Bruce Willis and Frontal Temporal Dementia: What to know about this fairly common form of dementia
In 2021, it was reported that the famous action hero actor, Bruce Willis, was stepping away from acting due to being diagnosed with Aphasia. Aphasia means “without speech” and describes a neurological condition that can affect an individual’s ability to speak or comprehend language. The news reports were a bit confusing as Aphasia is not necessarily a standalone diagnosis but rather a symptom due to an underlying neurological condition.
The reports of some of the challenges Bruce was experiencing suggested that he was having more extensive neuropsychological challenges than just Aphasia. Sadly, it was reported just earlier this year that Bruce Willis was diagnosed with Frontal Temporal Dementia (FTD).
FTD is the fourth or fifth most common type of dementia. It most often affects men, and the usual age of onset is a bit on the younger side than other common forms of dementia, afflicting those typically in their early 50s to late 60s. FTD has two different subtypes. One subtype is called Frontal Temporal Dementia-Behavioral Variant (FTD-BV). This is a devastating condition that impacts behavior in profound ways. Individuals with FTD-BV will often display complete changes in their personalities. They can become erratic with little to no impulse control. They may say or behave in very inappropriate ways (e.g. hugging complete strangers). The individual may display serious levels of apathy and lose the ability to show empathy.
The other subtype of FTD is called Primary Progressive Aphasia (PPA). PPA has three sub-conditions: Non-Fluent, Semantic, and Logopenic PPA. With each of these sub-conditions, the first noticeable symptoms are difficulties in speech and communication. Over time, the condition will progress and start to impact other areas of cognition and behavior similar to FTD-BV. While I have no personal knowledge of Bruce Willis’ medical history, the trajectory of his reported symptoms seems consistent with the expected course of Primary Progressive Aphasia in which it was speech difficulties that were first reported (e.g. could not say his lines properly) and then later symptoms of cognitive and behavioral challenges began to emerge.
Individuals who are concerned about changes in cognition or behavior should first discuss these issues with their primary doctor and have a full evaluation to rule out any medical findings that could contribute to declines in functioning. The next recommended step is to undergo a comprehensive neuropsychological evaluation. A neuropsychological evaluation will carefully evaluate cognitive functions and determine possible causes of any changes in brain function. To find a neuropsychologist in your area, go the American Board of Professional Neuropsychology website.
