So Many Thoughts In The Head But Can’t Voice Them: Aphasia

Did you ever try to get that screwdriver’s name out of your mouth, but just can’t say it? You know the word and how to pronounce it in your brain, it’s right there, but you find it difficult to say it verbally. It occasionally happens to all of us, irrespective of age, and it is normal. Aphasia is quite similar to this, and awareness of this strange circumstance will help you comprehend Aphasia meaning and related concepts.

What Is Aphasia?

Aphasia is a brain disorder in which a person has difficulty comprehending or understanding what other people speak. They also find trouble speaking, listening, writing, typing, etc. Aphasia often occurs in people with conditions like stroke, trauma, brain tumour, and other brain-related disorders. Aphasia makes it hard to name simple and everyday objects, and reading and writing are frustrating and irritating.

Aphasia Medical Definition

• Brain stroke, severe or traumatic brain injury and surgery can cause sudden-onset Aphasia can be caused by
• The gradual-onset Aphasia generally results from other disorders like brain tumour, infection, dementia, Alzheimer’s, Parkinson’s, etc.
• Aphasia happens with damage to parts of the brain that control spoken language.
• There is no need to worry since Aphasia is often treatable, and you can cure it permanently.

Causes of Aphasia

The primary result of this condition is damage to parts of the brain, thereby disrupting your brain’s functions. Some of the vital Aphasia causes include:

• Brain surgery and tumours
• Cerebral hypoxia
• Concussion
• Dementia and Alzheimer’s
• Epilepsy
• Migraines(temporary effect)
• Strokes
• Inflammation of the brain
• Chemotherapy
• Aneurysms
• Heavy metal poisonings and other toxins and poisons

People having Aphasia need not feel excluded or different since this is not a contagious disease. 2 million Aphasia people survive in the USA alone, with 1,80,000 people developing it each year. So, there’s no need to feel alone, and you are strong enough to battle this, although Aphasia is an uncommon condition. 1 in 240 people, or 0.37% of the Indian population, is going through Aphasia.

Aphasia Symptoms in Seniors

If you find any of the below signs and symptoms in your ageing loved one or parent, please don’t hesitate to contact the doctor for medical assistance and find effective ways to communicate with the patient to ensure continued freedom and independence.

• Using ParAphasias like a dog instead of a cat or using words that sound similar like a house for a horse, etc
• Making up words or mixing up sounds in words
• The trouble with numbers and solving basic math
• Difficulty understanding conversations and having trouble with reading, spelling, speaking, writing, etc
• Trouble indicating or naming familiar people, places, events, objects, etc

However, when the below-mentioned symptoms appear suddenly out of nowhere that is happening quickly, or without warning, this might be a sign of stroke or other dangerous condition irrespective of whether or not the person has these symptoms along with Aphasia symptoms then. Please get emergency medical attention (ER) immediately.

• Trouble thinking, focussing, or recalling
• Difficulty in swallowing
• Numbness or paralysis on the body’s one side
• Distorted or mumbled speech
• Confusion, irritation, frustration, or agitation
• Unilateral facial drooping or partial loss of vision
• Sudden and severe headache that disrupts your usual activities

Types of Aphasia

There are two types of Aphasia based on fluency known as

• Fluent Aphasia (Receptive) – Here, poor comprehension or understanding is evident in the person. Also, words here may lack meaning.
• Non-Fluent Aphasia (Expressive) – You can see a person’s good understanding. However, they may witness trouble finding words.

Before taking a look at Aphasia types, let’s get to understand the two specific parts of the brain that work together when talking:

• Broca’s area: This part controls the muscles used to speak. It is located in the brain’s left hemisphere and is responsible for speech gestures.
• Wernicke’s area: This part helps in language comprehension and controls the person’s ability to understand. It is responsible for selecting the right words when the person talks.

There are eight types of Aphasia, with the first three types being the main categories classified based on factors including fluency, understanding, and repetition. These types can also be divided based on the damaged part of the brain. Doctors consider these three factors to analyse various Aphasia types as mentioned below:

• Fluency: Are they talking smoothly, having the right pace, pronunciation, pitch, and grammar? Are they writing without any trouble?
• Understanding: Does the person comprehend what others are saying, and do they reply with reasonable sentences that make sense? Do they read and understand written words?
• Repetition: Does the person repeat words or complete sentences without added difficulty?

1. Broca’s Aphasia

Its other name is ‘non-fluent Aphasia’ and is one of the most common forms.

• Loss of fluency is evident here.
• They might struggle to form words and can’t repeat other people’s phrases but can easily repeat simple words.
• In severe cases, the person can go through mutism and can only make a single sound at a time.
• Here, the person can’t speak but still can understand others.
• One may find difficulty with repetition.
• Due to the damage to Broca’s area, some might experience one-sided paralysis in their body due to the effect on muscles responsible for movement.

2. Wernicke’s Aphasia

Unlike Broca’s Aphasia, this is part of ‘fluent Aphasia’. It is also a relatively common form.

• No loss of fluency. However, the patient’s speech is mostly confusing and consists of wrong and made-up words, also known as ‘word salad’ by the experts.
• Difficulty increases with the increase in the complexity of words used by others.
• Here, an ‘aphasic person’ struggles with the repetition of words.
• Vision problems arise in this type of Aphasia. Unlike in Broca’s type aphasia, people often don’t realise, or their brain can’t recognise that they have a medical condition of this Aphasia.

3. Global Aphasia

It can define as the ‘severe form of Aphasia’.

• All three main factors, including fluency, understanding, and repetition, are impaired.
• People going through this can struggle with most symptoms, including blindness, one-sided paralysis, etc.
• People having severe conditions like brain damage, major strokes, and head injuries are the most prone to this type of Aphasia.

4. Anomic Aphasia

People with this type of Aphasia struggle to find ‘words’ that describe actions. They often use non-specific words like ‘thing’ instead of specific terms.

5. Conduction Aphasia

No understanding is affected here. However, the patient struggles with the loss of fluency in repeat words.

6. Transcortical Motor Aphasia

This type is similar to Broca’s Aphasia but with less severity. No trouble with repetition of words is the main difference between Broca’s and this type.

7. Transcortical Sensory Aphasia

Aphasia of this type is similar to Wernicke’s Aphasia but with less severity. It can compare to motor Aphasia, but the key difference is that this type is most common in people having degenerative brain conditions like dementia and Alzheimer’s disease.

8. Mixed Transcortical Aphasia

It can compare to global Aphasia. However, a person with this type can still have no trouble repeating words said by others.

9. Special and Rare Type of Aphasia – Primary Progressive Aphasia (PPA)

• Brain injury or stroke cannot cause.
• PPA can classify as a form of a degenerative brain disorder like dementia, in which language loss is the primary symptom.
• PPA can treat to maintain language function for as long as possible
• ‘Primary Progressive Aphasia Stages’ include Stage 1 = Prodromal, Stage 2 = Mild, Stage 3 = Moderate, Stage 4 = Severe

Difference Between Aphasia and Dysphasia

Diagnosis

• ‘Aphasia examination’ includes both physical exam and other required tests to rule out the causes similar to Aphasia.
• Other tests include Sensory And Nerve Function Tests, Cognitive And Memory Tests, Diagnostic And Imaging Tests, etc.
• To classify the type of Aphasia, you can take tests like blood tests, CT scans, EEG, MRI, PET scans, X-rays, etc.

An Instance of Aphasia

You might have heard about one of the famous Hollywood actors, Bruce Willis. Bruce was diagnosed with Aphasia, impacting his cognitive abilities. Then, he stepped away from an acting career-starred in popular movies like Pulp Fiction, Die Hard, The Sixth Sense, Cosmic Sin, and many more.

Is Aphasia Treatable?

Yes. While there’s no direct Aphasia cure, treating the underlying conditions like stroke, tumour, injury, etc., that caused it can be the best way to treat an aphasic person. In the case of severe brain disorders, language and speech therapy, often involving family and loved ones, can be a great source of both communication and treatment.

What Type of Treatment Is Commonly Given To Aphasia Patients?

• Speech therapy combined with the knowledge of Brain Plasticity – the ability of the brain to repair itself is often the type of treatment an aphasic person receives, especially in the case of severe neurological disorders like brain tumour, stroke, etc.
• The brain plasticity allows the areas surrounding the brain to take over some functions during the recovery process, which helps in better recovery of language and understanding.
• Following the prescriptions and medicines, your doctor advised you that a balanced diet and healthy weight management can push you into great progress with positive results.

How Do You Care for a Patient with Aphasia?

• Give them enough time and flexibility to communicate in their way, and don’t force them to fit into the time frame.
• Include image sets, portable whiteboards, talking devices, etc., for better communication and understanding.
• Be patient, kind, supportive, understanding, and loving with your aphasic loved one.
• Appreciate and make them realise you love them for what they are.
• Introduce them to positive vibes with helpful apps like the ‘small talk’ Aphasia help app.
• Teach them sign language and touch therapy where communication will be smoother, which will make them even happier.
• Cheer them for Aphasia Awareness Month of June and remind them they are not alone in these difficult times.
• Remember, respect and dignity always comes first, even if it takes time to cool the environment.
• Eliminate all other noises and background music to increase their communicative value by giving full attention to them.
• Include your personalised love language and let them know you will be there for them every time.

FAQ’s

What causes Aphasia in the elderly?

Due to the damage or disruptions in the parts of the brain that control speech and language, Aphasia often can be seen in ageing people. Severe brain disorders like injury, tumour, stroke, etc., can be the main reasons for Aphasia in older adults.

Is Aphasia common in the elderly?

Yes. Aphasia is completely normal in the case of middle-aged and older adults. With the increasing age and health complications, Aphasia often occurs right after stroke or gradually increases for people with neurological disorders.

How do the elderly communicate with Aphasia?

You can introduce them to talking devices, portable whiteboards, image sets, sign language, touch therapy, etc., to make their communication easier and quicker. This way, you can make their difficult time more positive and fun.

What are the three types of Aphasia?

Broca’s Aphasia, Wernicke’s Aphasia, and Global Aphasia are three main types of Aphasia, among eight other types. Here global Aphasia is a severe one among all.

How can I help someone with Aphasia?

Listen to patients with full attention without getting irritated and create a safe space for them. Completely mute the background noise and let them take the time to communicate fully. Small gestures like this can go a long way.

Does Aphasia worsen with age?

People with Primary Progressive Aphasia (PPA) and other degenerative brain disorders like dementia, Alzheimer’s, etc., can lose the ability to speak and write with time. It gets worse with age, and an aphasic person might completely lose the ability to understand, speak, listen and write.