Aphasia: what triggers the disease, how can it be treated?

aphasia
What triggers the disease, how can it be treated?

Until a few days ago, very few people were aware of the disease: aphasia. Then Hollywood star Bruce Willis (67) justified the end of his career with it. But what exactly is aphasia, how does it manifest itself and how can it be treated? The Bavarian State Association for the Rehabilitation of Aphasics (BLRA) assumes that there are over 100,000 people affected in Germany alone – and provides answers to the most important questions.

What exactly is aphasia?

BLRA: Aphasia is an acquired, central language disorder that usually affects all areas of language – i.e. understanding spoken language, language production, reading and writing. But language levels such as sound formation, vocabulary and its meaning as well as grammar can also be affected.

What causes aphasia?

BLRA: This disorder is triggered by damage to the brain. Injuries, tumors, inflammation or degenerative diseases of the brain can lead to aphasia. However, the most common cause, at 65 to 80 percent, is stroke. In this case in particular, the time factor is crucial. Within the first 4.5 hours after the first symptoms, medical care in special departments, so-called “stroke units”, is particularly important. There, after a detailed examination, the appropriate therapy is carried out as quickly as possible. The aim is to save lives and minimize damage.

Can everyone suffer from aphasia? Which groups are most affected?

BLRA: In principle, aphasia can affect anyone. Experts differentiate between the various underlying diseases: For example, men suffer a stroke three times more often than women, 30 percent of which occur before the age of 65. Neurodegenerative diseases are more common with increasing age, accidents with serious brain injuries are more likely to occur in young adulthood. Overall, childhood aphasias are rare, since the young brain can often still reorganize itself.

What are the symptoms and consequences of aphasia?

BLRA: Normally, aphasia can affect all language areas. Therefore, there are usually limitations with different weighting in language comprehension, language production as well as reading and writing. Furthermore, problems in word finding, sentence structure and grammar as well as in the phonetic formation of words can often be observed. Highly automated areas of the language, such as days of the week, numbers, etc. can also cause difficulties. At the same time, additional problems in articulation or vocalization caused by the underlying disease can also occur. Depending on the physical limitations caused by the underlying illness and the language deficits, there are individual psycho-social consequences for the person affected: social withdrawal and limitations in everyday activities, role changes within the family structure, reduced self-esteem, occupational disability.

What is the treatment/therapy for aphasia?

BLRA: The basis is extensive medical care, so that the underlying disease can be treated in a targeted manner and secondary diseases can be avoided. Interdisciplinary cooperation between the medical, therapeutic and, if necessary, nursing disciplines, well-founded diagnostics in all areas and joint, coordinated treatment planning are particularly important. High-frequency speech therapy would be desirable and also required by the German Society for General Medicine and Family Medicine (DEGAM). This varies between 5 and 10 therapies per week over a period of 3 to 8 weeks. An interval of low-frequency therapy two to three times a week would then be advisable. This speech therapy treatment is based on well-founded diagnostics as the basis for individual, symptom- and everyday-oriented therapy planning with targeted speech-systematic exercises. Fortunately, the improvement of everyday skills and thus the personal, active participation of those affected by aphasia are increasingly of medical and therapeutic interest, so that not only deficits are minimized in the course of therapy, but the skills that are retained are also stabilized and expanded.

Can aphasia be completely cured?

BLRA: If you assume an acute event such as a stroke or traumatic brain injury, the first year after it occurs is of particular importance. If a stroke is treated quickly on the “Stroke Unite”, the chances are significantly better that the aphasic symptoms can be minimized or even completely eliminated. Medical and individual requirements, therapy frequency, therapy motivation, or the personal environment are other factors that influence the effectiveness of the treatment and the chances of complete rehabilitation. Nevertheless, it is reported that in about half of those affected by a stroke, no complete resolution of the symptoms can be observed. In the case of underlying neurodegenerative diseases, stopping the progression of the disease and maintaining language functions are usually the focus of therapy.

How do you deal with aphasics as a relative?

BLRA: An acute event or the diagnosis of a relative is often a shock for relatives as well. Normal everyday life can usually not be maintained. Relatives should therefore also seek information, help and support promptly, whether in a medical, therapeutic or private context – for example in self-help groups. Knowing about the (basic) disease and the aphasic symptoms also helps in communication with the relative and may protect against underestimating or overestimating the person affected by aphasia. It avoids frustration and aggression on the part of those affected and their families. First and foremost, respectful, age-appropriate interaction is important. Everyone should take the time to communicate, not interrupting the person concerned, but nicer: Summarizing what has been said or understood in short sentences; Ask questions or alternative questions. Those affected by aphasia often tire more quickly in conversations, in the presence of ambient noise or in everyday life. You need frequent rest breaks. That also has to be taken into account.

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