Differential Diagnosis for Dementia with Speech Issues as a Primary Symptom
- Single most likely diagnosis
- Primary Progressive Aphasia (PPA): This is the most likely diagnosis because PPA is a type of dementia that primarily affects language and speech abilities, with patients often presenting with gradual decline in their ability to speak, find words, and understand language.
- Other Likely diagnoses
- Frontotemporal Dementia (FTD): FTD can present with speech and language difficulties, among other symptoms such as changes in personality and behavior. The language variant of FTD is closely related to PPA.
- Alzheimer's Disease: While not primarily a disorder of speech, Alzheimer's disease can lead to significant language and communication difficulties as it progresses, especially in the later stages.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Creutzfeldt-Jakob Disease (CJD): This is a rare, degenerative, and fatal brain disorder that can present with a variety of symptoms including speech difficulties, among others like dementia, memory loss, and personality changes. It's crucial to consider CJD due to its rapid progression and fatal outcome.
- Normal Pressure Hydrocephalus (NPH): NPH can cause cognitive decline, gait disturbances, and urinary incontinence, and sometimes speech issues. It's treatable with the placement of a shunt, making it a critical diagnosis not to miss.
- Rare diagnoses
- Corticobasal Degeneration (CBD): A rare neurodegenerative disorder characterized by progressive cognitive and motor dysfunction, which can include speech and language difficulties.
- Progressive Supranuclear Palsy (PSP): Another rare neurodegenerative disorder that can affect speech, among other symptoms like difficulty with eye movements and balance.