In the not too distant past (last year, I think), Bruce Willis’s publicist made an announcement that he would be retiring from acting because of a diagnosis of aphasia. A few weeks ago, news broke that Willis’s diagnosis was "upgraded" to frontotemporal dementia. If you’re in your middle age years, like me, you know Bruce Willis was an amazing actor for so many roles- from the Die Hard series to a stint on Friends- and this may come as a shock that he’s "old" and has retired from acting.
The thing is, aphasia does not equal old age. Nor does dementia. And they really aren’t even common in older adults. So, for this to make US feel old, because he’s aging too.... aphasia and dementia aren’t the triggers here. Fear of aging is. Regardless, let’s explore what these are, and why it is so impactful to the career of an actor.
What is aphasia?
Simply put, aphasia is the loss of language function. This can happen for several reasons and have several different outcomes. That is, aphasia can impact language comprehension or language production or word naming or any other specific language function you can think of. It can singularly impact one of these, or impact a combination of functions. All of that depends on what part of the brain has been hit.
So, while language is primarily controlled in the left side (hemisphere) of the brain, there are several locations that work for more specific language functions. For example, Broca’s area is located closer to the front of the brain (frontal lobe) and is responsible for language output/production. Alternatively, Wernicke’s area is located further back on the left side of the brain (temporal lobe) and is responsible for making language make sense. The location therefore, varies with the function.
Why does this happen and what are the consequences?
The most common cause of aphasia is stroke. (Bruce Willis did not have a stroke, and I’ll discuss the specific cause to his aphasia in just a minute). And, for an adult at least, damage of some kind to one or more of the language centers can result in aphasia of some kind. Damage from stroke, traumatic brain injury, Alzheimer’s disease, cancer, Parkinson's disease related dementia, etc. can cause lots of different brain and function changes- including aphasia.
In Willis’s case, we've recently learned that his diagnosis for the cause of his aphasia is frontotemporal dementia. Remember above, where I said that language function is primarily located in the left frontal and left temporal lobes of the brain? And that damage to those areas could result in aphasia? That’s exactly what the frontotemporal dementia did. The dementia caused deterioration of the brain in those areas, leading to the loss of language function.
The consequences of this for the typical individual can be scary and/or life altering. But for an actor? Career ending. Imagine needing to speak for a role, and being completely unable to produce words (as in the case of Broca’s aphasia)? But even if your livelihood isn’t speaking, imagine what it’d be like to be unable to speak, write an email, or even understand what someone is saying to you? The frustration, fear, and potential for loss of social connection is hard for the aphasic patient and for their family.
Is there a cure?
Possibly. It depends on the cause. If the cause of aphasia is stroke (and we can stop the occurrence of an additional stroke or strokes) or traumatic brain injury (where what’s done is done and isn’t going to progress), we could use speech-language therapy to reroute brain signals to remediate some of the language function lost.
However, in the case of dementia, there is no stopping it. The deterioration will likely progress, and attempts at rerouting language messages to other brain pathways wouldn’t be long-lasting (even if we could make them happen in the first place). In fact, the symptoms will likely continue to increase and progress to things beyond language function, including behavioral challenges and personality changes... depending on which part of the brain is attacked next.
Treatment for frontotemporal dementia is primarily focused on treatment of the symptoms. For example, one might see antidepressant or antipsychotic medications used to help with behavior challenges. Unfortunately, these are not going to stop the progression or the damage set to occur.
The Perspective
Lest we think that this is all doom and gloom- it isn’t. While this is a difficult road for Willis to walk, and my heart breaks for him and his family as they maneuver through these next steps in his health journey, this is not the norm. Dementia of any kind, aphasia of any kind, stroke, and traumatic brain injury are NOT the way we typically age. Typical aging does not include these processes and health concerns. We can move into our older years with knowledge, compassion for the struggles we have, and create a culture of understanding that aging does not equal disease.
...and let us send prayers, healing vibes, or whatever you believe in to Willis and his family. This isn’t easy.
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