Experts explain what constitutes frontotemporal dementia

Bruce Willis: 67-year-old star tells the story of his battle with Alzheimer’s disease, aphasia and robbery

In a statement shared Thursday, the 67-year-old star’s family stated that while the news “is painful, it is a relief to finally have a clear diagnosis.”

“Unfortunately, challenges with communication are just one symptom of the disease Bruce faces,” his family said. “While this is painful, it is a relief to finally have a clear diagnosis.”

Willis’ family — including wife Emma Heming Willis, ex-wife Demi Moore and his daughters — first disclosed his diagnosis of aphasia back in 2022. They said at the time that Willis was suffering from a medical condition that was affecting his cognitive abilities and would be taking a break from acting.

There are two other types of FTD. Behavior variant frontotemporal dementia, or bvFTD, is characterized by changes in executive functions, thinking and planning.

Willis’ most recent acting credit is “Detective Knight: Independence,” which was released in January 2023 and is the third installment of the thriller film series “Detective Knight.” He also has action movie “Assassin” slated for release next month.

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“Bruce has always found joy in life – and has helped everyone he knows to do the same. It has meant the world to see that sense of care returned to him and all of us. “We have been so moved by the love you have all shared for our dear husband, father, and friend during this difficult time. You will allow us to help Bruce live as full a life as possible.

Because his symptoms began with difficulty speaking, Bruce Willis would be classified as having a type of FTD called primary progressive aphasia, said Dr. Henry Paulson, a professor of neurology and director of the Michigan Alzheimer’s Disease Center at the University of Michigan.

People with FTD typically live six to eight years with the condition, according to the US National Institute on Aging. Between 10% and 30% of FTD cases are inherited. There are no other known risk factors besides genetics and they are looking into the role the two hormones may have on the disease.

Primary progressive aphasia deteriorates parts of the brain that control speaking, writing and comprehension. The onset of symptoms typically begins before age 65, but can occur later.

The National Institute of Aging states that there is a type of motor neuron disease that can cause difficulties swallowing, rigid muscles, and difficulty closing buttons or operating small appliances.

A neurologist will conduct a careful clinical examination and psychological testing to assess cognitive skills in the case of mild to moderate FTD disorders.

In behavioral FTD, people rarely have issues with memory. Instead, they struggle to plan and sequence their thinking and have trouble setting priorities, according to the National Institute on Aging. They may act impulsively, say inappropriate words, or act disinterested in life if they are still parroting the same activity.

People with primary progressive aphasia may have trouble speaking or understanding words. Over time, they may fail to recognize familiar faces and objects. Some may become mute.

“PPA may start with difficulty simply finding words, so people begin to use simpler words or more generic words for things they can’t quite recall,” Paulson said.

He said it is a sign that someone should see a doctor when the language is more effortful on a daily basis or comprehension is going downhill.

It is not known at first if Motor neuron FTD disorders will affect memory, language or behavior. It’s possible that the inability to control movements is the initial sign. Difficulty with looking down and other eye movements is a hallmark sign of progressive supranuclear palsy.

“A brain MRI can tell us if certain parts of the brain are shrinking or showing signs of atrophy. We will do some blood tests to make sure we’re not missing some treatable causes of cognitive impairment like thyroid disease or vitamin B12 deficiency as well,” he said.

Sometimes, we’ll do brain metabolism scans as well. “It’s Positron Emission Tomography or PET imaging, and that can tell us which parts of the frontal lobes or the temporal lobes are involved.”

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“It is really important for people who have a progressive dementing syndrome like FTD to continue to eat well, exercise regularly, and stay connected with people. Those activities are not a cure, but they can help your brain work as well as possible.

A speech-language pathologist can help determine the best strategies and tools for an FTD patient struggling with language skills. Physical or occupational therapy, guided by a doctor specializing in these disorders, may help with movement symptoms.

I have seen patients who lost their speech and still go out and take pictures of their lives. They can’t tell me in words, but they can tell me in pictures,” Paulson said.

“I tell all my patients, ‘Don’t let this disease own you. You own it,’” he added. You have lost some skills because of the illness, but you still have a lot of skills left, so you work with the ones you have.

A diagnosis of Parkinson’s can be made in the 40s and 60s while Alzheimer’s can be made at a later age. Alzheimer’s is also more closely tied to hallucinations, memory loss and issues with spatial orientation, such as getting lost.

Brain images are used to diagnose chronic wasting disease (FTD). The results are analyzed in tandem with a patient’s medical history and symptoms. About 30% of people with frontotemporal degeneration inherit the disease; there are no known risk factors.