What It Means if a Family Member Has Aphasia vs. Dementia

This week, America learned the sad news that Bruce Willis plans to "step back" from his lucrative and long-standing career in Hollywood because he's suffering from aphasia. As parents, there's a chance your kids have heard or read the news and are wondering what aphasia is. Or perhaps they have grandparents or other loved ones dealing with aphasia or memory loss. It can be difficult for kids to understand these complicated disorders, and how to interact with people dealing with them.

Many people have never heard the term before, and likely don't have any idea what aphasia is. But I have personal experience with it, and I know how terrible it is. I'll share my story here, and also discuss what may be going on with Bruce Willis.

The vast majority of people tend to closely associate aphasia with dementia and other neurodegenerative disorders, so I'll go into the similarities and differences between aphasia versus dementia as well.

What Is Aphasia?

In short, aphasia is a condition that affects a person's ability to communicate and express oneself, says James Dan, M.D., geriatric clinical advisor and member of the Senior Helpers Board of Directors. "Aphasia manifests itself in the inability to read, talk, or write, and is not as much a condition in its own right, but rather is a symptom of a condition, often neurological in nature." In general, aphasia isn't a black and white situation; people suffering from aphasia may have moments of confusion followed by long spans of time where they're completely lucid. It isn't a situation where one day a switch is flipped and they can no longer find the right words.

Expressive aphasia, receptive aphasia, and global aphasia

There are two main types of aphasia, says Dr. Dan. The first is called expressive aphasia or Broca's aphasia. "Expressive aphasia typically manifests as difficulty in word-finding when speaking or writing. You know in your head what you wish to say, but quite literally can't find the words to say it," says Dr. Dan. The second type of aphasia is referred to as receptive aphasia, or Wernicke's aphasia, which means you have a difficult time understanding something that's said to you. "In a case like this, you can read and hear the words, but do not understand what they mean," says Dr. Dan.

Global aphasia, the most severe form of aphasia, occurs when there's widespread damage to the brain—often following a stroke, brain tumor, or traumatic brain injury—and can impact a person's ability to understand language or communicate at all.

One thing's for sure: aphasia can be terrifying when it strikes for the first time, and is likely incredibly frustrating if it endures, both for the sufferer and for those interacting with them. I was lucky; my experience with aphasia was brief, a condition called "transient aphasia," and it left no long-term side effects. After a visit to the emergency room and several follow-up visits with a neurologist, it was determined that the most likely cause of my episode of aphasia was an ocular migraine. We'll go into that and some other possible causes below.

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What Causes Aphasia?

Aphasia occurs across all age groups, races, and gender but is most common in older adults. If your kids will be spending time with a grandparent or other loved one who's suffering from aphasia, it may be helpful to explain why it's occurring. Here are some possible causes of aphasia.

Stroke

Most cases of aphasia are vascular in nature, says Dr. Dan, which means they're related to having a stroke. According to a study published in the Journal of Internal Medicine, as many as one-third of stroke patients suffered aphasia either during or immediately following their stroke.

Primary Progressive Aphasia

This rare neurological condition is actually a form of dementia where the main—and often only—symptom is aphasia. The disease tends to progress slowly, but ultimately causes sufferers to lose their command of language entirely.

Dementia

Memory-loss conditions like dementia and Alzheimer's attack the brain. As they progress, this of course can include the speech and language centers of the brain, which can lead to aphasia. This isn't reversible and can worsen to the point where sufferers no longer speak at all.

Ocular Migraine

Likely the least common cause of aphasia, especially among elderly people, is an ocular migraine. "Ocular migraines are a type of headache caused by blood vessel spasms, impacting one's vision, which can alter the ability to read, write, and recall words," says Dr. Dan. "Ocular migraines are a specific type of vascular problem linked to the condition. Meaning, aphasia can occur as a symptom of ocular migraines. Usually, these are reversible episodes that generally last a short period of time."

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Is Aphasia the Same as Memory Loss?

On some level, it makes sense to group aphasia into the same category as conditions like Alzheimer's and dementia. After all, someone suffering from aphasia will likely appear confused and unable to communicate properly. But many people suffering from aphasia don't have any memory issues whatsoever; they know exactly what they want to say, they simply struggle to find the right words to say what they're thinking.

Aphasia vs. Dementia

Dementia refers to a variety of memory-loss conditions that turn everyday tasks that are otherwise seen as simple, such as dressing, bathing, or eating, into difficult tasks because the person can't remember how or why to do them, says Dr. Dan. Often a person with dementia will struggle to remember a variety of things, rather than just words. They may forget where they live, what their name is, and even who certain family members are. There's no cure for this type of degenerative disease, which will progress to the point where a person forgets even the most basic functions, like how to eat.

While aphasia and dementia are different conditions on the surface, aphasia is often a symptom of dementia. "In Alzheimer's and less common dementias, the disease process affects specific speech areas of the brain, causing aphasia," says Dr. Dan. "While Alzheimer's is not always the definitive cause of aphasia, it's common that people living with Alzheimer's also have some form of aphasia."

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What to Tell Your Kids About Aphasia

The best thing you can help your kids keep in mind when visiting a loved one with aphasia is to show them love and respect in the same way as before they began to struggle with words. When engaging someone with aphasia in conversation, it helps to speak slowly and clearly, and only discuss one topic at a time to reduce confusion. There's no need for your kids to try to "carry" the conversation, or pretend they can understand what's being said. Instead, encourage your kids to relax and be themselves. While conversation is undoubtedly more difficult, there's a good chance the person suffering from aphasia will enjoy being around the people they love.