The MD evaluated Bruce Willis’ condition and gave details about the illness

In February 2023, Bruce Willis’ family announced that the 67-year-old actor had been diagnosed with frontal temporal dementia, a degenerative disease primarily affecting behavior and communication.

His health problems were first reported in March 2022. At that time, the actor’s family reported that Bruce was giving up acting because he was suffering from a disorder called aphasia, in which a person has difficulty speaking, understanding, reading or writing. Such symptoms began to appear in the Hollywood star as well – at first to a mild degree, but became progressive over time.

Aphasia can be caused by head trauma, stroke or a condition such as frontal temporal dementia.

Recently, Bruce’s daughter, Tallulah Willis, announced that her family intends to spread the word about frontal temporal dementia. She reasoned that there is not enough information about this disease: people need to know about it and be prepared if the disease runs in their family.

What is frontal temporal dementia

MD, professor, specialist in integrative and anti-aging medicine

“The condition ‘frontal temporal dementia’ is the most common type of dementia in people under 60. But not as much is known about this condition as other types of the disorder. This is one of the reasons Bruce Willis’ family is openly sharing news about the actor’s health condition.”

Frontal temporal dementia (FTD) is something of a catch-all term for a whole group of brain disorders. These conditions predominantly affect the frontal and temporal lobes, which are associated with personality, behavior, and speech.

In the formation of frontal temporal dementia, parts of these lobes of the brain due to the pathological process are shriveled, namely – atrophied.

In this case, the clinical symptoms in each particular patient depend on which part of the brain is affected. So, some people with frontal temporal dementia have personality changes. They become socially inadequate and may be impulsive or emotionally indifferent. Others lose the ability to speak correctly, which is called aphasia.

It was aphasia that started the disease in Bruce Willis.

Frontal temporal dementia can be mistaken for mental illness or Alzheimer’s disease, but professional doctors do not make such mistakes.

There is an important observation that LWD generally occurs at a younger age than Alzheimer’s disease. It often begins between the ages of 40 and 65, although it can occur later in life. LVD is the cause of dementia in about 10 to 20 percent of cases.

Symptoms

Signs of LVD vary from person to person and progress over time, usually over several years. People with frontal temporal dementia tend to have certain groups of symptoms.

Behavioral changes

These are the most common symptoms of frontal temporal dementia – include dramatic changes in behavior and personality. These include:

• increasingly maladaptive social behavior;
• loss of empathy and other interpersonal skills (e.g., lack of sensitivity to another person’s feelings);
• lack of criticism;
• loss of the “brake” on social behavior;
• lack of interest, also known as apathy;
• compulsive behavior (tapping, clapping hands, or swatting over and over again);
• loss of motivation for personal hygiene;
• changes in eating habits (e.g., people with LWD tend to overeat or prefer to eat sweets and carbohydrates);
• binge eating of non-food items;
• a compulsive desire to put something in their mouth.

Speech and language symptoms

Some subtypes of frontal temporal dementia result in changes in language abilities or loss of speech. Subtypes include primary progressive aphasia, semantic dementia, and progressive agrammatical aphasia, also known as progressive nonfluent aphasia.

These pathologies can cause:

• increasing problems using and understanding written and spoken language: people with LVD may be unable to find the right word for spoken language;
• problems naming things: sufferers may substitute a particular word for a more general word (e.g., using “she” instead of “pen”);
• insecure speech that may sound telegraphic: this is because people with LVD use simple two-word sentences and make mistakes in sentence construction.

Symptoms of involuntary movements

Rare subtypes of frontal temporal dementia cause involuntary movements similar to those seen in Parkinson’s disease or amyotrophic lateral sclerosis (ALS).

Such symptoms may include:

• tremor;
• abrupt movements;
• muscle spasms or twitching;
• poor coordination;
• swallowing problems;
• muscle weakness;
• inappropriate laughing or crying;
• falls or problems with walking and coordination.

Causes of occurrence

In LVD, the frontal and temporal lobes of the brain atrophy, which is due to a buildup of certain protein substances in the brain tissue.

Scientists describe frontal temporal dementia using patterns of changes in the brain seen in autopsies after death. These include loss of neurons and abnormal amounts or shapes of proteins called tau and TDP-43. Exactly what causes these processes is not known.

Some genetic changes associated with frontal temporal dementia have been identified, but more than half of people with LVD have no family history. Researchers have confirmed that transformations in frontal temporal dementia genes are also seen in amyotrophic lateral sclerosis. More research is underway to understand the link between these conditions.

Risk Factors

Your risk of developing frontal temporal dementia is higher if you have a family history of dementia. Other known risk factors are not known for sure at this time.

How the disease progresses

The progression of symptoms – in behavior, language, or movements – varies from person to person, but LVD leads to an inevitable decline in functioning. A patient’s condition can worsen over a period of anywhere from two to more than 20 years.

As the disease progresses, patients experience increasing difficulty in planning or organizing activities. They may behave inappropriately in society or at work, and have difficulty communicating with others or with loved ones.

Are there treatment options

There is currently no cure for frontal temporal dementia, nor are there any treatments that can slow or stop the progression of the disease.

How long you can live with the disease

Over time, frontal temporal dementia leads to physical complications such as pneumonia, infection, or injury from a fall. According to the Frontal Temporal Degeneration Association, the average life expectancy for someone with frontal temporal dementia, which Bruce Willis suffers from, is between 7 and 13 years after diagnosis.

The most common cause of death is pneumonia.