What exactly does Bruce Willis’ diagnosis mean?

Sadly, the star of the “Die Hard” movies is not as invincible as the character he portrays.

Bruce Willis’ family announced in an Instagram post on March 30 that the 67-year-old actor is retiring after being diagnosed with aphasia that is “affecting his cognitive abilities.” The news quickly sparked outpourings of support, as well as comments to the Los Angeles Times and other outlets from colleagues that Willis had been struggling on set for a few years.

Aphasia is a language disorder that results from damage to the part of the brain – the Broca area – that controls both expression and understanding. It can be caused by a stroke, which means an acute loss of the ability to speak or understand words, or by a condition that develops slowly due to a tumor or neurodegenerative disease like Alzheimer’s or another dementia, said Sean Horrigan, DO, of Neurologists of Cape Cod.

“The way the news was announced for Bruce Willis, it sounds as though this is something that may have been smoldering over time,” Dr. Horrigan said.

Willis’ family did not release any details about his diagnosis, and the characteristics of aphasia can vary. Some aphasia patients have trouble understanding what they are being told; others understand words but can’t express themselves, Dr. Horrigan said. “Or, you can have more of a global process, where you’re having a hard time both receiving and expressing communication.”

There are two broad types of aphasia – fluent and non-fluent - according to the National Institutes of Health.

One type of fluent aphasia is called Wernicke’s aphasia. Patients may speak in rambling sentences filled with made-up words that make no sense. The most common type of non-fluent aphasia is Broca's aphasia, according to the NIH. Patients may understand speech and know what they want to say but are able to speak only in short phrases. Other types of aphasia, such as global aphasia, result from extensive damage to the brain’s language areas and can rob a patient of the ability to communicate.

Help for Patients

Speech and language therapists try to help a patient restore lost speech or retain and use their remaining language skills. They also teach other ways of communicating using gestures, pictures or even smartphone apps, according to the National Aphasia Association.

Some types of aphasia respond well to therapy, Dr. Horrigan said.

“If it’s related to an event, such as a stroke, then speech and language therapy can be critical in the healing process and the recovery,” he said.

Other types of aphasia caused by neuromuscular or neurodegenerative disorders like dementia are harder to treat, he said.

“But there is still some benefit to working with speech and language pathologists and rehab facilities to try and preserve what you have longer,” he said. “We know that if you don’t exercise and try to keep the brain stimulated, strong and healthy, then these kinds of conditions can progress more quickly.”

The NIH has several tips for families and friends of those with aphasia, including:

• Participate in therapy sessions.
• Simplify language by using short, uncomplicated sentences.
• Write down key words to clarify meaning as needed.
• Maintain a natural conversational manner appropriate for an adult.
• Minimize distractions, such as the TV.
• Include the person with aphasia in conversations.
• Encourage any type of communication, whether it is speech, gesture, pointing, or drawing.
• Avoid correcting the person's speech.
• Allow the person plenty of time to talk.
• Help the person become involved outside the home.