Attenuating Aphasia

You’re telling a funny story about something that happened on your work commute and you have to stop mid story because you can’t get out certain words. You notice that it has been happening a lot lately. More than your average tip of the tongue forgetfulness. Could you have aphasia?

Aphasia is not a cognitive disorder and does not affect intelligence. Most frequently triggered by strokes or other brain trauma, the condition makes it difficult to speak, to find the proper words and to understand what is said or written. In less frequent cases, some people may have primary progressive aphasia. This secondary form of aphasia is prompted by degenerative disease such as Alzheimer’s disease and gets progressively worse over time.

Many people learned about this condition for the first time when reports surfaced that actor Bruce Willis suffered from aphasia. His family released a statement which said the condition was “impacting his cognitive abilities.”

About 1 million people in the United States currently have aphasia. Nearly 180,000 Americans acquire it each year.

Aphasia can take different forms. Some people with aphasia only have difficulty in understanding language, a result of damage to the temporal lobe, which governs how sound and language are processed in the brain. Others have difficulty speaking, indicating damage to the frontal lobe. A loss of both speaking and comprehension of language would suggest damage to both the large temporal lobe and the frontal lobe.

Almost everyone with aphasia struggles when trying to come up with the names of things they know but can’t find the name for. And because of that, they have trouble using words in sentences. It also affects the ability of those with the condition to read and write.

It is important to note that you can heal from aphasia caused by strokes with the help provided by speech therapy. With primary progressive aphasia you try to delay the progression. In fact, primary progressive aphasia can, rarely, be the first sign of Alzheimer’s disease. More commonly it is a form of frontotemporal dementia, which occurs when brain cells die in the lobes behind the forehead and behind the ears. Abnormal deposits of two types of proteins have been linked to this form of dementia.

Primary progressive aphasia starts slowly and at first can resemble the normal difficulty retrieving words that many people experience as they age. But then the forgetfulness gets worse and starts to affect daily activities.

Aphasia unfortunately is quite common. Approximately one-third of all stroke survivors suffer from it. There is no gender difference in terms of who suffers from the condition. But people at higher risk of stroke, so those with cardiovascular disabilities and diabetes, are more at risk. This also means that people of color are more at risk, simply because of the existing health disparities in this country.

Aphasia can occur at any age. It is usually people over the age of 65 simply because they have higher risk of stroke. But young people and even babies can develop the condition.

Diagnosis of aphasia is made by a neurologist usually after a stroke or hemorrhage. In these cases, patients will have displayed a sudden onset of the disorder. There will be a huge drop in their ability to communicate or speak.

With primary progressive aphasia, it’s harder to diagnose. Unlike in cases with stroke, the onset will be very mild at first, people will slowly forget the names of people or of objects. Similarly, difficulty in understanding what people are saying will be gradual. But it is these changes that trigger diagnosis.

The encouraging thing is that aphasia is treatable. In the non-progressive form consistent therapy will result in recovery of speech and understanding. One-on-one repetition exercises can help those with the condition regain speech. But the road can be long, and it depends on the extent of damage to the brain.

With primary progressive aphasia, symptoms of speech and language decline will get worse over time. Rehabilitation can help stroke survivors regain speech and the understanding of language and can slow symptoms in cases of primary progressive aphasia.

There do not appear to be any miracle drugs. For now, speech rehabilitation therapy is the most common treatment.