Bruce Willis diagnosis explained: How aphasia can lead to dementia

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Bruce Willis has been given a second devastating diagnosis less than year after it emerged he had an untreatable brain disorder.

The legendary actor has been told he has frontotemporal dementia (FTD) – an uncommon type of the disease that causes a deterioration in behavior, personality and language.

It affects the front and sides of the brain, differing from Alzheimer’s — the most common type of dementia — which affects most of the brain.

Just 11 months ago Willis was diagnosed with aphasia, a disorder that leaves sufferers struggling to communicate with others.

About two million Americans have aphasia, which doctors say can be a warning sign of FTD dementia because the two affect similar areas of the brain.

Bruce Willis diagnosis explained: How aphasia can lead to dementia

Bruce Willis has been given a second devastating diagnosis less than year after it emerged he had an untreatable brain disorder 

95% of right-handed people and two-thirds of left-handed people use the left side of the frontal and temporal lobes of their brains to process speech. The remaining one-third of left-handed people are right-brain dominate. When there is damage to this portion of the brain speech and language suffers.

95% of right-handed people and two-thirds of left-handed people use the left side of the frontal and temporal lobes of their brains to process speech. The remaining one-third of left-handed people are right-brain dominate. When there is damage to this portion of the brain speech and language suffers.

In their statement today, Mr Willis’ family said: ‘Since we announced Bruce’s diagnosis of aphasia in spring 2022, Bruce’s condition has progressed.

‘We now have a more specific diagnosis: Frontotemporal dementia (known as FTD).’

FTD is caused when abnormal proteins build up in the frontal and temporal lobes of the brain, damaging the cells there.

This causes them to start to die and this area of the brain to begin to shrink (atrophy) — exacerbating symptoms of the disease.

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There are two common forms of frontotemporal dementia.

The first is behavior variant frontotemporal dementia (bvFTD), with nerve cell loss occuring in areas of the brain affecting behavior, judgment and empathy.

The other form is primary progressive aphasia (PPA), which affects the nerve cells in the areas of your brain that affect comprehension and communication. These are key for language, speaking and writing.

About 50,000 to 60,000 Americans have FTD, estimates suggest, while in the UK it is thought to account for less than one in 20 of all dementia cases.

Aphasia is a disorder that affects how a patient communicates with others.

It is caused by damage to the areas of the brain that help someone to communicate — either Broca’s area, which controls speech, or Wernicke’s area, which controls word selection and understanding.

This can be triggered by strokes or head injuries as well as brain tumors, infections and dementia.

In one rare type of aphasia — primary progressive aphasia — the condition is a precursor to frontotemporal dementia (FTD).

Treatment can slow the progression of the disease, but there is no cure.

About 2million Americans have aphasia, while in the UK more than 350,000 people are living with the condition.

What are the symptoms of aphasia?  

Aphasia is often a warning sign of another condition, doctors say. Its symptoms include: 

  • Speak in short or incomplete sentences;
  • Speak in sentences that don’t make sense
  • Substitute one word for another or one sound for another;
  • Speak unrecognizable words;
  • Have difficulty finding words;
  • Not understanding other people’s conversations;
  • Not understanding what they read;
  • Write sentences that don’t make sense.
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How long can you live with aphasia?

The prognosis for a patient with aphasia depends on the cause of their condition.

Those who have a brain tumor may have a short life expectancy, but in cases where the patient is suffering from dementia, it is measured in years.

The UK-based Stroke Association says: ‘Deterioration can happen slowly, over a period of years.’

Is there a cure?

There is no cure for aphasia, with treatment instead focused on slowing the disease and managing the symptoms.

In some cases, medics may offer speech and language therapy to help a patient relearn the ability to speak.

But in others treatment will focus on managing another condition behind the aphasia, such as dementia.

What is primary progressive aphasia?

Primary progressive aphasia (PPA) is a rare condition and a type of frontotemporal dementia.

Patients suffer a gradual deterioration in the brain that affects their ability to communicate, express thoughts and understand or find words.

Symptoms appear gradually, often before the age of 65 years, and worsen over time. But patients may be able to live with the disease for several years by participating in daily activities after they begin.

Over time, however, patients may lose the ability to speak and write, and understand written or spoken language.

Some may also develop substantial difficulty forming sounds to speak, even if their ability to write is not significantly impaired.

As the disease progresses other mental skills such as memory and movement can become impaired.

It is caused by a shrinking of sections of the brain involved in speech and language. This tends to be associated with the presence of abnormal proteins.

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PPA is a rare form of the disease, with estimates suggesting less than 50,000 Americans suffer from aphasia.  

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