Frontotemporal Dementia: The Symptoms Explained by Bruce Willis
Acclaimed actor Bruce Willis has been diagnosed with frontotemporal dementia (FTD), according to a statement from his family on Thursday.
“Unfortunately, communication difficulties are just a symptom of the illness Bruce is facing,” the family writes. “While it’s painful, it’s a relief to finally have a clear diagnosis.”
In the spring of 2022, the 67-year-old ‘Die Hard’ and ‘Pulp Fiction’ actor was diagnosed with aphasia, a disorder defined by difficulties in speaking and understanding, explained Dr. Jasdeep Hundal, director of medical psychology and neuropsychology for the southern region of Hackensack Meridian Medical Group, narrates wealth. Stroke and head trauma can cause aphasia but also signal the onset of neurodegenerative diseases like dementia, he says.
The aphasia diagnosis led to Willis announcing his retirement from acting and there has been progress since then.
“FTD is a cruel disease that many of us have never heard of and can affect anyone,” the family wrote. Frontotemporal dementia (FTD) occurs when cells in the front and temporal sides of the brain die, resulting in speech and language problems.
“The neurons die off,” says Hundal. “The brain is actually shrinking.”
According to The Association for Frontotemporal Degeneration, FTD is the most common form of dementia in people under the age of 60. Aside from communication difficulties, the condition can cause “behavioural, personality, or movement changes,” the association says. Hundal says it’s important for people to know the signs and symptoms of FTD because it’s more common in younger groups.
“When we hear dementia, we generally think of Alzheimer’s,” he says, pointing out that the early signs of frontotemporal dementia may instead be subtle and language-based.
What are the symptoms of frontotemporal dementia?
FTD is degenerative, meaning that symptoms become more pronounced as the disease progresses. According to the National Institute on Aging, the symptoms of FTD can be difficult to decipher because they can reflect other degenerative diseases.
There are also different types of FTD, including behavioral FTD (bvFTD) and primary progressive aphasia (PPA).
“Symptoms of FTD are often misunderstood. Family members and friends may think a person is misbehaving, leading to anger and conflict,” according to the National Institute on Aging. “It’s important to understand that people with these disorders are unable to control their behavior and other symptoms, and lack awareness of their illness.”
Symptoms of behavioral variant frontotemporal dementia include:
- Problems with planning and prioritizing tasks
- repeat the same things
- act impulsively
- increasingly disinterested in things that are important to them
“Someone can start acting out of character in social situations,” says Hundal.
Symptoms of primary progressive aphasia (PPA) include:
- Difficulty speaking, reading, writing and understanding.
“You’re going to have trouble speaking clearly, or your dictionary in your head will shrink,” says Hundal. “You actually lose the meaning of words or you may have trouble finding the right word in conversation.”
As this type of FTD progresses, behavioral changes may also become more apparent.
“Problems with memory, reasoning, and judgment are not obvious at first but can develop over time,” says the National Institute on Aging.
Given Willis’ previous aphasia diagnosis, Hundal speculates that he falls into the primary progressive aphasia category of FDT.
“Without knowing his full history, my first thought given the limited information I have is that this is likely a PPA,” he says.
How is frontotemporal dementia diagnosed?
Most FTD cases occur between the ages of 45 and 64, and symptoms vary from person to person, which can lead to the condition being misdiagnosed as a mood disorder. Willis’ family wants to shed light on the need for more research and awareness-raising about this type of dementia so family members can understand that behavioral changes are typical in these cases.
Seeking a family doctor when these symptoms appear, followed by a visit to a behavioral neurology clinic, can help diagnose dementia using brain scans, which can examine whether the brain is actually shrinking in certain areas.
What is the prognosis for frontotemporal dementia?
The condition has no cure, and people can live anywhere from less than two years to over 10 years after diagnosis, according to the National Institute on Aging. No medications are available, Hundal says, but identifying existing symptoms can allow for other behavioral interventions, such as speech and language therapy or mental health care, if needed.
“Bruce has always found joy in life – and has helped everyone he knows do the same. It meant the world to see that sense of caring radiate back to him and all of us,” the family wrote. “We were so moved by the love you all shared for our dear husband, father and friend at this difficult time. Your continued compassion, understanding and respect will allow us to help Bruce live the fullest life possible.”
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