After retiring from acting in March 2022 due to a speech disorder called aphasia, Bruce Willis, 67, has been diagnosed with frontotemporal dementia, his family announced Thursday.
“Since we announced Bruce’s aphasia diagnosis in the spring of 2022, Bruce’s condition has progressed,” the Willis family said in a statement. “Unfortunately, the challenges with communication are just one symptom of the illness Bruce is facing. While this is painful, it is a relief to finally have a clear diagnosis.”
Frontotemporal dementia, or FTD, is a group of disorders caused by a buildup of tau and other brain cell-destroying proteins in the brain’s frontal lobes (behind the forehead) or temporal lobes (behind the ears). ). The condition usually appears between the ages of 45 and 64, according to Alzheimer’s Research UK.
“The most common dementia for people under the age of 60, FTD can cause communication problems, as well as changes in behavior, personality or movement,” according to a statement from the Association for Frontotemporal Degeneration.
People with FTD typically live six to eight years with the condition, according to the US National Institute on Aging. Between 10 and 30 percent of FTD cases are hereditary. Apart from genetics, there are no other known risk factors, although researchers are investigating what role the thyroid and insulin may play in the onset of the disease.
WHAT ARE THE TYPES OF FTD?
Because his symptoms started with slurred speech, Bruce Willis would be classified as having a type of FTD called primary progressive aphasia, said Dr. Henry Paulson, professor of neurology and director of the Michigan Alzheimer’s Disease Center at the University of Michigan. .
“Aphasia really means problems with language, and that can range from having trouble finding words to understanding what people are saying. It can occur due to a brain tumor, stroke or a progressive neurodegenerative condition,” he said. Paulson.
“Because his diagnosis is frontotemporal dementia, Mr. Willis clearly has a progressive neurodegenerative disease rather than a stroke or a tumor or some other lesion in the brain,” he added.
There are two other types of FTD. The behavioral variant of frontotemporal dementia, or bvFTD, is characterized by changes in executive functions, thinking, and planning.
Another type affects motor neurons and can manifest as an inability to swallow, stiff muscles, and difficulty using the hands or arms to “perform a movement despite normal force, such as difficulty closing buttons or operating small appliances.” , according to the National Institute on Aging.
WHAT ARE THE SYMPTOMS OF FTD?
At first, it can be difficult to know exactly what type of FTD a person has, or even if it is FTD, because the symptoms and the order in which they appear can vary from person to person and depends on which parts of the front line. or temporal lobes are affected.
In behavioral FTD, people rarely have memory problems. Instead, they have difficulty planning and sequencing their thinking and have trouble setting priorities, according to the National Institute on Aging. They may parrot the same activity or word over and over again, lose interest in life, and act impulsively, saying inappropriate words or doing things that others may perceive as embarrassing.
In primary progressive aphasia, or PPA, the person may have trouble speaking or understanding words, or may slur their words. Over time, they may not recognize familiar faces and objects. Some can become mute.
“PPA can start out with word-finding difficulty, so people start using simpler or more generic words for things they can’t remember,” Paulson said.
“That also comes with the territory of aging, but when language requires more effort on a daily basis, or comprehension goes downhill, that’s a sign that someone needs to see a doctor for an evaluation,” he said.
FTD motor neuron disorders may not affect memory, cognition, language, or behavior, especially initially. Early signs may include the inability to control movements or problems with balance and gait. A hallmark of one such disorder, progressive supranuclear palsy, is difficulty looking down or making other eye movements.
HOW IS FTD DIAGNOSED?
To diagnose FTD disorders, a neurologist will perform a careful clinical examination, along with psychological tests designed to assess cognitive abilities, Paulson said.
“An MRI of the brain can tell us if certain parts of the brain are shrinking or showing signs of atrophy. We’ll do some blood tests to make sure we’re not missing some treatable causes of cognitive decline like thyroid disease or deficiency of vitamin B12 too,” he said.
“And often, we’ll also be imaging brain metabolism,” Paulson said. “It’s positron emission tomography, or PET, and that can tell us which parts of the frontal lobes or temporal lobes are involved.”
HOW IS FTD TREATED?
Unlike Alzheimer’s disease, there are no current therapies to slow the progression of FTD. Medical professionals may attempt to improve a patient’s quality of life by prescribing medications to reduce agitation, irritability, or depression.
A speech-language pathologist can help determine the best strategies and tools for an FTD patient struggling with language skills. Physical or occupational therapy, guided by a doctor specializing in these disorders, can help with movement symptoms.
“It’s really important for people who have progressive dementia syndrome like FTD to continue to eat right, exercise regularly and stay connected with people. Those activities aren’t medicines, they don’t cure the disease, but they can help your brain work.” as well as possible,” Paulson said.
As the disease progresses, patients can continue to lead active and fulfilling lives, adapting to their symptoms in inspiring ways, he added.
“I’ve seen patients completely lose their speech, and yet they go outside, grab their camera, and take beautiful pictures of the life they’re living. They can’t tell me in words, but they can tell me in pictures.” Paulson said.
“I tell all my patients, ‘Don’t let this disease rule you. You own it,'” he added. “Sure, you have lost some skills due to the disease you have, but you still have a lot of skills left and you work with the skills you have.”