What is Aphasia?

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Originally published in News@TheU.

The entertainment world was shocked Wednesday when Bruce Willis and his ex-wife Demi Moore announced that the Hollywood icon of the “Die Hard” movie franchise is suffering from aphasia.

Around the world, many people Googled the word to learn what it meant and what the diagnosis would entail for the popular actor moving forward. In a statement on her Instagram account, Moore addressed Willis’ “amazing fans” to share that his cognitive abilities have been impacted.

“As a result of this and with much consideration, Bruce is stepping away from the career that has meant so much to him,” Moore said. “This is a really challenging time for our family, and we are so appreciative of your continued love, compassion, and support.” The post is signed by Willis’ current wife Emma, Moore, and his children Rumer, Scout, Tallulah, Mabel, and Evelyn.

Willis, 67, is a Hollywood superstar who has starred in dozens of critically acclaimed films including, “Pulp Fiction,” “The Sixth Sense,” and the “Die Hard” series. According to The New York Times, Willis has received three Golden Globe nominations, capturing one. He also won an Emmy for outstanding lead actor in a drama series for the TV show “Moonlighting.”

James Galvin, M.D., director of the University of Miami Miller School of Medicine’s Comprehensive Center for Brain Health and chief of cognitive neurology at the University of Miami Health System, explains aphasia and its treatment.

What is aphasia?

Aphasia is a medical term to describe conditions of disturbance of language (speaking, writing, reading, and comprehension) and is due to damage to the language centers in the brain. Aphasia can be “fluent” with good production of words, but a loss of the comprehension and understanding of the meaning of the words produced, or “non-fluent” with relatively preserved comprehension but a great difficulty in language expression such as speaking or writing.

The illness can be caused by a focal injury such as a stroke, traumatic injury, or brain infection (encephalitis). In this case, the presentation of aphasia is typically more acute or sudden. Aphasia can also be caused by more slowly progressing processes such as a brain tumor or a neurodegenerative disease such as Alzheimer’s disease or frontotemporal degeneration. In particular, a type of frontotemporal degeneration is known as primary progressive aphasia where language problems are the first, and in many cases the only symptoms.

Who is most at risk of contracting aphasia?

This depends somewhat on the underlying cause. In the case of a neurodegenerative disease, older age is a strong risk factor. Frontotemporal degeneration, for example, typically begins sometime between the late 40s to mid-60s, while Alzheimer’s disease more commonly begins at a later age. Tumors and strokes can occur at any age but are more common with increasing age.

Is there a treatment for aphasia? Or, if someone is diagnosed with it, how can they manage the ailment?

This again depends somewhat on the underlying cause. If an underlying cause can be identified, such as a tumor or infection, treatment of the cause may improve symptoms. If due to a stroke or traumatic injury where the lesion is “static” or non-progressive, speech and language therapy can provide improvements or, at the very least, coping strategies.

In the case of neurodegenerative disease, there are few clearly effective options, although some individuals may benefit for a short time from speech therapy. As swallowing difficulties can sometimes accompany language difficulties, it is important to rule this out so to avoid aspiration pneumonia.

What is the difference between simple “forgetfulness” and symptoms that indicate there is something more serious happening—like aphasia, dementia, or Alzheimer’s?

Memory loss is not a part of the normal aging process, although many older adults subjectively report their memory is not as good as it once was. Instead of being truly forgetful, processing speed declines so that it takes longer than usual to recall information. But with time, the information is recalled, and people can benefit from clues or prompts.

Progressive changes in memory, language, or other cognitive functions are often a sign of a neurodegenerative disease such as Alzheimer’s disease or a related dementia such as primary progressive aphasia, frontotemporal degeneration, or Lewy body dementia. Difficulty finding the right words can be an early sign of all of these conditions.

What is the difference between aphasia and dysphasia?

Aphasia is the loss of language, while dysphasia means impaired language. Neurologists often don’t use the term dysphasia because it can be confused with “dysphagia” which means difficulty swallowing.


Written by Ashley A. Williams for News@TheU.


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