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Primary Progressive Aphasia (PPA) is a language led dementia characterised by slowly worsening speech and language. It is associated with atrophy of the dominant temporal-parietal lobe regions and is commonly caused by frontotemporal or Alzheimer’s pathologies. There are three PPA variants: semantic variant PPA presents as difficulties producing and understanding words due to deterioration of semantic knowledge; logopenic variant PPA presents as difficulties in retrieving word forms, resulting in word finding and errors in producing words; and finally, non-fluent agrammatic variant PPA presents as an apraxia alongside a deterioration in the ability to understand and use complex grammar. This study examined people with PPA referred to a neurosciences department in a southern Indian hospital between January 2012 and December 2016. Of 166 patients referred to the unit over this period, 23 met the international diagnostic criteria for PPA. Of the 23 people with PPA, 10 were bilingual. They had a mean age of 58.8 years and on average had symptoms for 3.2 years prior to diagnosis. Sixteen people were diagnosed with non-fluent agrammatic variant PPA, six with semantic variant PPA and one with logopenic variant PPA. The researchers hypothesise that since there is a lower incidence of Alzheimer’s disease in the Indian population, this may account for the lower number of logopenic variant PPA, which is associated with AD and has a higher prevalence than the other variants in western countries. Alternatively, bilingualism may be a factor that contributes to the PPA presentation and its subtype. Given that the number of people with dementia is significantly increasing across the developing world, this study presents some initial and interesting findings around the differential diagnosis of people with language led dementia in India.

Clinical profile of primary progressive aphasias in a tertiary care centre from India.
Prabhakar A T, Mathew V, Sivadasan A, et al.
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Anna Volkmer

UCL, London, UK.

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