Bruce Willis Diagnosis: Symptoms of Frontotemporal Dementia

Actor Bruce Willis’ diagnosis of frontotemporal dementia has brought renewed attention to the disease, the symptoms of which include changes in behavior, language and communication.

Willis’ family, including his ex-wife Demi Moore, said in a statement Thursday that his diagnosis of aphasia, announced by the family in March, had progressed to frontotemporal dementia. Willis is 67 years old.

Frontotemporal dementia, or FTD, refers to a collection of disorders that primarily affect the frontal and temporal lobes of the brain. Diseases that fall under this umbrella are neurodegenerative, meaning they get worse over time.

Generally, there are two subdiagnoses, according to Dr. Paul Barton Rosenberg, professor of psychiatry and behavioral sciences at Johns Hopkins School of Medicine.

“One is a behavioral variant, where people can have a personality change and lose their inhibitions and social graces,” Rosenberg said. “Another is primary progressive aphasia, where people have trouble finding words or expressing themselves.”

In their statement Thursday, the Willis family said “unfortunately, the communication issues are just a symptom of the illness that Bruce faces.”

“While painful, it’s a relief to finally have a clear diagnosis,” the family wrote in their Instagram post, by “Ladies of Willis/Moore” family.

Symptoms and causes of frontotemporal dementia

Frontotemporal dementia results from a buildup of proteins in the brain, which can damage and shrink the frontal and temporal lobes.

Because these areas of the brain are associated with personality, behavior and language, the symptoms of a particular case of FTD vary depending on which area is most affected, according to Dr. Gregg Day, a neurologist at the Mayo Clinic campus. in Florida.

“Language and comprehension difficulties, as well as incorrect instructions could be symptoms of FTD,” Day said. “But when proteins build up in the parts of the brain that govern social cognition, unusual behaviors, such as acting out, disrespecting loved ones, loss of empathy, motivation, and of understanding can also be symptoms.”

Abnormal motor functions, such as problems with balance, vision, or moving on one side of the body, can also be symptoms.

Overall, many symptoms of FTD can be difficult to recognize in patients, and behavioral symptoms in particular can be difficult to separate from psychiatric illnesses, Day said.

“It makes sense that the Willis family, who have been open about Bruce’s condition, would only learn more specific information about aphasia months later,” he said.

Who is most likely to get FTD?

This type of dementia tends to present in younger people, especially those in their 40s, 50s and 60s, the two experts said.

“This disease is seen a bit earlier in life, which can make it more difficult because it’s an age when people have a lot of demands and responsibilities,” Day said. “They can have full-time jobs, partners, take care of young children. And when it affects language for someone who depends on it for a living, it will have an impact.”

FTD is relatively rare, “with an estimated lifetime risk of 1 in 742”, according to a 2019 study. The Mayo Clinic estimates that FTD is the cause of “about 10% to 20% of dementia cases”, which makes it rarer than Alzheimer’s disease.

Little is known about the causes or risk factors associated with FTD.

“The reality is that we don’t have a full understanding of what causes FTD,” Day said. “Causes can usually be genetic, but then we have exposures, things that happen to us, or habits that we have.”

Rosenberg said he can sometimes seem to “knock out of the blue”.

Are there cures or treatments?

No medication can stop or slow the progression of FTD. Instead, treatments focus on helping people manage symptoms, Rosenberg said.

“The main treatment for aphasia is speech therapy, which can be helpful,” he said.

It also helps keep a patient energized, Day said.

“For families, interacting with the loved one, involving them in activities and keeping them stimulated is the best they can do for them,” he said.

In general, the risk of FTD is lower in people who stay physically active, keep their brains regularly engaged and stimulated, and maintain healthy blood pressure and cholesterol levels, Day said.

He added that although research on frontotemporal dementia is ongoing, much more needs to be done to better understand the disease and raise awareness. In that sense, he said, the Willis family announcement is helpful.

“The family took this opportunity to do something caring, compassionate and selfless by spreading information about the disease,” Day said. “It’s a disease that few people have heard of, and maybe now it can help other people get diagnosed earlier.”