What is aphasia? An expert explains

Editor’s note: His family announced on March 30, 2022 that actor Bruce Willis, 67, was “walking away” from his career in film and television after developing aphasia.

His daughter, Rumer Willis, said in a message posted on Instagram that the condition was “affecting his cognitive abilities”.

Swathi Kiran, director of the Aphasia Research Laboratory at Boston University, explains what aphasia is and how it impedes communication with people with the condition.

What is aphasia?

Aphasia is a communication disorder that affects a person’s ability to speak or understand speech. It also affects how they understand written words and their ability to read and write.

It is important to note that aphasia can take many different forms. Some people with aphasia have difficulty understanding language only — a result of damage to the temporal lobe, which controls how sound and language are processed in the brain. Others have difficulty speaking only – indicating frontal lobe damage. Loss of both speaking and understanding language may indicate damage to both the large temporal lobe and frontal lobe.

Almost everyone with aphasia suffers when trying to figure out the names of things they know, but can’t find a name for. Because of that, they have difficulty using words in sentences. It also affects the ability of people with this condition to read and write.

What causes aphasia?

In most cases, aphasia results from a stroke or bleeding in the brain. It can also be caused by brain damage from a traumatic injury such as a car accident. Brain tumors can also lead to aphasia.

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There is also a separate form of the condition called primary progressive aphasia. This starts with mild symptoms but gets worse over time. The causes of primary progressive aphasia are not known to the medical community. We know that it affects the same areas of the brain as in cases where aphasia is caused by a stroke or bleeding, but the onset of symptoms follows a different path.

How many people does it affect?

Unfortunately, aphasia is very common. Nearly a third of all stroke survivors suffer from it. In the United States, about 2 million people have aphasia and about 225,000 Americans are diagnosed each year. Currently, we do not know what proportion of people with aphasia have the initial progressive form of the condition.

There is no difference between the sexes in terms of who suffers from aphasia. But people who are more likely to have a stroke — and thus those with cardiovascular disabilities and diabetes — are more likely to have it. This also means that minority groups are more at risk, simply because of the health disparities that exist in the United States

Aphasia can occur at any age. Usually people over the age of 65 are just because they are more likely to have a stroke. But this condition can develop in young adults and even children.

How is it diagnosed?

When people develop aphasia after a stroke or haemorrhage, the diagnosis is made by a neurologist. In these cases, patients will have demonstrated a sudden onset of the disorder – there will be a significant decrease in their ability to speak or communicate.

Primary progressive aphasia is difficult to diagnose. Unlike in stroke cases, the onset will be very mild at first – people will slowly forget the names of people or things. Likewise, the difficulty in understanding what people are saying will be gradual. But it is these changes that lead to the diagnosis.

What is the prognosis in both forms of aphasia?

People with aphasia caused by a stroke or bleeding will recover over time. The speed and amount depend on the extent of the damage to the brain, and what treatment they receive.

Primary progressive aphasia is a degenerative condition – the patient deteriorates over time, although the rate of deterioration can be slowed.

Are there treatments?

The encouraging thing is that aphasia is treatable. In the non-progressive form, consistent treatment will restore speech and comprehension. One-on-one repetition exercises can help those with this condition regain speech. But the road can be long and depends on the extent of the damage to the brain.

With primary progressive aphasia, symptoms of deteriorating speech and language will get worse over time.

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But the clinical evidence is unequivocal: rehabilitation can help stroke survivors regain speech and language understanding and can slow symptoms in cases of primary progressive aphasia.

Clinical trials of certain types of drugs are underway but are in the early stages. There don’t seem to be any miracle drugs. But at the moment, speech rehabilitation therapy is the most common treatment.

This article has been republished from The Conversation under a Creative Commons license. Read the original article.

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