Bruce Willis’ aphasia diagnosis draws attention to a common cognitive disorder

Until the recent news that Bruce Willis was diagnosed with aphasia and retired from acting, not many people were aware of the condition. Despite its regression, aphasia is not common.

Across Canada and the United States, it is estimated that more than two million people live with aphasia and its associated challenges in communication and in the use and understanding of language.

Aphasia affects language abilities, including listening, speaking, reading and writing. Some of the common language symptoms that occur in individuals with aphasia are:

  • Difficulty coming up with the right word. The individual may use a related word (for example, they may say or write “daughter” when trying to find the word “daughter”) or even use a made-up word (for example, say or write “disturbing” when trying to find the word “daughter” “).

  • Make grammatical or grammatical errors such as deleting word endings. Examples include leaving out the plural “s” or “ed” to indicate the past tense, or putting words in the wrong order, such as: “The cat was out of the house.”

  • The need for more time to process what they are told and the need for more time to formulate a response.

  • Difficulty understanding individual letters, speech sounds, or words when listening or reading, although before the onset of aphasia, these letters, sounds, and words were understood spontaneously.

For individuals with aphasia who use sign language, their ability to use and understand signs is also negatively affected. Some people with aphasia may also have problems using and understanding nonverbal means of communication, such as gestures and facial expressions.

Causes of aphasia

Aphasia affects language abilities including listening, speaking, reading and writing.
(stock struggle)

Aphasia is not a disease, but rather the result of damage to the language-dominant areas of the brain. This brain damage is usually caused by a stroke (interruption of blood flow to or into the brain), or sometimes from traumatic brain injury, a brain tumor, or an infection, such as meningitis. Stroke is the most common cause, with aphasia affecting approximately 30 percent of stroke patients.

Aphasia is also a major component of a progressive neurodegenerative disease called primary progressive aphasia, a type of frontotemporal dementia.

Because the parts of the brain that support language also support other cognitive abilities, individuals with aphasia may have difficulties with attention, memory, and thinking skills such as problem-solving or planning. People with aphasia may be challenged in these other cognitive functions because we often use and understand language in concert with these other functions. For example, practicing out loud or using your inner voice to silently repeat the items you were asked to pick up in the store.

There is great variation in the language symptoms experienced by individuals with aphasia. For example, one individual may experience equally significant difficulties across all language modalities. Another person may have difficulties with mainly verbal output and a little difficulty understanding what is being said, written, or gestured.

Similarly, there is a range of aphasia severity. Some people with aphasia may only be able to understand short, common words. Others may have difficulties understanding only when reading books or following complex podcasts that include, for example, technical jargon or complex stories.

Variation is also common among people with aphasia who are bilingual or polyglot. A person with aphasia may have similar difficulties in all of their languages ​​while another person may experience more in one language than in another.

Living with aphasia

A bald man in a black suit with other people behind him
Like Bruce Willis, who has retired from acting, many people with aphasia are unable to remain in their preferred profession.
(Canadian Press / Frank Jean)

Regardless of the breadth and severity of language symptoms, aphasia is a challenge for those with a language disorder, as well as for their family and friends. Aphasia can make it difficult to complete daily activities, such as reading prescription drug labels, booking an appointment, or using the phone.

Like Willis, many aphasic people will not be able to remain in their preferred occupation. Aphasia can also have negative consequences for roles, relationships, and social activities. Consider how many parenting components include language (listening to your child’s day at school, reading with your child, scolding) and how important communication is to maintaining close relationships with family and friends.

Most leisure activities similarly involve language, whether it’s reading for pleasure, watching movies, or traveling. Because of these daily struggles, many people with aphasia have psychological problems such as depression.

Assessment and services for people with aphasia

However, there is help and hope for those with aphasia. Aphasia research over decades indicates that there are many interventions to improve people’s language abilities and help them compensate for their language impairment. An important first step to getting help is getting an evaluation from a speech-language pathologist.

Due to the various manifestations of aphasia, a comprehensive assessment is required to determine its presence, the individual’s language, and communication strengths and weaknesses. The evaluation will also help the speech-language pathologist determine interventions that can help aphasic individuals and their families and friends achieve their language and communication goals.

In addition to assessment and intervention services, family and friends can find other ways to support a person with aphasia.

By sharing his diagnosis of aphasia, Willis and his family are helping to raise awareness of this complex and often debilitating language disorder. Raising awareness among the public and healthcare professionals is an important step in ensuring that individuals with aphasia can participate in their community and receive appropriate healthcare services.

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