What is aphasia, the disease that has led Bruce Willis to retire from acting?
Actor Bruce Willis, 67, is "walking away" from his film and television career after being diagnosed with aphasia, his family has announced. Here, everything he needs to know about the disease.
The news that movie star Bruce Willis is retiring from acting after being diagnosed with aphasia has highlighted the misunderstanding about the communication disorder. Here we explain in detail what this disease implies.
"Aphasia simply means that someone has a language problem that they weren't born with," explains Hugo Botha, a neurologist at the Mayo Clinic in Minnesota.
Does not normally affect intelligence
The most common causes are cerebrovascular accidents (CVA) or head injuries. Experts caution that while it can affect the production and understanding of spoken or written speech, it typically doesn't affect intelligence.
About two million Americans have it, according to the National Aphasia Association, and it's more common than Parkinson's, cerebral palsy or muscular dystrophy.
A 2016 survey conducted by the association found that less than 9% of respondents knew what aphasia was.
While it's usually caused by a one-time event like a stroke, "there are other possibilities, such as a neurodegenerative disease," explains Brenda Rapp, a cognition scientist at Johns Hopkins University.
In these cases, the damage is progressive and the therapy focuses on preventing future functional losses.
Willis' family, who revealed this week that the star of the "Die Hard" franchise has been diagnosed with the disorder, did not share the cause of his diagnosis in his statement
."Very complex machine"
The brain's system that governs speech is a "very complex machine" that involves the ability to choose the right words, move the mouth appropriately to vocalize them, as well as hearing and encoding their meaning, Rapp said.
We all occasionally have trouble finding the right word, "but this with aphasia happens a lot," he added.
Doctors occasionally classify aphasia into broad clinical categories that correlate with where the brain injury occurred.
expressive and receptive aphasia
In expressive aphasia, people "usually understand completely well, but have trouble getting words out," says speech therapist Brooke Hatfield of the American Speech-Language-Hearing Association (ASHA).
A person with this type of aphasia may use simple phrases like "want food" to be understood.
In receptive aphasia, "the words come easily, but they may not be the right ones. And it's hard for that person to understand what they're hearing," Hatfield added.
"Everyone has a chance to improve"
The good news, says Hatfield, is that "everyone has a chance to improve" in the long run. "There are people who had their stroke 30 years ago who are working on their language and communication and making progress."
The brain is extremely plastic, and speech therapy can activate other parts of it to "connect blocked pathways" in affected areas and forge new connections, Rapp says.
Such therapy also trains people to talk about a topic if they get stuck on a specific word.
Family members also develop strategies to make themselves understood better: "Things like shorter sentences, making sure you're talking to the person in sight and not from another room, and minimizing background noise," says Botha.
Some people do well with assistive devices because their ability to type isn't affected in the same way.
Experimental treatments
Looking ahead, there are experimental treatments that combine electrical stimulation of the brain with speech therapy, which have shown promising results in functional recovery, says Rapp.
All experts emphasize the importance of patience. Aphasia can be frustrating and isolating because "our relationships with others depend so much on being able to talk to them and communicate with them," says Rapp, which can lead to patients or their caregivers throwing in the towel.
"It's similar to suddenly waking up in a country where you don't speak the language," explains Hatfield, and less like a change in baseline cognitive abilities.
Filmmakers have long noted the deterioration of Bruce Willis
On the other hand, according to the Los Angeles Times, the announcement by Bruce Willis did not surprise people who have worked with the action hero. Filmmakers who have collaborated with Willis told the outlet that his decline has been evident for some time.
Some of the directors the newspaper spoke with described troubling moments during filming in which the "Unbreakable" actor appeared not to be fully aware of his surroundings and struggled with his lines, even as the producers ordered the film to be shortened. script to adapt it.
Director Mike Burns, who helmed "Out of Justice," said he quickly saw that the "Moonlighting" star was having trouble.
"After the first day on the job with Bruce, I got to see him firsthand and realized there was a bigger problem at play and why I had been asked to shorten his lines," Burns said, according to the Times.
Jesse Johnson, director of the low-budget film "White Elephant," said the Willis he met when filming began last year was a different person from the man he had worked with decades earlier.
"It was clear that he was not the Bruce that I remembered," Johnson acknowledged.
The Times reported that members of the film's crew recall Willis saying, "I know why you're here, and I know why you're here, but why am I here?"
"After our experience on 'White Elephant,' it was decided as a team that we wouldn't do another one," Johnson said of the proposal to work with Willis on another film.
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