What Journalists Should Know About Aphasia and Frontotemporal Dementia

Aphasia stands as a formidable adversary in the realm of neurological disorders, casting a veil over individuals' ability to comprehend language and communicate effectively. This condition's prominence soared into the public eye in 2022 when Die Hard actor Bruce Willis disclosed his diagnosis, shedding light on the profound challenges faced by those grappling with aphasia. Beyond its celebrity associations, aphasia is a complex condition typically stemming from damage to the left side of the brain, often emerging as a symptom of diverse medical ailments such as stroke, head injury, tumor, or degenerative brain disorders.

In addition to aphasia, another significant condition emerges: frontotemporal dementia (FTD), a range of brain disorders affecting crucial regions linked to personality, behavior, and language. As explained by experts from the Mayo Clinic, individuals with FTD may experience profound shifts in personality and language proficiency, underscoring the intricate nature of these neurological ailments. Dr. Gayatri Devi, a leading expert in neurology at Northwell Health, emphasizes the challenges in diagnosing FTD, especially in its early stages, highlighting its distinction from Alzheimer's disease.

Television host Wendy Williams recently revealed her diagnosis of both primary progressive aphasia and frontotemporal dementia after taking a leave from her talk show in 2021 to address health concerns. Following a series of medical evaluations in 2023, Williams received this diagnosis, highlighting the profound impact on language, communication, behavior, and function, as detailed in a news release.

Behavioral variant frontotemporal dementia (bvFTD) is the first subtype of Frontotemporal Dementia and is characterized by significant shifts in personality and behavior. Typically emerging in individuals aged 50s and 60s, this condition can onset as early as one's 20s or as late as their 80s. The hallmark of bvFTD lies in the pronounced loss of nerve cells in regions governing conduct, judgment, empathy, and foresight.

Primary progressive aphasia (PPA) represents another significant subtype of frontotemporal degeneration, affecting language abilities encompassing speaking, writing, and comprehension. While PPA commonly manifests in midlife, before the age of 65, it can also occur in later stages of life. 

Three Types of Primary Progressive Aphasia

There are three distinct types of PPA, each causing varying symptoms and characterized by the primary area of the brain they predominantly affect:

  • Semantic variant primary progressive aphasia impairs or even abolishes the ability to comprehend both written and spoken language. Words and phrases may lack coherence or relevance despite fluency in speech. 

  • Individuals with logopenic variant primary progressive aphasia experience difficulty in retrieving the appropriate words, even though they retain an understanding of their meanings. This results in repetition of sentences or phrases and frequent pauses while mentally searching for words. 

  • Nonfluent-agrammatic variant primary progressive aphasia affects speech production and the ability to form words, while comprehension remains intact, causing grammar issues to arise and leading to challenges in understanding complex sentences, pronouns, and verb tenses. 

When reporting on a source with aphasia, it is essential for journalists to provide accurate information about the condition and its various manifestations. In this case, the journalist could start by explaining the three distinct types of primary progressive aphasia (PPA) and their corresponding symptoms. Throughout the reporting process, the journalist should prioritize sensitivity, accuracy, and clarity to ensure the source's experiences are portrayed authentically and respectfully.

The Differences Between Frontotemporal Dementia and Altheimer's Disease

Age at the time of diagnosis is one notable way these two differ. FTD typically manifests in individuals between their 40s and early 60s, whereas AD becomes more prevalent with advancing age. Also, in early-stage Alzheimer's, memory loss often takes center stage, whereas early FTD symptoms predominantly revolve around alterations in behavior and language. However, as FTD progresses, memory loss may become more pronounced alongside its characteristic effects on behavior and language.

While both conditions may involve speech difficulties, individuals with Alzheimer's may struggle more with word retrieval and name recall. Conversely, they tend to maintain a better ability to express themselves coherently, comprehend speech, and read compared to those with FTD. One more notable distinction is the emergence of hallucinations and delusions as Alzheimer's progresses, whereas they are comparatively rare occurrences in FTD.

Distinguishing between FTD and Alzheimer's disease requires an understanding of their unique characteristics. By highlighting these differences, journalists can contribute to increasing public understanding and awareness of aphasia and FTD, ultimately promoting empathy and support for individuals living with these challenging conditions.