With all types of primary progressive aphasia (PPA), speech and language is affected. Symptoms vary depending on what type of PPA someone has. In all types of PPA, symptoms will get worse over time.

Semantic dementia

People with semantic dementia forget the meaning of words, as well as what objects and concepts are. For example, they may:

  • Have trouble using the right word – often saying another word or using a vague term like ‘thing’. This may start with names and other object words they don’t use very often. As time passes, people will also struggle with more common words and often ask what words mean.
  • Forget what items are used for such as every day or household items, tools and appliances.
  • Talk about things at great length and in a vague or repetitive manner.
  • Have difficulties understanding other people’s feelings.
  • Find it difficult to focus on less familiar topics.
  • Have problems reading and spelling.

In the later stages, they may:

  • Tend to say less.
  • Develop changes in behaviour and personality, like sudden obsessions or mood swings, strong preferences for sweet or other specific foods, and difficulty understanding social situations. These are more common and occur earlier in semantic dementia than the other types of PPA.
  • Find it difficult to recognise people they know, objects around the house or familiar sounds.
  • Need much more assistance to manage day-to-day life.

Progressive non-fluent aphasia

People with this condition have trouble speaking and make mistakes in how they say words or construct sentences. For example, they may:

  • Have trouble producing words, although they know what they want to say. Speaking may take a lot of effort and words may not come out right.
  • They may speak more slowly, seem to stutter and be hard to understand.
  • Often confuse opposite words such as using yes, when they mean no.
  • Find that words come out in the wrong order or are missed out altogether.

Over time, they may develop other symptoms including:

  • Problems with reading, writing and spelling.
  • Difficulty hearing.
  • Trouble understanding some words.
  • Changes in behaviour and mood, for example becoming frustrated, or depressed.
  • Find it harder to make decisions or plans.
  • Have difficulties swallowing food and drink.
  • May develop similar symptoms to Parkinson’s disease such as slowness, stiffness or clumsiness of movements.

Logopenic aphasia

People with logopenic aphasia have trouble finding the words they want to use. For example, they may:

  • Have trouble remembering the right word. The person may pause as they try to find the word they want.
  • Speak more slowly and hesitantly and find it hard to say words correctly.
  • Have trouble understanding and remembering more complex verbal information. This can make it hard to follow detailed conversations.
  • Experience behavioural symptoms such as frustration, agitation and withdrawal from social situations.

As time passes, people can have more problems with their memory and thinking. For example, someone may:

  • Forget conversations or appointments.
  • Become lost.
  • Find it hard to work out how much change they need for a bus fare.
  • Struggle to use household appliances, like washing machines.

These later symptoms are similar to those in Alzheimer’s disease.

You can speak to your doctor if you are concerned about any of the symptoms mentioned.

Ben H

My dad took early retirement at 58. His symptoms started with him not being able to find words every now and then. We realised that there was something not quite right, but because his memory was fine we thought it couldn’t be dementia.
Following his diagnosis, he lost the ability to read and write and then his speech went. He used to make random noises. He became obsessed with fluff on the carpet and my mum would buy boxes of tissues as he would fold them into squares continuously. In the latter stages he also wandered and got lost on more than one occasion.

- Ben, whose dad was diagnosed with PPA

Someone with PPA may show symptoms of more than one type of PPA at the same time, or as their condition progresses.

With all three types of PPA, problems get worse over time. It becomes harder for people to say what they need to, move about on their own and look after themselves.

Dementia is different for everyone who has it, and the speed at which it progresses can vary widely. Over time, someone with PPA will need more and more care and support until the end of their life.

What is primary progressive aphasia?

Information in this booklet is for anyone who wants to know more about primary progressive aphasia (PPA). This includes people living with PPA, their carers, families and friends.

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This information was written in April 2023 and is due for review in April 2025. It was written by Alzheimer’s Research UK’s Information Services team and Rare Dementia Support with input from expert and lay reviewers. Please contact us if you would like a version with references.

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