The actor’s family announced the diagnosis earlier this year, when Willis began to suffer a rapid deterioration in his language skills.
08 nov 2023 . Updated at 6:19 p.m.
“Since We announce the diagnosis of Bruce (Willis) aphasia In the spring of 2022, Bruce’s condition has progressed and we now have a more specific diagnosis: dementia frontotemporal (known as FTD)”, This is how the actor’s family announced his illness for which there is no treatment today. Now, Willis’s pathology is getting worse. Sources close to the actor revealed that he no longer recognizes his ex-wife, Demi Moore. After a trip to Italy, the actress came to visit him and, when she saw that he did not recognize her, she was “devastated,” according to the American press.
For his part, actor Glen Gordon Caron, a friend of Willis, also said that he can no longer have conversations with him, since “he is no longer fully verbal. He used to be a voracious reader and now he doesn’t read. “All those language skills are no longer available to him.” However, he noted that “he’s still Bruce. When you are with him you know it is Bruce and you are grateful that he is there, but the joy of life is gone.
Bruce Willis (68 years old) was diagnosed with aphasia in 2022. At that time, he announced that he was forced to retire from acting. Aphasia is a language disorder produced as a result of an injury or an alteration in the functioning of the parts of the brain responsible for expression, comprehension, reading and/or writing.
Aphasia can affect any age, but it is more common to affect adults, especially those over 60 years of age. In Spain, and according to data from the Spanish Society of Neurology (SEN), more than 350,000 people suffer from aphasia and about 25,000 new cases occur each year.
Why does aphasia occur?
Aphasia is not a disease, it is a symptom that an injury has occurred in the brain and the causes can be diverse. The patient has suffered a stroke, a traumatic brain injury, an infection (such as encephalitis), a brain tumor, or some type of neurodegenerative disease (Parkinson’s or some type of dementia, such as Alzheimer’s or frontotemporal dementia).
In the event that aphasia has its origin in a neurodegenerative disease, as in the case of Bruce Willis, it is called progressive aphasia and the affected person will progressively worsen as their disease progresses.
What is frontotemporal dementia?
Frontotemporal dementia is a group of disorders related to degeneration of the frontal or temporal lobes of the brain, which include brain tissue related to speech and language. Primary progressive aphasia, semantic dementia, and progressive agrammatic aphasia are the main subtypes of frontotemporal dementia that cause language problems. Among them, the most common is primary progressive aphasia, a neurodegenerative syndrome characterized by a progressive deterioration of language, while, initially, the rest of the cognitive functions are preserved. The usual age of onset of primary progressive aphasia is considered to be around 50 to 70 years.
The neurologist Javier CaminoI had already advanced a year ago in this interview with La Voz de la Salud, that Bruce Willis most likely suffered from primary progressive aphasia, which was finally confirmed this year. «The variant of frontotemporal dementia that Bruce Willis has is one in which the language disorder predominates, which is primary progressive aphasia. But there are other presentations of this dementia. What unites them all is that there is an atrophy and poor functioning of those brain lobes, the frontal and temporal. When frontal involvement predominates, there is usually a presentation with behavioral and behavioral symptoms, which is the behavioral variant. There would usually be disinhibition, compulsive behaviors, and apathy. Usually, this problem appears in younger patients. Therefore, it can confuse and patients may end up being evaluated by psychiatry, and that often delays the diagnosis,” explains Camiña.
This explains the speech symptoms that the actor had manifested in the first phase of the disease. «In the variant of primary progressive aphasia, language stands out. There are several types of affectation, but they are people who present a progressive difficulty in expressing, understanding or constructing sentences. Then, other symptoms are associated as in other dementias, which affect behavior and cognitive abilities,” observes the neurologist.
In addition to its symptoms, the key to detecting this disease lies in the age at which they begin to manifest. «In general, frontotemporal dementia occurs in younger patients than Alzheimer’s disease, in the late 50s and early 60s. Neurologists, with these symptoms, if it is a person too young to “If you have Alzheimer’s, we have to evaluate if it is frontotemporal dementia,” says Camiña.
Is there treatment?
Its approach is symptomatic, that is, it is aimed at controlling the symptoms, since it lacks specific treatment and there is currently no evidence that any treatment can modify the course of the disease. Frontotemporal dementia is the third most common cause of neurodegenerative dementia, after Alzheimer’s disease. Alzheimer and dementia with Lewy bodies.
«The issue is that this disease does not have a specific treatment. Having the diagnosis always helps the family know how to manage it, but in the case of Bruce Willis, the fundamental thing is language treatment, speech therapy. From there, the treatment of other symptoms that may accompany it, such as antidepressants, medications for sleep problems, if there are behavioral problems, drugs can be used to prevent hallucinations. But there is no specific medication for the disease,” Camiña clarifies.
The truth is that the disease will end up advancing. In this sense, “speech therapy serves to maintain or slow down its evolution, but also, above all, to train other communication strategies between the patient and her family. If there comes a time when you cannot express yourself orally, you have to write, or learn to use gestures. In speech therapy, tools are given, but sometimes it is difficult for us to see a very obvious effect in the patient. When a few years pass, the evolution of the disease is greater than what speech therapy can help to manage,” explains the expert.
Although studies are constantly being carried out to find effective drugs against dementia, the truth is that, in most cases, these are developments against Alzheimer’s. «Alzheimer’s receives a lot of attention because, in general, frontotemporal dementia has many different variants associated with it. There are gene therapy trials and then other very early drugs. There are few studies and, as it has a greater genetic component than other dementias, this may be a point of development. There are some trials with current Alzheimer’s medications, but in general, with very little response. As of today, there is little done. There will probably be some new developments, but not five years from now,” explains Camiña.
Can it be prevented?
Cases like that of Bruce Willis are difficult to avoid, since it is a type of dementia with a large genetic component. This is how Camiña explains it: «It is complicated, because having risk factors with a lot of genetic influence, it is difficult to prevent. In terms of the progression of the disease, other associated problems such as vascular risk, which, in dementia, accelerates the decline a little or accumulates the damage, does not have as much weight here as in Alzheimer’s. “It is a disease that is less conditioned by the patient’s way of life.”
However, exercising the mind can be useful to limit, as much as possible, the progression of the disease, improving the person’s quality of life. “For example, having a intellectual activity “That allows reading and social activities generates greater cognitive or language reserve, but there is nothing very specific for prevention,” says the neurologist.
If we talk about dementia at a general level, the panorama changes. Here we can influence the risk with our lifestyle over the years. «The best way to reduce the risk of dementia is to have a physically active life, avoid a sedentary lifestyle, do regular physical activity. Avoid vascular risk factors, avoid hypertension, diabetes, cholesterol, tobacco, sleep apnea. And, from there, having an intellectually active and socially active life has also been shown to improve the preservation of brain function. Various studies have shown that people who live in a bilingual environment have greater linguistic ability and easier recovery than those who only know one language. Learning a language, mastering it, the more vocabulary we have, the more we speak it, that’s what matters,” explains Dr. Camiña.
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