Have you ever been in a conversation with someone and suddenly forgot the word you wanted to say? Or have you suddenly forgotten a friend's name? It's actually normal for this to happen once or twice. But if this happens frequently, if you have difficulty finding words, or if your speaking speed gradually slows down, it's not normal. This condition may be the beginning of a condition called Primary Progressive Aphasia (PPA) . Let's talk about this simply today.
Simply put, what is PPA?
Primary Progressive Aphasia (PPA) is a neurological condition that affects our brain. It mainly affects our language skills, such as our ability to speak, understand what others say, read, and write. Since it is a progressive condition, the symptoms gradually worsen over time.
PPA is a type of dementia . Specifically, it belongs to a group of dementias called `Frontotemporal Dementia (FTD).` In this, cells in the frontal and temporal areas of our brain that control language and speech gradually die and shrink. Sometimes, PPA can be an early sign that someone has Alzheimer's disease .
Are there main types of PPAs?
Yes, PPA can be divided into three main types based on the way the symptoms manifest. This classification is a great help for the patient's family to understand the symptoms. But keep in mind that some patients may not be able to fit into any of these three types exactly.
| PPA Type | Main features |
|---|---|
| Semantic variant PPA (svPPA) | The main problem with this is forgetting the meaning of words . It is difficult to understand words when someone is talking or reading a book. You forget the names of objects. For example, instead of saying "dog", you can use a common word like "animal". |
| Nonfluent agrammatic PPA (nfaPPA) | In this case , speaking becomes slurred, words are difficult to match . Grammar is used incorrectly. Speech is in short sentences. Small words like "a", "the" are avoided. The voice may also change. |
| Logopenic variant PPA (lvPPA) | The main problem with this type is that they can't find the right words to say . They often stop talking to look for words. It's hard to repeat what someone else has said exactly. |
How the disease progresses (stages)
PPA doesn't get worse all at once. It happens gradually.
Early stage (Mild Stage)
At first, you may not notice much difference. Sometimes it takes a while to find a word, or your speech may be a little slurred. But most of the time, you will be able to do your daily tasks on your own .
Later Stage
As the disease progresses, it becomes difficult to live alone. Symptoms that may be seen during this time include:
- Talking is reduced a lot. It is difficult to understand what is being said.
- I can't understand what others are saying.
- It becomes difficult to make complex decisions like money management .
- The ability to think and plan decreases, making it impossible to do things like driving.
- Even basic tasks like washing, dressing, and eating require someone's help.
- Walking becomes slow and stiffness occurs.
- It becomes difficult to swallow food.
- Sometimes they may show agitated and aggressive behavior.
The most important thing is not to panic when you see these symptoms, but to treat the patient with love and patience.
What are the causes of PPA?
As we discussed earlier, the main cause of PPA is the shrinkage (atrophy) of the language-related parts of the brain. This shrinkage is caused by abnormal proteins that build up in the brain. Scientists have identified several types of these proteins. They are tau, TDP-43, and amyloid . These proteins damage brain cells and reduce their function.
There are several risk factors that affect this:
- Having learning disabilities like dyslexia during childhood.
- Having someone in the family with this condition ( genetic influence ).
How to diagnose the disease?
If you suspect that you or someone close to you has PPA, it's important to see a qualified doctor . Your doctor will ask you about your symptoms, how long they've been present, and your family medical history. In addition, they may perform several tests to help diagnose the condition.
| Test | What does this simply do? |
|---|---|
| Neurological exam | Your mental state, reflexes, movements, and strength are tested to get an idea of your brain function. |
| Speech-language evaluation | A Speech-Language Pathologist will test your speaking and comprehension skills. |
| Neuropsychological evaluation | They test the brain's thinking abilities by asking them to answer questions, draw pictures, and solve puzzles. |
| Brain Scans | An MRI (Magnetic Resonance Imaging) scan can look for areas of shrinkage in the brain. A PET (Positron Emission Tomography) scan can find areas of decreased brain activity. |
What are the treatments?
Unfortunately, there is no cure for PPA yet. There is also no medicine to stop the progression of the disease. However, there are many treatments that can help improve the patient's quality of life and facilitate communication.
- Speech Therapy: A speech therapist can help the patient develop any remaining communication skills and practice new communication methods (e.g., sign language, picture cards). This is very important.
- Occupational and Physical Therapy: These treatments help with problems such as walking difficulties and balance problems that occur as the disease progresses.
- Medications: Your doctor may prescribe appropriate medications to control depression, anxiety, and disruptive behavior caused by PPA.
For someone living with this disease, the love, support, and patience of family and loved ones is invaluable.
Take-Home Message
- Primary Progressive Aphasia (PPA) is a progressive condition that affects the language-related parts of the brain.
- This is a type of dementia that mainly affects the ability to speak, understand, write, and read.
- Symptoms such as difficulty finding words, slurred speech, and forgetting the meaning of words may be seen in the early stages.
- Although the disease cannot be completely cured, treatments such as speech therapy can improve the patient's quality of life.
- If you or someone close to you has these symptoms, it is very important to see a doctor immediately for advice.
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