primary progressive aphasia

The Difference Between Alzheimer’s Disease and Primary Progressive Aphasia

Kimberly Williams-Paisley learns the difference between Alzheimer’s disease and primary progressive aphasia after her mother’s diagnosis with PPA. The two situations share many similarities, and it can be hard for the general public to understand how they differ.

We’ll outline these differences in this latest installment of our online book club speaking about Kimberly Williams-Paisley’s book, Where the Light Gets In. She writes about her mother’s experience with primary progressive aphasia.

How It Begins

The common age of onset for Alzheimer’s Disease and primary progressive aphasia is different. Williams-Paisley learns on page 82:

Most people diagnosed with AD are over sixty-five. The first symptoms of frontotemporal dementia (FTD) often become apparent in fifty- or sixty-year-olds, making the disease relatively more common among younger people. Dr. Mesulam told us that PPA often seems to affect women in their sixties, like my mother.

PPA may affect people much earlier. Additionally, PPA affects words first while Alzheimer’s disease affects memory. A doctor explains on page 82:

He’d based his conclusion on the fact that Mom’s difficulties really begun with speaking and writing, hallmarks of aphasia. PPA first attacked the part of her brain behind her forehead. This frontotemporal area is primarily responsible for language. Her memory was healthy. That alone set her apart from people with AD, whose earliest symptom is usually forgetfulness.

Language loss, not memory loss, is a hallmark of early PPA.

How It Ends

Williams-Paisley learns that the two conditions will resemble each other more towards the end stage. On page 82, the doctor warns:

As the disease progressed, he told us, she would need help going to the bathroom, showering, dressing, and eating. We would see behavioral changes. And most likely dementia would spread throughout her brain. Eventually, the symptoms would resemble the last stage of AD. We learned later that this meant she would probably disengage from her environment, rarely say a word, and eventually lose control of movement and the ability to swallow, among other things.

Williams-Paisley remembers that they waited for a “shred of good news” while the doctor outlined PPA’s progression, but there was none beyond the family being better equipped to understand the road ahead.

For more information on the differences between Alzheimer’s disease and primary progressive aphasia, see this earlier post on brain differences between the two conditions.



  • Deirdre C
    May 1, 2019 at 6:23 pm

    This is very sad. I was hoping there would be some hopeful information that I could apply to my mother’s situation. It is all relatable, just not hopeful – unfortunately.

  • Lori Jackson
    June 9, 2019 at 8:32 pm

    I feel like you do. It’s horrible to see what is happening to my mom too. She’s in great health. She even beat cancer. But she can’t speak even one complete sentence. I’m looking for someone to talk to.

  • Barbara williamson
    July 9, 2019 at 7:20 pm

    Unfortunately this sounds like my 58 year old daughter. She also has controlled Epilepsy. Her EEG’s are all normal and she has only had 4 seizures since she was 15 years old. Her Neurologist claims her word finding and language problems are from stress and anxiety and recommended therapy which is not helping. I am at a loss as to who to turn to for help. Any suggestions would be gratefully received.

  • Maya Brainard
    July 10, 2019 at 11:04 am

    Dear Barbara, speech and language problems can result from many neurological conditions including psychological ones. It is very hard to give advice online. What we would recommend is to get a second opinion if you feel the current assessment/treatment is not adequate. Also seeing a speech and language pathologist can help your daughter deal with her language problems.

  • Teresa Dye
    August 2, 2019 at 7:27 pm

    My dad suffers from this, he has little to none speech left, he sleeps more now, maybe as an escape. My mom is left with all this, she calls me more often to talk, because dad can’t much anymore.

  • Charles
    August 3, 2019 at 10:57 am

    Can POA be brought on by heavy statin use which deprives the brain of necessary steroids that it needed to function. This is another hidden secret that the pharmaceutical companies are not telling the public?

  • Laraine Goodban
    August 5, 2019 at 2:03 pm

    My husband has been diagnosed 1st with Early onset Dementia at 56 years of age he is now 69 years Young 2nd they said at the memory Clinic he has Alzheimer’s and we’re treating him for that up until 2 years ago.3rd latest diagnosis is logopenic variant PPA. He is on antidepressants blood pressure medication Trazodone and Risperdal. He gets very frustrated because he can’t communicate he’s lost over 25 lb in the last 2 years. No one seems to be able to help. Everyone passes him back to me and I am a sole caregiver, I am not a paid professional, if they don’t know how to deal with it how do they expect me to.

    I need desperately means of communicating with him so he can communicate with me. He also has to wear hearing aids as he has industrial deafness but he keeps taking them out or trying to eat them.

  • Emily Barrett
    August 11, 2019 at 12:30 am

    The information on the internet about the relationship between early onset AD and PPA is very confusing, and after researching this I do not believe that the website is providing accurate information about the relationship. I suggest that you ask your physician to summarize.

  • Pam Goslar
    August 12, 2019 at 6:14 pm

    Laraine Goodban – Your husband’s story sounds so much like my husbands although he is a few years older. I don’t have any answers for you as I too am searching! My husband doesn’t have the hearing aid issue and isn’t on as many medications. but the communication issue the same. My heart goes out to you and want you to know you are not alone! Pam

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