What is aphasia? | Next Avenue

Before we knew about Bruce Willis’ diagnosis, aphasia was not well understood

The National Aphasia Association conducted a survey six years ago to find out what people know about aphasia. Only 8.8% of respondents correctly identified aphasia as a language disorder. The other 91.2% had no idea. It was the recent announcement from the family of actor Bruce Willis of his diagnosis that propelled aphasia into the spotlight.

Actor Bruce Willis in 2019 | credit: Photo by Henry Nichols/Reuters

“Aphasia is a general term used to describe language impairment,” says Dr. William Ho, MD, associate professor and chair of the division of cognitive neuroscience at the Rutgers-Robert Wood Johnson Medical Institute for Health, Healthcare Policy, and Aging Research. “It affects the production or comprehension of speech and a person’s ability to read or write. It results from a brain injury, such as a stroke, a brain tumor, or a brain infection. Another form is primary progressive aphasia (PPA).”

“It affects the production or understanding of speech and a person’s ability to read or write.”

Aphasia ranges from mild to severe. Some people with aphasia have trouble remembering words or putting sentences together.

“Every now and then, we’ve all at one time or another had the word on the tip of our tongue,” Hu says. “If we occasionally forget, don’t worry. If it happens often, it’s a good idea to talk to your doctor. More severe forms make speaking difficult, to the point that [a person’s speech] It’s hard to understand.”

Aphasias can be difficult to understand, but the inability to process language does not affect one’s intelligence.

Symptoms of aphasia

The main symptoms of aphasia include:

  • difficulty speaking
  • Struggling to find the right word
  • Using the wrong word or words when speaking
  • Having trouble finding the right words or using the wrong words when writing
  • Speak in short sentences
  • Saying unrecognizable words

Diagnosis of aphasia

The first step is getting a diagnosis, which usually happens if you’ve been treated for a stroke, brain injury, or brain tumor. During the test, your doctor will ask questions to monitor your language skills. Your doctor will look for:

  • How to use the rules
  • How do you form sounds and letters?
  • Your ability to understand words and sentences
  • How to follow directions

Your doctor may also ask you to look at pictures and describe and name things. Computerized tomography, magnetic resonance imaging, or positron emission tomography may be prescribed.

Understanding and treating aphasia

“Treatment depends on the type of aphasia,” Hu says. “For example, a person who has had a stroke may benefit from speech therapy. Depending on the severity of the stroke, normal speech can return at any time.”

A person with aphasia due to head trauma can recover after successful surgery. For example, removing a brain tumor or treating a brain infection can return to normal speech.

“Aphasic aphasia is not all dementia, but aphasia can be a symptom of dementia.”

PPA occurs in adults in their 50s and 60s. It is a progressive neurodegenerative disease that affects language.

“Not all aphasias are caused by dementia, but aphasia may be a symptom of dementia,” says Claire Sexton, senior director of science and communication programs for the Alzheimer’s Association. “Many people with common dementias such as Alzheimer’s disease eventually develop symptoms of aphasia as neurodegeneration progresses in the brain. Primary progressive aphasia is a form of frontotemporal dementia, with aphasia being one of the initial symptoms.”

PPA is not the same as Alzheimer’s disease. PPA affects language first; Alzheimer’s disease affects memory first. A study published in the journal Neurology found that about 40% of people with Alzheimer’s also had PPA. The study also found that memory is preserved longitudinally in PPA, which is associated with Alzheimer’s disease.

What to do after a diagnosis of PPA

Darlene S. says: Williamson, president of the National Aphasia Association: “After a diagnosis of PPA, make sure you put together a good medical team.”

She recommends seeing a neurologist who has experience treating PPA. “It often takes some time to get a definitive diagnosis of PPA. It is recommended that you ask any neurologist directly if they have experience with this diagnosis.”

She also recommends working with a speech-language pathologist who has experience with PPA.

“Again, ask to make sure your therapist has experience because PPA is a very specific type of aphasia. Treatment should be specific to PPA,” Williamson says. “When aphasia is the result of a stroke, treatment aims to restore language. In PPA, treatment aims to preserve language and develop strategies to help the individual when their language declines. Excellent treatment includes family members and other loved ones. People and friends who communicate regularly. with the individual so that they learn the best communication strategies and practices that will support the person’s communication needs.”

Williamson stresses the need to involve the family. “It’s an essential part of following up,” she says. “The family needs not only communication strategies but also education and support from a knowledgeable counsellor, ideally from other families who have experienced this diagnosis. There is hardly anything more valuable than bonding with other families who share this experience.”

The National Aphasia Association for Families provides education, bonding with other families, and professional resources to help them find experienced PPA professionals.

Contact Tips

meIf you have aphasia, here are some communication tips:

  • Use your iPad or a computer to write down what you want to say
  • Carry picture cards with words and pictures
  • If possible, draw or write pictures or words on a blank board
  • When speaking, speak slowly and try to remain calm
  • Carry a card to share with strangers to tell them you have an aphasia and to find out what an aphasia is

If you have a friend or family member with aphasia, try the following:

  • Speak in short, simple sentences so that the person with aphasia understands you
  • When giving directions, break each into one step
  • do not shout
  • Don’t talk to someone as if they were a child
  • Don’t ask open-ended questions like, “What would you like to have for dinner?” Offer this person a choice: do you want an apple or a banana?
  • Be patient and attentive

Practice self-care

Watching a close friend or family member struggle with language difficulties is challenging. It’s an emotional time, not just for the person you care about, but for yourself as well. If necessary, talk to a therapist and take care of yourself.

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