What is aphasia, the condition Bruce Willis lives with?

Written by Abby Foster, Allied Health Research Advisor, Monash Health

After a career spanning 40 years, 67-year-old Bruce Willis has stepped away from acting due to health issues, including a diagnosis of aphasia.

Willis’ family released a heartfelt statement via Instagram today to let fans know.

Never heard of aphasia? You’re not alone.

Aphasia is a communication disability caused by damage or changes to the language networks of the brain.

Often considered a difficulty with “getting words out”, aphasia can in fact impact every aspect of a person’s life.

How does aphasia affect people?

A person with aphasia can have difficulty speaking, understanding others, reading, writing and using numbers.

Aphasia impacts everything from conversations, negotiating, expressing emotions, storytelling, asking questions, to writing an email.

When communication is affected, so is the ability to share information, engage in relationships and interact meaningfully with the world.

Aphasia can change relationships with family and friends, make it harder to get out and do things (such as use public transport or do the shopping), affect self-identity and, as for Willis, can impact the ability to work.

Depression and other negative mood changes are common in people with aphasia, as is a reduction in their self-perceived quality of life.

Willis has given up his acting career due to the condition. Frank Masi/AAP

What causes aphasia and how common is it?

Different types of aphasia can result from different brain conditions, most commonly stroke but also brain tumour, traumatic brain injury, and types of dementia, such as primary progressive aphasia.

So there is a wide range of variability in the severity and types of communication affected.

Primary progressive aphasia can occur in younger people, but is most commonly diagnosed between age 50 and 75.

One-third of people who have had a stroke will also experience aphasia.

While it’s most likely to affect older adults, brain injuries, strokes and tumours causing aphasia can also affect children, adolescents and young adults.

Based on current stroke statistics, it is estimated that at least 140,000 Australian live with aphasia.

Despite the high rates and evidence of negative impacts, awareness of aphasia in the public and health-care professions is low.

What else plays a role?

A person’s environment has a big impact in enabling or disabling people with aphasia.

The social determinants of health influence the way someone experiences, recovers from, and lives with aphasia.

So people who have good access to health care, who hold high social positions, are wealthy, and have the support of an engaged family may be less impacted by the condition. Willis can be grateful in this respect.

The impact of aphasia is not just felt by the person with aphasia. The psychological and social impact, as well as the disability resulting from aphasia on the family is significant.

How is it treated?

There is no cure for aphasia. But interventions such as speech pathology can make a massive difference. Though there is no “one size fits all” approach.

Speech pathologists are experts in communication disabilities. They work within multidisciplinary health-care teams across a variety of hospital and community-based sites. This includes working with medical, nursing and allied health professionals such as psychologists, occupational therapists, social workers and physiotherapists.

Interventions for people with progressive and post-stroke aphasia are tailored to the person, their family and community, with consideration of many factors including aphasia diagnosis and cause, severity and type of communication difficulties, level of participation in communication-related activities, the communication environment, their goals, mood and quality of life.

New and improved treatments are also being developed.

Bruce Willis and his wife on the red carpet.

Willis’ family posted the news of his diagnosis to social media. Evan Agostini/AAP

Do I have aphasia? What should I look out for?

Sudden or gradual decline and changes in communication, personality, behaviour, memory and thinking skills should be investigated by a doctor. This could be a local GP, neurologist or geriatrician. A speech pathologist can also be a part of this process.

Be aware of the signs of stroke and aphasia associated with dementia. This may include difficulty finding the right word, mixing up words or sounds (for example, “cat” or “gog” for “dog”), using nonsense words, not being able to get any words out or not being able to understand others. If these changes are sudden or accompanied by a facial droop or difficulty moving your arms or legs, treat it as a medical emergency and seek urgent medical attention.

Willis and his family demonstrate love and strength in facing aphasia “head on”. Their sentiments of embracing social connectedness and to continue to live by Willis’ words of “Live it up” provide hope for others with aphasia around the world.

We can all play our part in being more effective communication partners for people living with aphasia.

Authors: Abby Foster, Allied Health Research Advisor, Monash Health