Primary Progressive Aphasia (PPA) is caused by the gradual degeneration of brain tissue in the parts of the brain that control speech and language.

The way PPA progresses varies from person to person and from one subtype of PPA to another. Grethcen Szabo, a speech language pathologist at the Adler Aphasia Center in NY says:

Many of the individuals with PPA that we have seen have not been given a firm diagnosis and very few have information on the specific subtype.

First steps

The best way to receive a detailed evaluation and prognosis about PPA is a referral to a neurologist or neuropsychologist who has experience with PPA. Make sure you ask your neurologist to refer you to a speech-language pathologist (SLP) for speech therapy. If you can’t find a neurologist who has worked with other patients with PPA, you can make an appointment with a speech-language pathologist (SLP) who has PPA experience and who can refer you to a neurologist that is familiar with this condition.

The early stage

Initially, for a time period that can last a couple of years, a person diagnosed with PPA will exhibit a progressive loss of speech and language capabilities (aphasia). At this stage, patients may not notice any changes in other mental functions and activities of daily living.

Symptoms may include: slowed or halting speech, decreased use of language, word finding difficulty, written or spoken sentences with abnormal word order, substitution of words, mispronouncing words, talking around a word, difficulty understanding conversation, sudden difficulty understanding simple words, problems writing, problems reading, difficulty with spelling, difficulty with arithmetic.

In the earlier stages, patients with PPA and their caregivers need resources to help them manage the challenges they are experiencing. These could include both physical and emotional challenges. Local speech therapy centers or individual SLPs who are experienced with PPA can provide many of these resources.

The later stages

Due to the progressive nature of PPA, language abilities will continue to deteriorate over many years.

With time, PPA may affect other cognitive abilities such as memory, reasoning and visual perceptual skills. The rate of progression of PPA varies and it is unknown why some people progress more rapidly than others.

At later stages of PPA progression, patients may need to transition from a speech therapy center to a memory-care center or an assisted living center.

Where to find more information

We have dedicated resources that provide further information about understanding, diagnosing, and managing PPA. For any questions please email us at

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