Patient management by the primary care physician

• Investigate the onset of language difficulties. When did it begin and how did it evolve?
• The primary care physician will perform/order cognitive testing, brain imaging (MRI or CT scan) and blood tests to eliminate alternative causes.
• The primary care physician may also refer to a behavioral neurologist to determine the specific variant of PPA.
• To precisely identify the language difficulties and diagnosis, an assessment in speech-language pathology is necessary. Depending on the patient’s and the relatives’ needs, regular speech-language pathology intervention may be offered.
• Currently, there are no pharmalogical treatments that can cure PPA. For cases with underlying Alzheimer’s pathology (for example, the logopenic variant of PPA), an acetylcholinesterase inhibitor (Aricept [Donepezil] or Exelon [Rivastigmine]) can be tried.
• Do not hesitate to take action regarding the behavioural changes, first by using a non-pharmalogical approach, next with SSRIs or neuroleptics.
• In all cases, patients should be encouraged to follow the recommendations for cognitive health such as good eating habits, exercising, and having stimulating social activities, adapted to their condition.
• Publications on cognitive health :
  • Dementia Prevention - 12 Modifiable Risk Factors And Their Means Of Prevention
  • U.S. National Institute on Aging - Cognitive Health and Older Adults
• Referal to a specialised clinic