Bruce Wills diagnosis puts FTD on centre stage again  

HOLLYWOOD: As Hollywood actor Bruce Willis has been diagnosed with frontotemporal dementia (FTD), a type of dementia that impacts executive functioning like language and motor skills, the debilitating disease becomes subject of discussion among the experts, stressing the need for raising awareness about its effects and symptoms.    

The diagnosis for the 67-year-old actor was disclosed by his family in a statement published on The Association for Frontotemporal Degeneration website.

Willis was previously diagnosed with aphasia, a disorder that affects people’s ability to communicate, in 2022.

His ex-wife, actress Demi Moore, sharing the news on her Instagram says: “Since we announced Bruce’s diagnosis of aphasia in spring 2022, Bruce’s condition has progressed and we now have a more specific diagnosis: frontotemporal dementia (known as FTD). Unfortunately, challenges with communication are just one symptom of the disease Bruce faces. While this is painful, it is a relief to finally have a clear diagnosis.”

Willis’s family, in a statement on the same website hopes the news of Willis’s diagnosis will raise awareness of the condition, which affects around 60,000 Americans, the majority of whom are in their 50s and 60s.

“Bruce always believed in using his voice in the world to help others, and to raise awareness about important issues both publicly and privately. We know in our hearts that – if he could today — he would want to respond by bringing global attention and a connectedness with those who are also dealing with this debilitating disease and how it impacts so many individuals and their families,” the family wrote.

FTD involves the degeneration of several parts of the brain, but has the greatest impact on the frontal and temporal lobes, which are responsible for executive functioning tasks like decision-making, language, and social skills.

“FTD is unique in it causes loss of function in two of the four lobes of the brain, in the frontal and temporal lobes sparing the parietal lobes and cerebellum,” says Dr Clifford Segil, neurologist at Providence Saint John’s Health Center in Santa Monica, CA.

Unlike Alzheimer’s disease, FTD does not affect memory, but a person’s personality, ability to communicate, and motor skills.

When language impairment occurs, it is called primary progressive aphasia (PPA).

Early signs include mild behavioral issues such as apathy, lack of empathy, or issues comprehending words, says Dr S Ahmad Sajjadi, an associate professor of neurology and pathology at University of California, Irvine.

Symptoms of advanced disease include severe obsession, agitation, and disinhibited behavior, he adds.

“In PPA patients can become mute or lose their ability to comprehend even single language structures,” Sajjadi says.

FTD is often misdiagnosed as a movement disorder like Parkinson’s disease or a psychiatric issue.

To diagnose FTD, a neurologist will examine the symptoms and perform brain scans — magnetic resonance imaging (MRI) and glucose positron emission scans — to see if and how the brain structure is affected.

FTD is a form of young onset dementia, says Sajjadi, adding it accounts for about 10 to 20pc of dementia cases, and is one of the most common types of dementia in younger people.

Though Alzheimer’s dementia is much more common than FTD, patients under 60 who rapidly develop cognitive, language, and behavioral issues should be evaluated for FTD, maybe even before Alzheimer’s dementia, says Segil.

He says that about a third of the disease cases are inherited, and other than family history, little is known about the risk factors for FTD.

“Despite not being common, FTD is a devastating illness since it affects individuals in the prime time of their life and when many still have young families,” Sajjadi says.

While some forms of dementia advance rapidly, FTD’s symptoms progress more gradually, says Sajjadi.

However, the speed of progression of the condition varies from person to person.

In rare cases, the disease can progress quickly, significantly impacting a person’s memory and cognition.

Some patients will simultaneously develop amyotrophic lateral sclerosis (ALS) — a nervous system disease that impacts speech, movement, and cognition.

“In patients who have this form of disease, progression is fast,” says Sajjadi.