Are you slowly losing your ability to speak? This could be Primary Progressive Aphasia (PPA)

Do you sometimes feel like you can't find the right words to say? Or do you find it hard to understand what someone is saying? Maybe you know someone in your family, a mother or a father, who has this kind of difficulty? Although these things may seem like normal things that happen as you get older, sometimes they can be a symptom of something deeper. Today we're talking about one such condition, Primary Progressive Aphasia (PPA).

What exactly is PPA?

Simply put, Primary Progressive Aphasia (PPA) is a brain disorder. It is a neurodegenerative disease that gradually weakens the nervous system and gradually worsens over time. Specifically, it damages the parts of the brain that are involved in our ability to speak, read, write, and understand language.

Imagine that our brain is like a big library. All the books, words, and meanings related to language are stored in a special section of that library. PPA is exactly what happens when the books in this section gradually, one by one, decay and become unusable.

PPA is considered a form of Frontotemporal Dementia (FTD) or Alzheimer's Dementia . These diseases cause the frontal and temporal lobes of our brain to gradually become inactive. Our language abilities are mainly controlled by these parts.

What are the main types of PPAs?

PPA is mainly divided into three types. The characteristics of each type are slightly different. Let's understand it clearly from this table.

What could be the symptoms of this disease?

Symptoms vary depending on the type we discussed earlier. Typically, these symptoms can begin to appear between the ages of 50 and 70. They gradually become worse over time.

Characteristics of logopenic variant PPA

• It's hard to find the right word to say.
• Difficulty understanding long or complex sentences.
• It is more difficult to say long sentences than short ones.
• Frequent pauses when speaking.
• Mispronouncing words.
• Using other words instead of some words (e.g. saying "cat" instead of "dog").

Non-fluent (agrammatic) variant PPA features

• Difficulty using the lips and tongue to make sounds properly (apraxia).
• Difficulty swallowing.
• Problems with walking and movement (slow and stiff movement, loss of balance, frequent falls).
• Removing words from sentences and speaking simply (e.g., "Mom is going to dinner" instead of "I'm going to dinner with Mom").
• Difficulty understanding long or complex sentences.
• Some people may find it completely difficult to speak and may even become mute .

Semantic variant PPA features

• Forgetting what familiar items are and what to do with them.
• Not remembering the meaning of words.
• It's hard to find the right word to say.
• Reading and writing difficulties.

What causes PPA? Are there any risk factors?

This condition occurs because the cells in the parts of our brain that control language gradually die. This causes the brain tissue to shrink. In medicine, we call this atrophy . This shrinkage is what causes the loss of language-related abilities.

Although this condition can occur in anyone, some people are at higher risk.

• If someone in the family has had PPA.
• Having certain genetic variants , such as `(C9orf72, MAPT or GRN)`.
• If you had a learning disability as a child.
• Having Alzheimer's disease.

But sometimes this situation can occur without any obvious reason.

How does a doctor find this?

If you have language problems, you should definitely see a doctor. The doctor will ask you about your symptoms and your family's medical history. Then, they may do some tests to confirm the diagnosis.

• Neurological examination: Your balance, reflexes, and nervous system function are checked.
• Cognitive tests: Tests that measure memory, thinking ability, and language abilities.
• Brain scans: An MRI (Magnetic Resonance Imaging) or CT (Computed Tomography) scan may be done to see if there is any shrinkage or other changes in the brain.

Stages of PPA disease

Because this disease gradually worsens over time, several stages have been identified.

1. Stage 1 (very mild): Very minor language difficulties are evident. It may be thought to be due to aging or stress. It is rare to get a diagnosis at this stage.

2. Stage 2 (mild): Language problems arise frequently. Your family members also begin to notice this difference. This begins to affect daily activities.

3. Stage 3 (Moderate): Daily tasks become very challenging to do on your own. Talking to others and being social can be very frustrating.

4. Stage 4 (Severe): It is very difficult to speak and understand language. Help with daily activities is needed. Living alone can be dangerous.

5. Stage 5 (very severe): Speech and language comprehension are largely lost. Behavior and thinking changes occur. 24-hour care is required.

6. Stage 6 (final): Unable to speak or understand language. May utter non-verbal sounds. May lose ability to move.

Is there a treatment for this?

Unfortunately, there is no cure for PPA yet. Nor can the disease be stopped from getting worse. However, there are treatments that can help manage symptoms, slow the progression of the disease, and make life easier.

Your doctor may recommend treatments such as:

• Speech therapy: This helps maintain language skills for as long as possible and learn new communication techniques.
• Learning new communication methods: Getting used to using things like sign language or picture cards.
• Medication: Medications such as Selective Serotonin Reuptake Inhibitors (SSRIs) may be prescribed to control behavioral changes, depression, or anxiety.
• Alzheimer's medications: If the cause of PPA is Alzheimer's disease, medications such as donepezil or rivastigmine used for that condition may be prescribed.

What will life be like with this disease?

PPA is a condition that worsens over time. Eventually, language and communication skills can be completely lost. As the disease spreads to other parts of the brain, thinking and behavior are also affected.

Generally, the average life expectancy after the onset of symptoms is five to seven years, but this varies greatly from person to person. So don't be alarmed by statistics. Only your doctor can give you the best information about your condition.

PPA, Primary Progressive Aphasia, aphasia, difficulty speaking, forgetting words, brain disease, dementia, Alzheimer's, frontotemporal dementia, language problems