Primary progressive aphasia: practice and support at home

What primary progressive aphasia is

Primary progressive aphasia (PPA) is a gradual loss of language caused by a neurodegenerative disease. Unlike aphasia after a stroke, it does not begin suddenly, and it slowly gets worse rather than better. In the early years, language is often the main problem, while memory for everyday events and the ability to look after oneself may be largely intact.

Specialists describe three main types, based on an international consensus published in 2011:

• Semantic variant. The meaning of words fades. A person may struggle to name things and also to understand what common words mean, while speech stays fluent.
• Nonfluent (agrammatic) variant. Speech becomes slow, effortful, and short on grammar. Some people also develop apraxia of speech, a difficulty planning the movements for speech.
• Logopenic variant. Word-finding pauses are frequent, and repeating longer sentences becomes hard, while single-word understanding is relatively preserved.

Diagnosis takes a neurologist, often with brain imaging and language testing. A speech-language pathologist is an important part of the team from the start.

Practicing the words that matter most

Practice cannot stop the disease, and no one should promise that it will. But research shows that practicing specific words can improve or maintain the ability to say those words for a time. In one study, people with the semantic and logopenic variants practiced naming sets of words, improved on them, and many kept those gains at follow-up. A 2024 systematic review of behavioral treatment in PPA reached a similar conclusion: practice helps most with the words and tasks that are practiced.

That makes the choice of words important. Build a personal list:

• Names of family members, friends, and pets
• Places the person goes: church, the store, a friend’s house
• Favorite foods, drinks, and everyday objects
• Words for hobbies, routines, and things the person likes to talk about

Practice a little most days. Say the word, use it in a sentence, and talk about the person or thing it names. If a word is lost entirely, set it aside rather than drilling it to frustration.

Keeping communication going

• Slow down and simplify. Short sentences, one idea at a time, and extra time to answer make a large difference.
• Use more than words. Gestures, pointing, writing a key word, and showing photos all carry meaning when words do not.
• Offer choices. “Coffee or tea?” is easier than “What would you like?”
• Stay included. Keep the person part of conversations and decisions. Talk with them, not about them.

Our guide to communicating with someone who has aphasia has more techniques that work for PPA as well.

Planning ahead while language is stronger

Some of the most useful work happens early, while the person can still take part fully:

• A communication book or phone album with photos and names of people, places, foods, and activities, so the person can point when a word will not come.
• Recorded stories and preferences. Life stories, favorite music, likes and dislikes, written or recorded in the person’s own words.
• Medical and legal decisions, discussed and written down while the person can express their wishes clearly.

A speech-language pathologist can help choose and set up tools that will still work as language changes.

Where Parrot Software fits

Parrot Software is practice software. It does not treat the disease, and we make no claim that it slows it. What it can do is make regular practice of personally important words easier. You can practice the names of your own family and friends using your own photos, and programs such as Mastering Personal Information and Functional Vocabulary cover the facts and everyday words people need most.

The first week is free, with no credit card. To get a feel for how the programs work before signing up, try the free Action Verbs lesson, which needs no account. For simple exercises to do together, see free aphasia exercises.

Common questions

How is primary progressive aphasia different from aphasia after a stroke?

Aphasia after a stroke starts suddenly and usually improves over time. Primary progressive aphasia (PPA) starts gradually, is caused by a neurodegenerative disease, and slowly gets worse. Many of the same practice tasks are used for both, but the goal in PPA is to keep communicating for as long as possible rather than to recover lost language.

Can practice slow down primary progressive aphasia?

There is no evidence that practice slows the disease itself. What research does show is that practicing specific words can improve or maintain the ability to say those words for a time. That is worth doing when the words are ones the person really uses, such as the names of family members.

Which words should we practice?

Choose words that matter in daily life: names of family and friends, favorite foods, places the person goes, and words for hobbies and routines. Practicing a personal list is more useful than practicing random words, because gains tend to stay with the words that were practiced.

When should we start planning for later stages?

Early, while language is still relatively strong. That is the best time to build a communication book or phone album with photos and names, record important stories and preferences, and talk through medical and legal decisions. A speech-language pathologist can help set up tools the person will be able to use later.

Does Parrot Software help with primary progressive aphasia?

Parrot Software is practice software, not a treatment for the disease. It can help with practicing personally important words: you can practice the names of your own family and friends using your own photos, and programs such as Mastering Personal Information and Functional Vocabulary cover everyday words and facts. A speech-language pathologist can advise on how it fits with other care.