Bruce Willis’s family recently said that he would stop acting because he has a language disorder called aphasia, which is caused by damage to the parts of the brain that control speech and understanding.
CU Anschutz Today sat down with Peter Pressman, MD, associate professor in cognitive and behavioural neurology at the University of Colorado School of Medicine, to talk about how aphasia is often hidden behind other diagnoses, why treating and supporting the individual is important with aphasia, and the outlook on recovery.
What Is The Problem?
Aphasia is a loss of language ability that comes on over time. This is different from not being able to speak, which could be caused by paralysis of the mouth or tongue, but it goes further than that. It would involve both speaking and writing, or recognizing, or listening and reading.
What Can Cause Aphasia?
Aphasia can be caused by damage to any part of the brain that helps with language. Different kinds of aphasia can happen depending on what part of the brain is hurt.
Most of the time, aphasia is caused by a stroke, but it can also be caused by a head injury, a disease that causes nerve cells to die, a tumor, or some infections.
Does This Mean That Alzheimer’s Disease Is Also Neurodegenerative?
Alzheimer’s disease and frontotemporal dementia. I’m an expert on a rare disorder called primary progressive aphasia, which is caused when a neurodegenerative disease, like Alzheimer’s or frontotemporal dementia, attacks only the part of the brain that controls language. So, instead of the slow loss of memory that most people think of when they think of Alzheimer’s, you see a slow, steady loss of language skills.
What Are The Signs Of Having Aphasia?
The symptoms of aphasia vary, and so can how bad they are. The National Aphasia Association says that in the worst cases, the condition can make it “almost impossible” to talk to the patient.
When aphasia is mild, it may only affect one part of how you use language. A person with mild aphasia might not be able to remember the names of things or have trouble reading or putting words together to make clear sentences.
Boxer said that mild aphasia can be hard to spot because most people lose some memory as they age. “Is it just getting old, or is it something else?”
Can you tell me more about the different subsets of aphasia that you see in your patients?
In general, there are three types: receptive aphasia, which means you have trouble understanding, expressive aphasia, which means you have trouble expressing your thoughts and ideas, and global aphasia, which means you have trouble with both.
The truth is, though, that aphasia comes in many different forms.
Do Older People Seem To Be More Likely To Have Aphasia, Or Does It Depend On The Cause?
The prevalence of aphasia increases with age because stroke is the most common cause of the condition and stroke is more common in older people. This is also true due to various diseases that happen when the brain ages, like Alzheimer’s. So there is a link between age and aphasia, but it’s really because of the link between aphasia and the diseases that can cause it.
Do People Who Use Sign Language Also Have Aphasia?
Yes. If you had aphasia and could use sign language, you would have the same problems, but you would show them through signs instead of words.
How Is Aphasia Usually Found Out?
It’s not always easy. Sometimes it’s pretty clear. And, to be honest, in common situations like a stroke, it can be very clear and dramatic at that time. Someone is clearly having a hard time getting their words out. That can be very scary. And that is a good reason to go to the hospital right away.
When it comes to primary progressive aphasia, which is what I study, the language problems come on more slowly. It sneaks up on people, and it can take years to figure out what’s wrong. No one knows how to explain it. Not necessarily because they have aphasia, but because the way we talk about slow language loss isn’t good.
Most people who come to the clinic with what is called a “memory problem” And it’s not always easy to figure out that they just can’t remember words or what things mean. Often, this requires the medical provider to be aware, pay close attention, and have some skill.
What Are The Different Ways To Treat Aphasia?
Well, of lesson you want to treat the real problem, whatever it is. If it’s a stroke, you want to make sure this person doesn’t have anymore. You would start there.
Speech therapy is the main way to get better from almost any kind of aphasia. Depending on the type of aphasia, speech therapy is designed, built, and given in different ways. For example, it wouldn’t make sense to treat receptive aphasia the same way as expressive aphasia. They’re not the same at all. And that’s another example of using a broad brush. Specialists will learn more about how the aphasia works and adjust their treatment to fit.
There are also things like ways for people who care about a person with aphasia to talk to them. There are many different ways to talk to people in a good way. So, you can usually find a better way to do something. There are ways to deal with it, like joining a support group or paying attention to your mood. You can also make sure that the person’s quality of life stays as high as possible and that they are as safe as possible.
I think it’s important to remember that even though aphasia can be very frustrating, people can still do a lot. Often, aphasia doesn’t affect other parts of the brain. So some people with aphasia are perfectly able to drive. They can still do the things they like to do as long as they find a way to tell people what they need to do.