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Salman Azhar, MD, is director of stroke care at Lenox Hill Hospital, Northwell Health
The family of legendary actor Bruce Willis, 67, announced that he is retiring due to cognitive problems related to a condition called aphasia.
Aphasia is a disorder that affects a person's ability to express and understand thoughts, follow commands, and communicate.
But it is primarily a language disorder because it is less related to a person's ability to pronounce words or articulate sounds.
Someone suffering from aphasia appears to speak clearly while the meaning of their words is incoherent. They may even have difficulty communicating through writing or sign language.
It is also important to understand that there is a big difference between ordinary episodes of difficulty remembering a person's name and a more serious medical problem.
When people are tired or multitasking, they may forget the names of friends or restaurants or even where they left their keys. But usually a healthy person is able to eventually remember the word or thought sought.
Aphasia is completely different. Someone suffering from this condition may not be able to identify common objects. For example, they may have difficulty naming a keychain, a phone, or the sleeve of their jacket, even if the object is right in front of them.
There are reports that Bruce Willis (above) has been showing signs of decline on film sets for several years, suggesting that his aphasia is the symptom of a neurodegenerative disorder related to dementia.
They may also not be able to understand thoughts. If you ask a person with aphasia if the moon is made of cheese, they may answer "yes" without realizing that their answer is clearly wrong.
And often those affected by aphasia have difficulty with both functions – articulating and understanding thoughts.
To diagnose aphasia, a doctor must do a scan of the brain. This and specific language and cognitive testing will reveal the cause of the disease and lead to the correct diagnosis and subsequent treatment if necessary.
95% of right-handed people and two-thirds of left-handed people use the left side of the frontal and temporal lobes of their brain to process language. For the remaining third of left-handed people, the right hemisphere of the brain dominates. When this part of the brain is damaged, speech and language suffer.
Aphasia can be triggered by either an acquired injury or a degenerative condition.
An acquired injury usually occurs very suddenly and can include a stroke, physical trauma, infection, or even a brain tumor.
If a loved one suddenly becomes unable to speak, they should be taken to the hospital immediately because they may have suffered a stroke, which cuts off oxygen to the brain. When the brain is deprived of oxygen, brain cells die.
The scan of a brain that has suffered a sudden injury appears to show damage that over time can lead to a well-circumscribed hole in the brain.
In these cases, aphasia sufferers may benefit from treatments that restore blood flow to the brain and then speech and language therapy. Therapy allows language to improve over time as the brain recovers.
95% of right-handed people and two-thirds of left-handed people use the left side of the frontal and temporal lobes of their brain to process language. For the remaining third of left-handed people, the right hemisphere of the brain dominates. When this part of the brain is damaged, speech and language suffer.
Unfortunately, and based solely on public information, I do not believe this is the case with Bruce Willis.
There are reports that he has been showing signs of decline on film sets for several years, suggesting that his aphasia is the symptom of a neurodegenerative disorder related to dementia.
A former co-star, Lala Kent, who played Willis' daughter in Hard Kill, claims Willis unexpectedly fired a prop gun at the wrong cue twice during filming in 2020.
Willis' longtime stunt double Stuart F. Wilson recalled in an interview this week: "Sometimes when you talked to me [Willis] he just seemed distracted and we would think it didn't mean anything, but you would wonder if there were other things going on.
These anecdotes suggest that Willis may be suffering from primary progressive aphasia or another type of similar cognitive disorder, a neurodegenerative disorder that causes progressive loss of ability to communicate as well as other cognitive difficulties such as loss of memory, attention and concentration. or executive function.
The appearance of the brain in such cases is very different.
Author, Dr. Salman Azhar
The dominant left hemisphere of the brain shrinks over time and appears atrophied compared to healthy parts of the brain.
Unfortunately, this means that traditional speech therapy cannot significantly help. The functioning parts of the brain cannot compensate for the lost function because everything gets worse at the same time.
There are also no medications to treat this condition.
The key to diagnosing and treating any neurological disease is early detection. Although there is only so much that can be done to reverse some degenerative brain diseases, patients' lives can be significantly improved by creating a supportive living environment.
For a man like Willis, whose life is spent in public and on movie sets and where his ability to communicate effectively is paramount, stress likely exacerbated his symptoms. It's unclear when his condition was diagnosed, but it's clear his family is taking steps to support him.