Bruce Willis is stepping away from acting. The 67-year-old actor, well known for his roles in the Die Hard series, The Sixth Sense, Pulp Fiction, as well as many others, has recently been diagnosed with aphasia, his family said. Ex-wife Demi Moore announced on Instagram:
“To Bruce’s amazing supporters, 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. As a result of this and with much consideration Bruce is stepping away from the career that has meant so much to him. This is a really challenging time for our family and we are so appreciative of your continued love, compassion and support. We are moving through this as a strong family unit and wanted to bring his fans in because we know how much he means to you, as you do to him. As Bruce always says, ‘Live it up’ and together we plan to do just that.”
The statement was jointly sent by Moore, their daughters Rumer, Scott, and Tallulah, as well as Willis’ current wife Emma Heming Willis, and their daughters Mabel and Evelyn.
The Los Angeles Times reported that those who have worked with Willis recently have been concerned about his cognitive decline. He struggled to remember his dialogue, and at times would need to be fed his lines through an earpiece. In some cases, his lines were shortened, and increasingly, action scenes, especially those with complex choreography, were filmed with a body double.
However, fans shouldn’t worry about missing new Willis movies for quite a while. According to IMDB, he has two films out this year: Gasoline Alley and A Day to Die, and eight other films are already completed or in post-production.
What Is Aphasia?
Aphasia is a neurological disorder caused by damage to the portions of the brain that are responsible for language production or processing. For most people, these areas are on the left side of the brain. Aphasia may occur suddenly or progressively, depending on the type and location of brain tissue involved.
The disorder impairs the expression and understanding of language as well as reading and writing. Aphasia may co-occur with speech disorders, such as dysarthria or apraxia (the inability to put together the correct muscle movements to produce speech), which can also result from brain damage.
Aphasia is not a disease, but rather, a symptom of brain damage. Although it is primarily seen in individuals who have suffered a stroke, aphasia can also result from conditions such as a brain tumor, infection, inflammation, head injury, or dementia that affects language-associated regions of the brain.
It is estimated that about 1 million people in the U.S. today suffer from aphasia. The type and severity of language dysfunction depends on the precise location and extent of the damaged brain tissue.
The Brain Anatomy of Language
There are several areas of the brain that play critical roles in speech and language:
- Broca’s area: Located in the posterior inferior frontal gyrus, Broca’s area is associated with speech production and articulation.
- Wernicke’s area: Located int the posterior superior temporal lobe, Wernicke’s area is associated with language processing and comprehension.
- Arcuate fasciculus: A band of nerves that connects Broca’s and Wernicke’s areas. It is important for word formation, speaking clearly, and understanding concepts in language form.
- Angular gyrus: Located in the anterolateral region of the parietal lobe, near the superior edge of the temporal lobe, this involves problems in transferring visual information to Wernicke’s area, in order to make meaning out of visually perceived words.
Generally, aphasia can be divided into four broad categories:
- Expressive aphasia (also called Broca’s aphasia) involves difficulty in conveying thoughts through speech or writing. The person knows what they want to say but cannot find the words needed.
- Receptive aphasia (Wernicke’s aphasia) involves difficulty understanding spoken or written language. The individual hears the voice or sees the print but cannot make sense of the words.
- Global aphasia results from severe and extensive damage to the language areas of the brain. People lose almost all language function, both comprehension and expression. They cannot speak or understand speech, nor read or write.
- Individuals with anomic or amnesia aphasia, the least severe form of aphasia, have difficulty in using the correct names for particular objects, people, places, or events.
Aphasia can also be characterized as fluent or non-fluent. Wernicke’s aphasia is the most common type of fluent aphasia. Those afflicted often speak in long sentences that don’t make sense. They may add unnecessary words or made-up words, and are typically unaware of their mistakes.
Broca’s aphasia is the most common type of nonfluent aphasia. Those with this type of aphasia may understand speech and know what they want to say, but are unable to do so. They frequently use short phrases, which are produced with great effort.
Treatment of Aphasia
In some instances, an individual will completely recover from aphasia without treatment. In most cases, however, language therapy should begin as soon as possible and be tailored to the individual needs of the person.
Research has shown that language and communication abilities can continue to improve for many years and are sometimes accompanied by new activity in brain tissue near the damaged area. Some of the factors that may influence the amount of improvement include the cause of the brain injury, the area of the brain that was damaged and its extent, and the age and health of the individual.
Rehabilitation with a speech pathologist involves extensive exercises in which individuals read, write, follow directions, and repeat what they hear. Computer-aided therapy may supplement standard language therapy.
Aphasia therapy aims to improve a person’s ability to communicate by helping the individual use their remaining language abilities, restore language abilities as much as possible, and learn other ways of communicating, such as gestures, pictures, or use of electronic devices.
Individual therapy focuses on the specific needs of the person, while group therapy offers the opportunity to use new communication skills in a small group setting.
Recent technologies have provided new tools for people with aphasia. “Virtual” speech pathologists provide patients with the flexibility and convenience of getting therapy in their homes through a computer. The use of speech-generating applications on mobile devices like tablets can also provide an alternative way to communicate for people who have difficulty using spoken language.
According to the National Institute on Deafness and Other Communication Disorders (NIDCD), a relatively new area of interest in aphasia research is noninvasive brain stimulation in combination with speech-language therapy.
Two such brain stimulation techniques, transcranial magnetic stimulation and transcranial direct current stimulation, temporarily alter normal brain activity in the region being stimulated. Researchers originally used these techniques to help them understand the parts of the brain that played a role in language and recovery after a stroke. Recently, scientists are studying if this temporary alteration of brain activity might help people re-learn language use, and several clinical trials funded by NIDCD are currently testing these technologies.
Michele R. Berman, MD, is a pediatrician-turned-medical journalist. She trained at Johns Hopkins, Washington University in St. Louis, and St. Louis Children’s Hospital. Her mission is both journalistic and educational: to report on common diseases affecting uncommon people and summarize the evidence-based medicine behind the headlines.