My first memory of the actor Bruce Willis was in Moonlighting, a television series that ran in the mid-1980s. Alongside Cybill Shephard’s character, Bruce Willis’ David Addison was also a private detective who boasted a wicked sense of humor. Later, he became known for his roles in movies, such as Die Hard and Sixth Sense.

Bruce Willis is back in the headlines. He retired from acting last year following difficulties experiencing aphasia. Recently, he was diagnosed with frontotemporal dementia, a progressive brain condition that most people hadn’t heard of – until now.

What is frontotemporal dementia?

The National Institute of Health (NIH) defines frontotemporal dementiaOpens in new tab or window, or any of the frontotemporal disorders (FTD), as a condition occurring when there is damage to “neurons in the frontal and temporal lobes of the brain.” Symptoms include difficulty communicating and walking, emotional issues such as angry outbursts, and odd, forgetful behaviors. The NIH website states, “FTD is rare and tends to occur at a younger age than other forms of dementia. Roughly 60% of people with FTD are 45 to 64 years old.”

FTD might begin with one symptom, as was the case for Bruce Willis. Then, the disorder progresses into other areas.

Medical specialists and patients alike struggle to confront the exact type of frontotemporal disease. Doctors will often categorize the disease according to brain scans and how a patient’s symptoms have manifested. If the patient is experiencing dementia symptoms, they will classify the diagnosis as frontotemporal dementia. Other times, they will diagnose a person with a frontotemporal disorder if their symptoms appear as instability with walking or talking.

What are the types of FTD?

In my mother’s care home, there were two individuals who experienced an FTD. To the average onlooker, both outwardly appeared calm. If I was visiting on a bad day for either resident, I might experience one person unintelligibly communicating with the staff and the other aggressively shouting at the wall. Like any dementia, as well as FTD, their diseases were as unique as the individuals they had always been.

Chances were, they were diagnosed with one of three types of frontotemporal disorders: behavioral variant frontotemporal dementia (bvFTD), primary progressive aphasia (PPA) or movement disorders. Each comes with its own challenges but is clearly identified by their label.

BvFTD involves loss of cognitive functioning. Individuals will struggle to plan or execute a short series of instructions. Or they might repeat the same activity over and again.

PPA involves loss of communication skills, including reading, writing, speaking, and understanding what others are saying. They might also become mute. Someone with PPA might develop dementia, as communication skills are closely linked to our cognitive abilities. This is what we see happening with Bruce Willis. It’s worth noting within the PPA category, there are three subtypes, depending on which language problem occurs first:

  • Semantics or understanding of word meanings.
  • Agrammatic where a person struggles to put sentences together, omitting words that link nouns and verbs.
  • Logopenic or difficulty locating the right word.

The final FTD category is movement disorders in the brain that are disruptive. This category also contains two subtypes:

  • Corticobasal syndrome, where someone loses the ability to control movement and experiences muscle rigidity.
  • Progressive supranuclear palsy, where a person loses their ability to walk or maintain their balance while standing.

It’s hard to imagine that superstar Bruce Willis, known for his quick wit, bravado and action-oriented films, can no longer shout, “Yippie-Kai-Yay,” followed by a series of expletives, as he did in Die Hard. It’s hard to believe he can no longer save the world as he did in Armageddon.

Last month, his family issued a statement saying, “Bruce always believed in using his voice in the world to help others, and to raise awareness about important issues both publicly and privately. We know in our hearts that if he could today he would want to respond by bringing global attention and a connectedness with those who are also dealing with this debilitating disease and how it impacts so many individuals and their families.”

Is there a cure?

The answer is a simple no. However, scientists such as neurologist Andrew Budson of the BU Alzheimer’s Disease Research Center, have seen promising results from prescribing medications from the Prozac family of drugs. Also, they are finding ways to zero in on the diagnosis through tests that measure the electrical activity of the brain. Mostly, scientists work to help individuals determine where they fall on the spectrum of the diagnosis and teach them to manage day to day. Equally important, they encourage families to be the best support for their loved ones in the long run.

In Moonlighting, Cybill Shephard’s character, Maddie, asks of Bruce Willis’ character, David Addison, “David, may I please have some ANSWERS?” To which David answers, “Delaware, all of the above, 90 degrees.”

Perhaps Bruce Willis knew then there were no easy answers regarding life’s strange turns.