- The family of Bruce Willis shared that the actor is retiring following a diagnosis of aphasia.
- There are several types of aphasia and each may affect a different area of the brain, resulting in impairments to speech, cognition, and movement.
- Strokes are a common cause of aphasia, accounting for 40% of all cases.
“As a result of this and with much consideration, Bruce is stepping away from the career that has meant so much to him,” his family said, without revealing what might have caused Willis’ condition.
Sanam Hafeez, PsyD, an NYC-based neuropsychologist and director of Comprehend the Mind, told Healthline that strokes are the most common cause of aphasia, and affect up to 40 percent of stroke survivors.
“It can happen suddenly,” she said. “After a stroke, head injury, or gunshot wound — but may develop slowly if there is a brain tumor, infection, or progressive neurological disease.”
Hafeez explained that aphasia is caused when there is damage to the language-dominant side of the brain, usually the left side, and can be brought on by:
- Head injury
- Brain tumor
“The symptoms of aphasia can vary from person to person, depending on which type they have,” she said.
According to Hafeez, aphasia symptoms vary depending on which part of the brain is affected.
“For example, those with Broca’s aphasia, also known as expressive aphasia, may eliminate the words ‘and’ and ‘the’ from their language, speaking in short but meaningful sentences,” she said.
Hafeez pointed out that that part of the brain is also essential for motor movements, so people with expressive aphasia often suffer from right-sided weakness or paralysis of an arm or leg.
Another type is called Wernicke or
This makes people tend to speak in long confusing sentences, add unnecessary words or create new words, and have difficulty understanding what others are saying, said Hafeez.
But global aphasia may affect our ability to communicate even more severely.
“People with global aphasia may find it difficult to speak or comprehend language as a whole,” she said.
Dr. Jay Pathmanathan, medical director, Beacon Biosignals, adjunct assistant professor of neurology at the University of Pennsylvania Perelman School of Medicine, and medical director at Crozer-Chester Medical Center School of Clinical Neurophysiology said it’s difficult to say whether aphasia affects intelligence.
“Since the ability to communicate, which is what aphasia affects, reflects much of what we consider intelligence,” he said.
Pathmanathan added that, depending on the cause, aphasia might occur without any impairment in emotional intelligence – our sense of right and wrong, or ability to feel emotions.
However, it’s different if the problem is a neurodegenerative disease that causes brain cells to “die off.”
In that case, Pathmanathan said, aphasia is typically associated with loss of intelligence and changes in the person’s behavior.
“Though this may be a very slow process, gradually worsening over years,” he said.
“I tend to view aphasia as one of my professors described it — like living in a foreign country where you can’t understand the language,” said Pathmanathan.
“You know when people are happy, sad, or angry. You can probably express how you’re feeling as well — but only in limited ways,” he continued. “If that country’s language is similar to yours, you might even be able to convey some of your thoughts. But fundamentally, you are still you.”
With aphasia, people may still be able to communicate in some form, “but conveying thoughts and complex desires can be limited or impossible,” explained Pathmanathan.
“It depends on the parts of the brain involved and the underlying cause,” he said.
Pathmanathan said there are very rare types of aphasia where only one form of communication is involved.
“For example where someone might be able to write but not speak. But in general, the language problem affects all forms of communication; speaking, writing, texting, and so forth.”
Hafeez said the goal of treatment is to improve the ability to communicate, and ways to do that include:
- Speech-language therapy
- Nonverbal communication therapies, using computers or pictures
- Group therapy for patients and their families
“Some people with aphasia have been able to recover completely without treatment,” she said. “But for most, some amount of aphasia typically remains.”
While speech therapy can often help to recover some speech and language functions over time, many continue to have problems communicating, noted Hafeez.
“This can be difficult and frustrating both for the person with aphasia and for their family members,” she said. “It’s essential for family members to learn the best ways to communicate with their loved ones.”
According to the
Dr. Jared Knopman, a neurosurgeon at Weill Cornell Medicine and New York-Presbyterian, said stroke risk factor reduction measures could lower the risk of this debilitating condition.
“Blood pressure and cholesterol control, smoking cessation, a healthy diet, and exercise can lower the likelihood of developing or experiencing a recurrence of stroke; the most common cause of aphasia,” he said.
“You need to have patience and empathy when interacting with people who suffer from aphasia,” said Knopman. “It is especially hard for someone unable to express the words they know they want to say. It is even harder to see those they are attempting to interact with become frustrated with their inabilities.”
Hafeez said there are ways to enhance communication, and methods depend on the degree of the condition.
This includes keeping noise and distractions down when possible, and when speaking with them turn off the TV, radio, or loud household appliances.
You should also continue to speak with them in adult terms. “Don’t infantilize them,” Hafeez emphasized.
Don’t speak louder to have the person hear you unless they are hearing impaired and make eye contact when speaking with them.
”If you need to give them instructions, break them down into small steps,” she said. “Give them time to absorb the information.”