Aphasia: Communication Disorder in Spotlight After Bruce Willis Announcement. Here are the Facts

A medical term little known to most people has been widely talked about this week after it was announced that actor Bruce Willis, 67, is stepping away from movies because of a recent diagnosis of aphasia, a language disorder that affects a person’s ability to communicate. Aphasia is “impacting his cognitive abilities,” Mr. Willis’s family wrote in a social media post.

About 1 million people in the United States currently have aphasia, and nearly 180,000 Americans acquire it each year, according to the National Aphasia Association. However, the term “aphasia,” is unknown to most Americans.

Guilherme Dabus, M.D., co-director of interventional neuroradiology and vice-chief of the department of neuroscience at Miami Neuroscience Institute.

Aphasia results from damage to portions of the brain that are responsible for language. For most people, Aphasia commonly occurs after a stroke or head injury. But it may also develop slowly, as the result of a brain tumor or a progressive neurological disease, including Alzheimer’s disease.

“Aphasia most commonly occurs when areas of the brain that control language are damaged,” explains Guilherme Dabus, M.D., co-director of interventional neuroradiology and vice-chief of the department of neuroscience at Miami Neuroscience Institute. “There are different degrees of the condition. Mild cases can make it difficult for a person to find words to communicate. And you have more extreme presentations where, basically, a person doesn’t have any verbal output, or they cannot comprehend, or both, depending on the area of the brain that is affected.”

The disorder impairs the expression and understanding of language — and reading and writing as well. Most people who have aphasia are middle-aged or older, but anyone can acquire it, including young children.

“Sometimes people with Aphasia cannot understand what they’re being told,” said Dr. Dabus. “The symptoms can resemble dementia. Whatever degree, a person with Aphasia needs to be diagnosed and treated as soon as possible.”

Most often, the cause of the brain injury is a stroke, according to the U.S. National Institutes of Health (NIH). A stroke occurs when a blood clot or a leaking or burst vessel cuts off blood flow to part of the brain. Brain cells die when they do not receive their normal supply of blood, which carries oxygen and important nutrients. Other causes of brain injury are severe blows to the head, brain tumors, gunshot wounds, brain infections, and progressive neurological disorders, such as Alzheimer’s disease, the NIH states.

How much a patient recovers and how long it takes depends on the location of the brain injury, how much of the brain is affected and how quickly they receive intervention. Some patients recover completely, but many have lifelong communication challenges.

Primary treatment for aphasia is speech and language pathology. A therapist completes a thorough assessment of the patient’s communications skills and deficits, and develops an individualized treatment plan. Depending upon the severity of aphasia, therapy may include teaching the patient, family members and care givers alternative forms of communication.

Patients may experience one of three types of aphasia:

• Expressive – impaired speech and articulation but complete comprehension.
• Receptive ‒ fluid speech but impaired comprehension.
• Global – combination of expressive and receptive including both deficits of expression and comprehension or brain injury.

The National Aphasia Association, or NAA, put out a statement following the news of Mr. Willis.

“In 2016, the NAA conducted a survey to discover how much the general public knew about aphasia,” reads part of the statement. “Only 8.8 percent of respondents knew what aphasia was and correctly identified it as a language disorder. That means that the other 91.2% may be struggling to understand Bruce Willis’s aphasia announcement.”