Primary Progressive Aphasia (PPA) is a form of dementia caused by a disease process in the brain that results in degeneration of nerve cells that control our ability to use language. This form of dementia can occur in individuals as young as their 40s, but can also appear any time thereafter.

PPA begins very gradually and is initially experienced as difficulty with thinking of common words while speaking or writing. The ability to understand what others are saying or what is being read also declines. In the early stages, memory, reasoning and visual perception are not affected by the disease so individuals with PPA are able to function normally in many routine daily activities. PPA progressively worsens to the point where verbal communication by any means is difficult.

• Increased difficulty thinking of words

• substituting the wrong word (e.g., "school" for "work")
• mistakes in pronunciation (e.g., "track" for "truck")
• talking around the word (e.g., "We went to the place where you go to get milk." for the words "grocery store"

• Reduced ability to understand speech

• having trouble following conversations, especially in large groups
• asking for information to be repeated and misunderstanding things that are said

• Decreased use of language

• speech may become empty of any real information and difficult to understand early in the course of the illness
• eventually, there may be an inability to use speech to communicate

• Problems reading or writing

• difficulty reading signs or following written directions
• inability to write letters or make out checks

• Problems in arithmetic and calculations

• may lose ability to perform even simple mathematical operations
• may have problems handling money and making change

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At present, there is no cure for the degenerative diseases that cause PPA. There are two basic approaches to treatment, however. The first is to focus treatment directly on the language skills that are impaired, and the second is to provide alternative communication strategies or devices.

More information

Northwestern University, Feinberg School of Medicine
www.brain.northwestern.edu/ppa/handbook.html

Pick's Disease Support Group
www.pdsg.org.uk/Factsheets/PPAphasia.htm

Mayo Clinic
www.mayoclinic.org/primary-progressive-aphasia/index.html

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