Actor Bruce Willis in 2018
Less than a year after announcing that Bruce Willis was diagnosed with aphasiathe actor’s family released a more specific diagnosis this Thursday: the 67-year-old artist has a type of insanitycurrently without a cure, called frontotemporal dementia (FTD, its acronym in English).
According to two doctors interviewed by the BBC, the aphasia — language impairment, manifested by difficulty speaking or understanding other people — is a frequent first sign of frontotemporal dementia. Aphasia can have several causes, such as a stroke or a brain infection, but when related to dementia such as frontotemporal or Alzheimer’s and other signs, is characterized as primary progressive aphasia (APP).
according to a study published in October 2022 in the scientific journal Nature Communications, FTD is responsible for 5 to 10% of cases of dementia. The most common type of dementia remains Alzheimer’s.
Neurologist Gustavo Franklin explains that, as the name implies, frontotemporal dementia affects the frontal and temporal regions of the brain. There is a variant of the disease that manifests itself, as in the case of Willis, in the language difficulties (more associated with the impact on the temporal region). There is also a variant marked by changes in behavior (connected to the frontal region).
“At the beginning of the diagnosis, there may be changes in behavior, such as the expression of more sexual language. Disinhibition is very characteristic”, says Franklin, referring to the behavioral variant.
“And these behavioral changes can lead to wrong diagnosesas anxiety, depression, bipolarity It is schizophrenia. Already in language, the person is taken as inattentive, lazy, anxious “, completes the doctor from Hospital Marcelino Champagnat, in Curitiba (PR).
Coordinator of the neurology sector at Hospital Santa Lúcia, in Brasília (DF), the physician Thais Augusta Martins clarifies that the diagnosis of this type of dementia rarely occurs in the first consultation, but over time. Clinical diagnosis — that is, based on medical follow-up — is the main way of identifying the disease, but it can be complemented by imaging tests, genetic analysis It is cognitive tests.
This is even the combination of information that allows to differentiate the type of dementia—for example, Alzheimer’s FTD.
“Bruce Willis’ diagnosis was only completed now. In fact, it is really over time that the diagnosis will be made, with the evolution of the clinical picture, possibly reaching the name and surname of the disease”, explains the doctor, who is also director of medical assistance at Hospital Santa Lúcia.
In a note signed by the five daughters of Willis, by current wifeEmma Heming, and by ex-wife, Demi Moore, the family thanked the fans for their affection and announced the new diagnosis. “Unfortunately, the challenges in communication are only one of Bruce’s symptoms. Although be something painfulit is a relief to finally have a clear diagnosis”, says the note.
In March 2022, upon disclosing that the actor had aphasia, the family also announced that he would put term the career.
genetic background
The disease is progressive, which means that it is not possible to reverse it and that the clinical condition tends to worsen over time. In reality, only the symptoms can be treated. “There is not no medicine that changes the natural course of the disease. Doctors medicate for behavioral part and multidisciplinary therapies, such as physiotherapy and speech therapy”, points out Thais Augusta Martins.
Frequently, frontotemporal dementia (FTD) manifests itself in the so-called pre-senile period, that is, before age 60 — more precisely among the 45 and 65 years old. This is a different feature of Alzheimer’s, which tends to appear later.
The study published last year in Nature Communications found that in about 15% of cases, FTD is related to the specific mutation of a gene. According to doctors, this form of dementia has a strong background genetic —more than Alzheimer’s. Therefore, the same family more than one person can have FTD over time.
“Have been discovered countless genes associated with frontotemporal dementia. However, the determining genes are not always identifiable — so the medical community does not advocate research (genetics) for those who don’t have cases in the family”, says Franklin.
For the families of those with this type of dementia, Martins recalls another challenge: dealing with the changes expressed by a loved one. “The patient begins to do inappropriate things, saying inappropriate things in public. It is a suffering for the family, it is difficult to accept. The family says: wow, he would never say that, he would never say bad words”, exemplifies the doctor. less speech abilityand the family suffers a lot from it too.”
Willis’s family, in the released statement, said they hoped the actor’s situation help to raise awareness about the disease.
“At the moment, there are no treatments for the disease, a reality that we hope can change in the coming years. As Bruce’s condition progresses, we hope that any media attention will raise awareness of this disease, which needs much more knowledge and study.”
“Bruce has always believed in use of his voice to help other people and to draw attention to important matters, both in public and private,” wrote the actor’s daughters, wife and ex-wife.
