What is the Difference between Dysarthria, and Aphasia, the Condition that Afflicted Bruce Willis? Did He Experience Symptoms of Dysarthria?

About 3 months ago we heard the sad news that Bruce Willis was diagnosed with aphasia (language impairment) and decided to retire from acting because of it. Although the details were not shared it was thought that he had a form of progressive aphasia called Primary Progressive Aphasia, or PPA.

Recently I was able to watch some of Willis’s recent interviews and movies and I noticed something that was not much talked about in many articles that covered his sad condition. American Siege which came out in 2022, is Bruce’s last released movie. In the movie I noticed more than anything else, that Bruce had “effortful speech”. His speech production had slowed down, he had difficulty articulating and his intonation of his speech (also called prosody) was unfortunately not right .

Looking back at his previous movies and interviews since 2015 this became more apparent in 2018 in “The Comedy Central’s Roast of Bruce Willis”. He could make full grammatical sentences but had somehow “garbled” speech which is different from interviews and movies from years before.

In an interview for his 2019 movie Glass, he also sounds “non-fluent” and has many pauses. In medical field this trouble with enunciation of words and sentences is called “dysarthria”. It is possible that even before Willis had aphasia, he started experiencing signs of dysarthria, which got worse over time, hence, primary progressive dysarthria.

Dysarthria, in contrast to aphasia, is a disorder of speech articulation. Aphasia is a disorder of difficulty with finding words. Aphasia has to do with the dictionary in our brain, but dysarthria has to do with how the brain plans our mouth and tongue muscles so we can enunciate words. Primary progressive dysarthria is usually caused by conditions that cause degeneration of brain cells. They are not very common and can be sometimes misdiagnosed. Two most common causes of primary progressive dysarthria are progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). The challenge with these conditions is that they may get progressively worse over time. Speech therapy research has shown some promise in treatment of these conditions and the individual with these conditions may need multiple interventions over the years to help them cope with changes.

PSP and CBD do not always present with “dysarthria”. They may present with issues with balance, falls, and slowing of limb movements. Why would some people present with balance issues and others with speech problems. Scientists believe this has something to do with having a vulnerability in the brain. Individuals who have weakness in speech or reading and writing are more prone to manifest speech problems if they are afflicted by degenerative brain diseases like PSP and CBD.

In a speech Bruce Willis delivered as an honoree of the American Institute for Stuttering, he shared that he stuttered his speech around the age of 6 years. At the time there was no available therapy for him, but he later found out that acting [and likely singing] improved his stuttering and that is likely what determined his path towards becoming an actor.

There is so much to learn from Bruce Willis’ story. We all have strengths and weaknesses in our brain function, and we can compensate for our weaknesses by using our strengths. Many individuals with speech or language difficulties are superior in artistic realms. Einstein, who is known for his revolutionary and genius theories in physics, had difficulty with language development. His brain, which has been studied by brain scientists shows how differently his language regions of the brain were organized. Bruce had a strong “will” to overcome his limitation. While suffering from his speech disorder, he appeared in tens of movies. That's admirable!