What Is Aphasia?

Until recently, most people had little awareness of aphasia. In 2016 and 2020, for example, surveys conducted by the National Aphasia Association estimated that less than 10% of the population had heard of the language syndrome.

Experts say that’s likely changed since news broke in March 2022 that movie star Bruce Willis had aphasia and would step away from acting. The announcement caused internet searches on aphasia to spike for a week, according to Google Trends.

“Having any medical problem happen to someone we know or admire encourages us to find out more about it. Many people will now be more familiar with aphasia and know that it’s a language impairment,” says Nina Dronkers, a long-time aphasia researcher, adjunct professor of psychology at the University of California–Berkeley, and adjunct professor of neurology at the University of California–Davis.

[See: Best Foods for Brain Health.]

What Is Aphasia: Causes and Symptoms

Aphasia is the umbrella term for language disorders that keep people from speaking or comprehending. The syndromes are triggered by brain damage from:

— A stroke (interruption of blood flow to the brain due to a blockage or hemorrhage).

Traumatic brain injury (such as a head injury caused by an accident).

— Neurodegenerative disease, like Alzheimer’s.

— A brain tumor.

— Infectious disease, such as encephalitis.

When someone has aphasia, it might be hard to:

— Find the right word for a sentence.

— Produce sounds correctly.

— Grasp the meaning of words.

— Read or write.

Symptoms of aphasia depend on brain damage location. For example: “Damage to the parietal lobe in the back of the brain may cause reading and writing problems. Damage to the left temporal lobe may affect your ability to match concepts and words. Damage to the frontal lobe may cause difficulty with speech production,” Dronkers says.

[SEE: Early Signs of Dementia.]

Types of Aphasia

There are many kinds of aphasias. They fall into several categories.

Fluent Aphasia

People with fluent aphasia are able to produce connected speech, but it may lack meaning. Types of fluent aphasia include:

Anomic aphasia. People with anomic aphasia may be able to speak and understand language, but they have difficulty retrieving everyday words. They may misname objects or mispronounce words.

Conduction aphasia. People with conduction aphasia have difficulty repeating phrases and sentences, due to auditory short-term memory loss.

Wernicke’s aphasia. People with Wernicke’s aphasia have speech that is well-formed but makes no sense. They may not comprehend what someone is saying and may be unaware that they’re speaking without being understood.

Transcortical sensory aphasia. People with transcortical sensory aphasia sound like they have a Wernicke’s aphasia, but their ability to repeat words and sentences is remarkably preserved.

Nonfluent Aphasia

People with nonfluent aphasia have difficulty producing speech. Types of nonfluent aphasias include:

Broca’s aphasia. People with Broca’s aphasia can have preserved comprehension, but their speech is slow and effortful. They have a hard time forming complete sentences or understanding sentences with complex grammar. They also struggle with reading and writing.

Global aphasia. This is considered the most severe form of aphasia. People with global aphasia are unable to produce or understand words and sentences. They’re also unable to read or write. Global aphasia typically occurs after a stroke.

Transcortical motor aphasia. A person who has transcortical motor aphasia may understand language but have a hard time forming sentences properly or spontaneously answering questions. Like transcortical sensory aphasia, their ability to repeat full sentences is remarkably intact.

Primary Progressive Aphasia

Primary progressive aphasia, or PPA, is caused by neurodegenerative brain disease such as Alzheimer’s disease or frontotemporal dementia.

PPA is marked by obvious difficulties finding words beyond age-related cognitive decline. Patients may stop talking in the middle of a sentence and pause frequently in speech to find the right words.

The disorder is not usually inherited. “But there are instances where individuals from families that possess known genetics for neurodegenerative disease can develop primary progressive aphasia,” notes Dr. Zachary Miller, associate professor of neurology with University of California–San Francisco who treats patients at the UCSF Memory and Aging Center.

There are three variants of PPA:

Nonfluent variant. People with nonfluent variant PPA can understand words but they have problems forming words, understanding complex sentences and getting grammar right.

Logopenic variant. Logopenic variant PPA is marked by difficulty finding words and repeating sentences due to auditory short-term memory problems.

Semantic variant. This aphasia includes a loss of conceptual knowledge. People with semantic variant PPA have profound difficulties understanding written or spoken language. “Someone might say, ‘Pass me a bowl,’ and the patient will ask, ‘What’s a bowl?’ They can speak fluently, but they lose the connection of concepts,” Miller explains.

PPA often remains isolated as a language difficulty for a few years before it takes on other characteristics (such as memory problems) of the dementia that’s causing it.

[READ: Memory Decline Isn’t Inevitable.]

Diagnosis of Aphasia

For people who’ve experienced an urgent medical problem or emergency, such as a stroke or brain injury, aphasia diagnosis may take place in a hospital or rehabilitation setting.

For people whose aphasia creeps up slowly, diagnosis starts with a visit to a primary care physician. That expert can refer you to:

— A neurologist, who looks for the underlying cause of disease.

— A neuropsychologist, who looks for particular deficits in cognition.

— A speech language pathologist, who looks for deficits in the ability to comprehend language and produce speech.

“It helps to bring a family member to an evaluation. It should be a person who’s around frequently and can say what they’re observing. Providing as many of those details as possible will help paint the picture of what’s going on,” notes Jeremy Davis, chief of the Division of Neuropsychology at the University of Texas Health Science Center at San Antonio and in the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases.

Treatment and Prognosis

Aphasia treatment starts with addressing the underlying condition. Coping with aphasia’s day-to-day challenges, meanwhile, requires speech therapy.

“The goals of treatment are to try to teach other areas of the brain to help take over the functions that were lost, and also to teach the patient strategies to compensate for their deficits,” Dronkers says.

For difficulty producing speech, words might be reinforced by:

Overenunciating. “You may work on moving your mouth and lips to overenunciate or work on certain words and phrases that are important for you to say,” Miller says.

Rebuilding word associations. “You can practice by writing the name of an object, saying it and reading it, while looking at or holding the object,” Dronkers says.

Learning new means of expression. “People who have difficulty articulating a sentence might do better if they sing it. It circumvents the speech production mechanism and relies on a different output system,” Dronkers says. “Or they might use an app with images they can point to. On our UC Berkeley Aphasia Lab Recovery website, we list a number of apps that can be used.”

For difficulty with word finding, you might give the brain cues to find a missing word. For example, if you can’t remember the word for “hat,” call it “the thing you wear on your head” or use other related words to describe what you’re trying to say. “At some point, you’ll activate cell clusters in the brain that have information about the object, and trigger the missing word,” Dronkers says.

Family members, coworkers and caregivers can also support people with aphasia. For example, they can ask yes or no questions of someone who has difficulty producing speech. “The family needs to understand that it takes someone a while to get the words out,” Davis says. “They need to have patience and allow the person more time.”


When it’s caused by a stroke or traumatic brain injury, aphasia often evolves into a milder form. “As a person recovers, the aphasia becomes less severe within the first year,” Dronkers says.

The prognosis isn’t as encouraging for people with primary progressive aphasia, which continues to get worse, though speech therapy can help stave off the decline.

Individual counseling and attending an aphasia support group can be helpful, since talking about the difficulties of aphasia can make them less frightening. And any effort to understand, maintain or improve communication — at any stage of aphasia — can enhance someone’s quality of life.

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What Is Aphasia? originally appeared on usnews.com

Update 05/06/22: This story was previously published and has been updated with new information.

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