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Aphasia ― At a loss for words

March 31, 2022

Hollywood star Bruce Willis is "stepping away" from acting after an aphasia diagnosis. The language disorder affects a patient's ability to communicate with those around them. It's caused by damage to the brain.

Bruce Willis
Bruce Willis is perhaps best known for his role as detective John McClane in the "Die Hard" action movie franchiseImage: Angela Weiss/AFP

It came as a surprise to his fans and colleagues:  Bruce Willis' family announced that the Hollywood star would stop making movies after having been diagnosed with aphasia. Until recently, The 67-year old had worked on numerous film projects, some of which are scheduled for release this year.

"As a family we wanted to share that our beloved Bruce has been experiencing some health issues and has recently been diagnosed with aphasia, which is impacting his cognitive abilities," said a statement by Willis' ex-wife and actress Demi Moore on Instagram. "As a result of this and with much consideration Bruce is stepping away from the career that has meant so much to him."

Aphasia affects all linguistic abilities

Aphasia is the acquired inability to formulate words or comprehend language. It can occur after damage to the left side of the brain. Aphasias are usually caused by a stroke. However, brain hemorrhages or craniocerebral injuries like they occur after an accident, brain tumors or inflammatory processes can also result in aphasia. From one day to the next, a person loses the ability to communicate with words.

The sudden loss of speech affects all linguistic abilities: Speaking and understanding, as well as reading and writing.

But aphasia is "only" a language disorder. Thought processes or intellectual abilities are not or only slightly disturbed.

For those affected and their loved ones, the situation is extremely stressful. The patients can no longer name even the most mundane things in life. They know what an object is, but simply lack the words.

Different forms of aphasia

There are many types of aphasia. They can be distinguished from each other based on the extent of the damage.

Amnestic aphasia

Amnestic aphasia is the mildest form of aphasia, in which sufferers have word-finding difficulties when naming objects directly. They mask the speech disorder by, for example, paraphrasing the words or using figures of speech.

Broca aphasia

People who speak in a staccato or telegram style, using very short, simple sentences or stringing together individual key words, may suffer from Broca aphasia. Although the flow of speech is strained and slowed down by the search for suitable words, the affected person can still be understood comparatively well.

Wernicke aphasia

People who suffer from Wernicke aphasia form very long, convoluted sentences in which individual passages are sometimes repeated. Those affected seem to speak fluently, but it is very difficult for them to find the right words, and often their sentences do not make sense. That makes it difficult to understand them.

Global aphasia

People with global aphasia often speak only single words or repeat the same phrases. With this, the most severe form of aphasia, the patient can hardly be understood at all.

Therapy partially possible

The acquired speech disorder is not irreversible, but it requires a lot of training in targeted speech therapy to learn to speak, and often also to write again.

Especially after a first stroke, about one third of the patients experience a largely normalization of speech functions within the first four weeks. After that, however, the chance of improvement declines steadily.

This article was originally written in German.

Edited by Andreas Illmer

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