Aphasia Can Impact All Aspects of Communication

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Aphasia affects two million Americans, according to the National Aphasia Association (NAA), but a 2016 survey from the organization found that less than nine percent of respondents knew what the condition was.

Visibility is increasing as celebrities like Bruce Willis, who went public in March 2022 about his diagnosis, and Wendy Williams (who was recently diagnosed with the language disorder), share their experiences. Now more people are beginning to understand just how serious it can be.

Both Williams and Willis are reported to have been diagnosed with frontotemporal dementia (known as FTD), in addition to aphasia. FTD is a group of brain disorders impacting the front and temporal lobes of the brain, which can result in language, behavioral, and personality changes, per Mayo Clinic.

It's not uncommon for aphasia and dementia to be connected. In fact, "people with the most common types of dementia, such as Alzheimer's disease and vascular dementia, usually have a mild form of aphasia," according to the United Kingdom National Health Service.

Though aphasia isn't talked about much, both celebrity diagnoses have brought new attention to the disorder as well as its impact on patients and their loved ones. Here's everything you should know about the condition, including aphasia symptoms, causes, and treatments.

What Is Aphasia? Symptoms and Causes

"Aphasia is the inability to communicate or speak," says May Kim-Tenser, MD, neurologist with Keck Medicine of USC. Aphasia presents in different ways (see below), but the condition can affect all aspects of communication: speaking and understanding spoken word, as well as writing and reading.

"Usually aphasia occurs after a stroke, and it's pretty sudden in onset, or it can occur after a head injury," Dr. Kim-Tenser says. Aphasia may also come on gradually from a slow-growing brain tumor or a degenerative disease, such as dementia. "Usually [aphasia caused by those conditions] is chronic and happens over time," Dr. Kim-Tenser explains.

Because of the relationship between strokes and aphasia, people with risk factors for stroke (including high blood pressure, diabetes, and high cholesterol) are also at higher risk for aphasia. Older people, especially people over the age of 65, and those with a family history of stroke are also at higher risk.

Though all types of aphasia affect language, specific symptoms vary between people and forms of the condition. The NAA recognizes several different types, including the following.

Global aphasia: This is the most severe form of the condition. Patients with global aphasia can produce "few recognizable words," are able to understand little to no spoken language, and cannot read or write.
Broca's aphasia, or nonfluent aphasia: Patients with Broca's aphasia may be able to read and understand speech but have severe difficulty with speech and writing.
Wernicke's aphasia, or fluent aphasia: This form of aphasia impairs the ability to write, read, or understand speech. According to the NAA, patients with Wernicke's aphasia can produce "connected" but abnormal speech interspersed with irrelevant words and confusing sentences.
Anomic aphasia: People with anomic aphasia have a persistent inability to find the exact word they're looking for, especially nouns and verbs. This goes for both speaking and writing, although they can typically read and understand speech.
Primary progressive aphasia: This form of aphasia is caused by neurodegenerative diseases, such as Alzheimer's or FTD, and is characterized by a slow, progressive impairment of communication ability.

Is Aphasia Treatable?

Treatment for aphasia varies based on the cause of the condition, Dr. Kim-Tenser says, but typically involves speech and language therapy. Patients "need to relearn and practice language skills," she explains. Depending on their type of aphasia, they may also learn other ways to communicate. Techniques might include writing but not necessarily verbally communicating the language or using a board with letters, Dr. Kim-Tenser explains.

It's important to remember that aphasia that comes on suddenly can be both the result of stroke or a sign that a stroke is occurring. If you notice that you or someone else is suddenly struggling to speak coherently, call 911 and go to the emergency room, Dr. Kim-Tenser says. If it is an acute stroke, there are "acute treatments that can potentially reverse the aphasia," she explains, including clot-busting medications or surgically removing a clot in the affected blood vessel.

For those affected by long-term aphasia either personally or with a loved one, frustration over communication is common, Dr. Kim-Tenser says. Some patients are just not able to communicate what they're trying to say. "There's a lot of patience that needs to be had," she says. Dr. Kim-Tenser also notes that aphasia support groups and stroke support groups (for those whose aphasia was caused by a stroke) are available for patients and their families.