June 9, 2022

The loss of language: Aphasia explained

Edwin Tasch, MD, chief of neurology for Kaiser Permanente in Santa Clara, California, helps us understand this medical condition during Aphasia Awareness Month.

When actor Bruce Willis was diagnosed with aphasia in March 2022, the announcement had some people asking: What is aphasia? In fact, according to the National Aphasia Association, nearly 85% of people have never heard the term “aphasia.” 

Media outlets explained that the actor had trouble remembering his lines and even sometimes where he was.

Although it is a lesser-known disorder, aphasia affects at least 2 million Americans annually. It’s a frustrating condition that often evokes sadness and even hopelessness in those who have the condition and their families. Edwin Tasch, MD, chief of neurology for Kaiser Permanente in Santa Clara, explains the complexities of the condition and what families can do if they are experiencing this. 

What is aphasia?

Aphasia is a disorder of language and how the brain processes and produces it. There are multiple types, the 2 most common are: 

  • Expressive aphasia: When someone has difficulty producing language. Someone experiencing this may have challenges speaking, including stuttering, speaking very slowly, or an inability to speak clearly or use the correct words. 
  • Receptive aphasia: When someone has trouble understanding language, both written and spoken. The person with this condition may have difficulty comprehending what is spoken to them or what they are reading. This type is less common than expressive aphasia. 

Can aphasia affect anyone?

Yes. Although most common in people 50 or older, the spectrum is wide-ranging from 5 years old to 90. Expressive aphasia, for instance, can cause speech impediments in children when the language centers of the brain are slower to develop.

What causes aphasia?

The primary cause of aphasia is stroke. One-third of all strokes result in the language disorder. It can also be caused from a head injury or brain tumor or infection. 

Another type of aphasia, known as Primary Progressive Aphasia, is caused by a neurodegenerative disease, such as Alzheimer’s disease. PPA results from the deterioration of brain tissues vital for speech and language. Other symptoms of PPA may be memory loss. 

What does aphasia look like? 

In some people, aphasia can be very mild, making it difficult for family members and even physicians to notice. In other cases, it can be severe, affecting a person’s ability to speak clearly, write, read, and listen. All who suffer from aphasia, however, have difficulty communicating. 

Common symptoms include: 

  • Mixing up words or sounds 
  • Speaking with nonsensical words, often combining 2 words into 1
  • Inability to understand what others are saying
  • Stuttering, speaking slowly, or speaking in short, incomplete sentences

For some, aphasia can come on slowly, while for people who have suffered a stroke, for example, the symptoms are sudden.

How is aphasia treated and can it improve?

Aphasia is treated in various ways. For some people, the condition can improve, but for others it’s progressive. 

A speech-language pathologist can help people relearn lost skills or learn new ways to communicate, such as using gestures or drawing.

Since people diagnosed with aphasia are often not cognitively impaired, being unable to communicate thoughts and feelings is emotionally very difficult. Mental health therapy is recommended to cope with the side effects such as depression. 

Do you have advice for people supporting a family member who has aphasia?

Be patient. Give them time and space to communicate however they can. 

Implementing the tools recommended by a physician or therapist can help everyone involved find strategies for better communication, emotional coping, and bonding. 

Learn more about aphasia on kp.org.