In my continuing series on What is dementia?, Part 4 I promised to review aphasia. It suddenly seems more relevant to me as well just now too; I was diagnosed with PPA when first diagnosed with a front temporal dementia, although had seemed to stave off the progression with speech pathology techniques. However in this last few weeks, it is getting noticeably worse, and my ability to read, hand write, understand others, comprehend what I read and speak is becoming much more difficult.
Many types or causes of dementia also have similar symptoms such as memory loss, and can include varying types of aphasia. The National Aphasia Association in the USA defines aphasia like this:
“Aphasia is an impairment of language, affecting the production or comprehension of speech and the ability to read or write. Aphasia is always due to injury to the brain-most commonly from a stroke, particularly in older individuals. But brain injuries resulting in aphasia may also arise from head trauma, from brain tumors, or from infections. It is experienced by the groups of dementia under the FTD category, but is also seen in some types of Alzheimer’s disease.”
The Mayo Clinic simply defines it like this: “Aphasia is a condition that robs you of the ability to communicate. It can affect your ability to speak, write and understand language, both verbal and written.”
Dr Ronald C. Petersen, M.D., Ph.D., has just done a whirlwind tour of Australia visiting five cities in almost as many days as part of the Alzheimer’s Australia Dementia Awareness Month 2016 activities. His staff profile at the Mayo Clinic says, “he focuses on investigations of cognition in normal aging, mild cognitive impairment and dementia. Dr. Petersen and his colleagues evaluate cognitive changes in normal aging as well as in a variety of disorders involving impairment in cognition, such as Alzheimer’s disease, frontotemporal lobar degeneration and Lewy body dementia. He directs the Mayo Clinic Alzheimer’s Disease Research Center and the Mayo Clinic Study of Aging, both of which involve the study and characterization of aging individuals over time with an emphasis on neuroimaging and biomarkers.”
Yesterday I asked Ron is aphasia a symptom of brain injury, stroke or some dementia, or is it an actual type of dementia. He explained that aphasia and the other dementia related types of aphasia such as Primary Progressive Aphasia (PPA) are symptoms of the injured area of the brain, and not themselves a type of dementia. It is though, complicated, and many websites seem to imply it is a type of dementia, some patients even get told they have PPA dementia, to add to the confusion.
The Mayo Clinic clearly states, “the main treatment for aphasia is speech and language therapy” so I wonder why then, all people with dementia are not routinely referred to a speech pathologist at the point of diagnosis?????
It is extremely confusing though, as for example, Neura Australia states that “Progressive Non-fluent Aphasia is a form of FTD, and that frontotemporal dementia (FTD), includes behavioural variant FTD (bvFTD), Semantic Dementia (SD), Progressive Non Fluent Aphasia (PNFA), Logopenic Progressive Aphasia (LPA), Corticobasal Syndrome (CBS) or Progressive Supranuclear Palsy (PSP)”.
Dr Petersen said yesterday that the aphasias were not actually dementias, and for example, it is now thought that LPA may in fact be a symptom of one of the rarer types of Alzheimer’s disease and not FTD (or at least, that is my recollection!).
I’d really love for a group of world researchers and clinicians to WORK TOGETHER in collaboration, and come up with one set of easy to understand fact sheets on all of the different types or causes of dementia – and what is a dementia versus what is a symptom of dementia.
This particular blog has been challenging to write, and I apologise for the confusion about aphasia, and whether some of the types of aphasias are dementias, or symptoms of dementia. I’m still unclear, as although I had thought any type of aphasia was a symptom of stroke, brain injury and some types of dementia, they are not an actual type or cause of dementia.
If anyone out there can provide us all with a simple, accurate definitive on this, I’d be very grateful and happy to be educated!
This video does give quite a good insight into what it is like living with aphasia;