What is Aphasia and Should Seniors Worry About It?


Actor Bruce Willis has been in the news quite a bit recently, but this time it’s not about his latest action movie. In fact, the big news is that he won’t be making any more movies. That’s because he’s struggling with aphasia, a language disorder that makes it tough to speak, read, write, or understand what others are saying.

There were signs of his condition for years before his family officially announced his diagnosis and subsequent retirement from acting. According to an in-depth article about Bruce Willis in the Los Angeles Times, his fellow actors were concerned about his abilities on set. He would struggle to remember the script, and thus some of his lines were shortened. He would sometimes need to be “fed” his lines through an earpiece. And occasionally, action sequences with complex choreography were filmed with a body double – perhaps because Willis had trouble understanding the detailed instructions necessary to stay safe during the stunts.

Seeing the news about aphasia’s effect on Bruce Willis’s life and career might make you wonder if aphasia is something you need to worry about, too. That’s especially true if you’ve been stumbling over words, finding it tough to say what you mean, or suffered from a momentary lapse in memory when you can’t remember what you meant to say. But aren’t those all things that naturally come with aging?

Understanding what aphasia is can help differentiate when this condition may be present versus what is normal behavior for senior adults. Let’s look at this unique condition.

What is Aphasia?

The National Aphasia Association defines the condition as “an acquired communication disorder that impairs a person’s ability to process language, but does not affect intelligence.

Those who have aphasia might lose the ability to speak. They can also have difficulty with reading and writing. It can be tough for them to understand what others are saying. That is because the language center of their brain is affected; in most cases, nothing else is. That’s why aphasia is not considered a cognitive disorder.

There is some misunderstanding that the person with aphasia has a sort of mental illness or cognitive impairment. This isn’t true at all. Someone with aphasia is just as intelligent as they have always been. But it’s easy to see how someone might make that assumption, as a person with aphasia might be able to speak, but what they say can be jumbled and make no sense.

According to Rush University Medical Center, there are three primary types of aphasia:

·         Receptive Aphasia. This happens when a person has damage in the temporal lobe. They can speak but it might be tough to understand them. They know exactly what they are trying to say but their brain just doesn’t allow them to say it. On the other hand, they might have trouble understanding even simple words and sentences from others.

·         Expressive Aphasia. This happens when there is damage to the frontal lobe. A person can often understand everything that is said to them but have difficulty speaking in response. They might find it easier to communicate with single words. And though they can often get their point across, their grammar is affected; they will likely “lose” verbs and use too many nouns. They might also use gestures to communicate better.

·         Primary Progressive Aphasia. This type of aphasia, sometimes known as PPA, is caused by deterioration of the brain. These individuals might miss words during conversations, replace one word with another that is often similar (such as using “cat” for “leopard”) or make up words that sound like nonsense. It’s important to remember that PPA is not dementia. With dementia, the memory is often affected first, and that can lead to problems with language. With PPA, the person’s memory is intact.

Though these are the primary types of aphasia, there can be many other forms of it[1]. A specialist can narrow down the type as they investigate the cause and create a treatment plan.

The good news is that not everyone who has aphasia will continue to get worse. Aphasia can be caused by numerous things, including a brain tumor or a serious brain injury, but it is most often caused by stroke. Those who have a stroke or brain injury will likely not see their language abilities get worse; whatever form their aphasia takes is as bad as it gets. However, those with PPA could see everything related to speech and understanding it decline slowly over time.

Is Aphasia a Condition of the Elderly?

Cases of aphasia do tend to increase with age, but that’s not necessarily because aphasia attacks the elderly. And it’s important to remember that aphasia is not a common condition; according to the National Institute on Deafness and Other Communication Disorders, only about 180,000 people are diagnosed with it each year. It usually occurs in those who are middle-aged or older. Bruce Willis was 67 when his family announced the diagnosis. 

The increase of aphasia cases with age could stem from the fact that more seniors have strokes than younger people. It’s also more common for elderly people to fall, which could lead to the traumatic brain injuries that might cause aphasia.

To protect against the consequences of being a greater fall risk, it’s important for seniors to engage in aging in place home modifications that can keep them safer, such as grab bars installed in the bathroom or non-skid flooring installed throughout the home. It’s also a good idea to wear an emergency response solution that can allow you to reach out for help immediately if you do fall. Prompt medical attention can make all the difference, especially when it comes to a brain injury.

Treatment for Aphasia

Though aphasia can’t be reversed, it is possible to work with a speech therapist to regain some language skills. Some individuals can get back enough function to continue on with their lives as normal, with some adjustments. Others might not get back function at all.

It begins with an MRI to determine what is causing the aphasia. Brain tumors often grow slowly and affect other parts of the body as well – these readily appear on an MRI. It is possible that the aphasia will vanish when the tumor is removed.

An infection in the brain is a much less common reason for aphasia, but it does happen.

A stroke is the most common reason for aphasia. The damage done by a stroke can appear on an MRI. It is possible for a person to have a stroke, especially a transient ischemic attack or TIA, and not know that they had one. A “silent stroke” can lead to brain injury, including aphasia[2].

A brain injury, such as that suffered from a senior falling at home, might be evident from the start. However, the CDC reports that while more than one in four elderly individuals suffers a fall every year, less than half of them tell their doctor. This can be a serious issue if they bumped their head and wound up with an injury that doesn’t get treated promptly.

That’s one good reason to invest in a medical alert pendant or wristband, specifically one with fall detection. This technology means that the medical alert device itself can detect falls and automatically send a help signal. This allows you to get the help you need fast.

Remember: If you suffer a fall, it’s important to tell your doctor and get checked out right away. If your fall results in pain, injury or loss of motion, get help immediately. Seniors are at great risk of suffering an internal injury, such as a fracture, that needs to be dealt with promptly to ensure the best possible outcomes.

If aphasia has been established, speech therapy is usually the next step. This can take many forms and the treatment depends on the person’s goals. Someone might have the goal of being able to speak well enough to carry on a conversation in a room full of colleagues and continue working, while someone else might simply want to be able to send a text message.

If it becomes clear that language abilities can’t be restored, speech therapists will focus on other ways to communicate, such as drawing, gesturing, or using a text-to-speech device. Assistive technology for seniors has become much more advanced in recent years and can make it easier to communicate on a day-to-day basis. Speech therapists will also work with a person’s family to help them adapt to a new way of communicating with their elderly loved one.

Getting Support for Aphasia

Those with aphasia can be quite confused about what is happening to them, and that is exacerbated by the fact that it’s hard for them to understand the language used to explain it. They can become quite frustrated, feel isolated and depressed, and withdraw from family, friends, and the activities they used to enjoy because they have so much trouble communicating.

A Boston University study reveals that about 2.5 million people in the United States are living with aphasia. Even that conservative estimate is more than those living with ALS, Huntington’s, and Parkinson’s – combined[3]. To help ease the frustration for the person with aphasia and for their family, it’s important to educate everyone impacted as quickly and thoroughly as possible. It’s also a great idea to find a support group that can give a helping hand not only to the person with aphasia but to family, caregivers, and friends.

It’s also vitally important to think of safety for those with aphasia. Being unable to communicate can make it difficult or even impossible to communicate via phone or text. When an emergency strikes, that difficulty in communication could literally mean the difference between life and death. That’s why it’s so important to provide ways to communicate a problem that doesn’t require speech – and that’s a good reason to use a medical alert system with fall detection.

Let Alert1 help you rest a little easier by knowing that help is always just a button press away.