All About Primary Progressive Aphasia (PPA)

Jul 29, 2019 | by Lingraphica Editorial Team

All About PPA Blog (1)

Primary Progressive Aphasia, or PPA, is a type of aphasia. But, it is different from other types of aphasia in several ways. Let’s take a closer look at what PPA is, how it is different from aphasia due to stroke, how it is diagnosed, and where you can turn for support.

What is Primary Progressive Aphasia (PPA)?

Primary progressive aphasia (PPA), a subtype of frontotemporal dementia or degeneration (also known as FTD), is a rare degenerative brain and nervous system disorder that causes speaking and language skills to decline over time.

A person becoming symptomatic with primary progressive aphasia may have trouble naming objects or may misuse word endings, verb tenses, conjunctions, and pronouns.

Unlike aphasia, which is the result of brain damage (like stroke or injury), primary progressive aphasia is a progressive type of dementia.

Under the PPA disorder, there are three variants: nonfluent/agrammatic, semantic, and logopenic. 

The Three Types of Progressive Aphasia (PPA)

Nonfluent/Agrammatic PPA

  • Impaired grammar
  • Omission of some words
  • Labored or effortful speech
  • Difficulty understanding long/complex sentences
  • Trouble with producing movement of mouth and tongue (apraxia)
  • Difficulty swallowing and possible mutism (at later stages of disease)

Semantic PPA

  • Loss of word meanings
  • Trouble with single-word meanings (“What is an apple?")
  • Unable to remember common/familiar items (spoon, brush, soap, etc.)
  • Difficulty with writing/reading words that sound similar but are spelled differently/have different meanings (here and hear)

Logopenic PPA

  • Trouble finding the right word
  • Slow, hesitant speech
  • Trouble repeating long sentences/phrases
  • Substitution or omission of letters (“tap” instead of “cap” or “wee” instead of “week”)
  • Difficulty swallowing (at later stages of disease)

How is PPA Different From Aphasia Due to Stroke?

PPA is a progressive brain disorder.  That means that a person with PPA will continue to see a decline in language skills as time goes on.  

There is currently no treatment or cure for PPA, and in most cases, the progression cannot be slowed. In some cases, mutism will occur later in the disease progression. Communication devices can be used to help someone who has PPA with speaking or word retrieval.

By contrast, aphasia due to stroke means that after the stroke has concluded, no further damage or decline will occur as a direct result of that event. Strokes are not progressive in nature. Working with a speech-language pathologist (SLP), online therapy platforms, communication apps, and speech generating devices can all help to improve communication for those with aphasia due to stroke.

How is PPA Diagnosed?

In most cases, a neurologist will diagnose PPA. According to the website of the Association for Frontotemporal Degeneration (AFTD), three criteria must be present for a diagnosis of PPA:

  1. There is a gradual impairment of language (not just speech).
  2. The language problem is initially the only impairment.
  3. The underlying cause is a neurodegenerative disease.

It is not uncommon to have several misdiagnoses before getting to one of PPA, especially if a neurologist hasn’t been involved in the medical exams. If you suspect a misdiagnosis by a general practitioner or family doctor, seek out help from a neurologist.

Where Can I Turn For More Information/Support on PPA?

The Association for Frontotemporal Degeneration offers information about PPA, support groups, research and clinical trials, and advocacy. Visit their website at or call their HelpLine at 866-507-7222 for more information.

A speech generating device may also be helpful for people with PPA, because it provides them the ability to:

  • Build personalized icons and phrases to use when word-finding and speaking are difficult or begin to decline.
  • Create “motor memory” early by practicing and using the device, which will help with communication as the disease progresses.
  • Record his/her own voice when creating icons and phrases that will speak back to him/her when using the device.
  • Take the device to medical appointments to communicate how he/she is feeling.
  • Communicate with family and friends at any place and any time.
  • Take photos and save important events or activities on the device.

Learn About Speech Generating Devices