What to Know About Aphasia

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This week, Bruce Willis’s family announced that the 67-year-old actor is stepping away from his acting career. “Our beloved Bruce has been experiencing some health issues and was recently diagnosed with aphasia, which is impacting his cognitive abilities,” his daughter Rumer wrote on Instagram. Aphasia, which affects an estimated 2 million Americans, is a language disorder that impacts someone’s ability to communicate with others. While the Willis family didn’t specify the cause of the actor’s diagnosis, aphasia is linked to brain damage, either as a result of stroke, injury, or illness. Here’s what to know about the condition.


What is aphasia?

Aphasia is a language disorder that affects a person’s ability to communicate, impairing speech and speech comprehension, reading, and writing. Caused by damage to the brain’s language centers, it impacts the ability to access ideas and thoughts. There’s a wide range of symptoms, all involving some kind of impairment in speaking, comprehension, reading, or writing. People with aphasia might have trouble naming something they already know (this is called “tip of the tongue” phenomenon), mix up sounds in words, misplace or misuse words, invent words, use the same words over and over, or struggle to use numbers or do math.

Aphasia doesn’t necessarily affect all modes of communication. People with mild forms of the disorder may only have trouble retrieving the names of objects or struggle to string words together. In most cases, there’s impairment to multiple channels of communication, but at least some are accessible enough for the person to communicate.


What causes aphasia?

Willis’s family didn’t specify what kind of brain damage brought on his aphasia, but the most common cause of the condition is stroke. Brain injuries, brain tumors, infections, or neurodegenerative diseases can also cause aphasia if any part of the brain that processes language is affected.

Aphasia is usually the result of damage to the left side of the brain, where the areas responsible for language are located. Depending on what area of the brain is damaged, aphasia will take different forms, the most common of which are Wernicke’s aphasia and Broca’s aphasia. Wernicke’s aphasia is typically the result of temporal-lobe damage and impacts someone’s ability to connect speech with meaning: They’ll often speak in long, incoherent sentences and are unaware of their mistakes. Broca’s aphasia, caused by frontal-lobe damage, makes it difficult to form words at all. People with Broca’s usually speak in short sentences that make sense but are missing small words like “is” or “and,” and they can understand speech relatively well. Because the frontal lobe also regulates motor movement, people with Broca’s aphasia often experience weakness or paralysis in their right arm or leg.

Depending on the cause, aphasia can develop at different rates. A brain injury or stroke, for example, which disrupts blood flow to the brain, would cause a rapid onset, whereas neurodegenerative diseases like Alzheimer’s often involve something called primary progressive aphasia, where someone gradually loses their ability to communicate over time from brain tissue deterioration. Brain infections or tumors also cause a slower onset.


Can aphasia be treated?

It depends. If there’s a tumor pressing on a particular part of the brain that’s successfully removed, the aphasia often resolves. The same goes for brain infections if they’re treated early. People who’ve suffered brain damage can recover from their symptoms, though if the aphasia lasts longer than two or three months, experts say it’s doubtful they’ll be able to communicate the same way they did before the damage.

In most cases, patients work with a speech and language therapist to help them communicate as effectively as possible. While SLTs can help aphasia patients regain speech, a major part of their treatment is learning to communicate in new ways — using cards with words on them, drawing pictures, relying on facial expressions and gestures, or using apps designed to help them generate speech.

What to Know About Aphasia