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Bruce Willis has frontotemporal dementia

16 March 2023

Here’s what we know

Bruce Willis, Hollywood actor, recently announced that he has been diagnosed with frontotemporal dementia (FTD), a rare form of younger-onset dementia that affects the frontal and temporal lobes of the brain.

In Australia, it is estimated that between 10,000 and 15,000 people currently live with FTD, and most will have been diagnosed before the age of 65 years. The cause of FTD is not yet fully understood, but researchers agree it is linked to a build-up of abnormal proteins in the brain.

Aphasia is a common symptom of FTD, and this is what Bruce Willis' family reported in an initial social media post early last year.

“Aphasia is a communication disorder that affects a person's ability to express and understand language,” says Dr David Foxe, who is a clinical neuropsychologist and FTD researcher with the FRONTIER Research Group, Brain and Mind Centre.

“In FTD, aphasia will manifest in different ways depending on which part of the brain is most affected. For example, damage to the left frontal lobe will cause a non-fluent presentation, which is characterised by difficulty in producing language, including issues with grammar, syntax, and pronunciation. In contrast, damage to the left temporal lobe will cause a semantic presentation, which affects the ability to understand and use words and concepts.”

“To complicate matters further,” Foxe says, “aphasia can also occur in dementias caused by other brain pathologies, such as Alzheimer’s disease. These language presentations of dementia are grouped together under the umbrella term of ‘primary progressive aphasia’, or PPA”.

Frontotemporal dementia — Diagram displaying the umbrella terms frontotemporal dementia and primary progressive aphasia, the clinical presentations, and the main underlying pathologies causing these diseases.

“This can make things really confusing for individuals diagnosed with one of these aphasia dementias as the terms FTD and PPA can often be used interchangeably by doctors,” says Foxe.

“For example, in the case of the semantic presentation of FTD, some doctors will say ‘the semantic variant of FTD’ whereas others might say ‘the semantic variant of PPA. Both are correct”.

This confusion about the terms aphasia, dementia, and FTD has been especially evident with the recent news of Mr Willis’ diagnosis.

Bruce Willis' announcement has raised awareness of FTD and related conditions such as PPA. As more people become aware of FTD, it is hoped that there will be an increased understanding, funding, and support for research into these complex and debilitating conditions.

Professor Olivier Piguet, Director of the FRONTIER research group.

“Research into its underlying mechanisms is ongoing, and new treatments and interventions are being developed", says Professor Olivier Piguet.

There is currently no cure for FTD; however, clinical drug trials are currently under way with others soon to commence in Australia in the next 2 years. Current treatment options are primarily focused on managing symptoms and improving quality of life for as long as possible.

Recently, FRONTIER and the University’s Communication Disorders Treatment and Research Clinic have formed a partnership to provide student-led speech pathology clinical services to dementia patients experiencing problems with language.