your medical team may also recommend medications to help with your mood.
