Medicines for Aphasia

What it is

Aphasia is a condition that affects a person’s ability to use and understand language. It is caused by damage to the parts of the brain responsible for language (usually on the left side of the brain). Importantly, aphasia affects language, not intelligence — a person with aphasia still has their thoughts, knowledge, and personality, but has difficulty expressing or understanding them through language. The most common cause of aphasia is stroke (which damages the language areas of the brain), but it can also result from other causes of brain damage, such as a head injury, a brain tumour, a brain infection, or progressive conditions (including a form of dementia that particularly affects language). Aphasia can affect different aspects of language, and the pattern depends on which part of the brain is affected — it can involve difficulty with: speaking (finding the right words, forming sentences, or getting words out); understanding what others say; reading; and writing; and it varies in severity, from mild word-finding difficulties to severe difficulty with all aspects of language. Aphasia can be very frustrating and isolating, as it affects communication — which is central to daily life, relationships, and independence — but the person’s thinking and awareness are usually intact, which is important for others to understand. The main treatment and support for aphasia is speech and language therapy, which helps people to improve their language and communication, and to find alternative ways to communicate; recovery and improvement are often possible, particularly after a stroke (where improvement can continue over time, especially with therapy), though the extent varies. Support for the person and those around them, and strategies to aid communication, are important. The key messages are that aphasia is a difficulty with language (not intelligence) caused by damage to the brain’s language areas, most often after a stroke, and that speech and language therapy and communication support help.

How it is treated

Aphasia is managed with speech and language therapy and communication support, aimed at improving language and finding effective ways to communicate, alongside treating the underlying cause and supporting the person and those around them. First, the underlying cause is identified and treated — for example, treating and managing a stroke (aphasia after a stroke is common, and stroke is a medical emergency needing urgent treatment), or addressing another cause; the aphasia is then assessed, usually by a speech and language therapist, to understand which aspects of language are affected and how. The cornerstone of support is speech and language therapy: a speech and language therapist works with the person to help them regain and improve their language abilities (speaking, understanding, reading, and writing) as much as possible, and to develop strategies and alternative ways to communicate (which may include gestures, drawing, writing, communication aids or apps, and other methods); therapy is tailored to the individual and their type and severity of aphasia, and can help, particularly when started and continued as appropriate. Recovery and improvement are often possible, especially after a stroke, where improvement can continue over time, particularly with therapy and practice — though the extent and pace vary between individuals. Supporting communication in everyday life is very important: those around the person (family, friends, and carers) can learn strategies to make communication easier — such as speaking clearly and giving time, using simple sentences, using gestures, writing, or pictures, checking understanding, and being patient and encouraging — which greatly help the person to communicate and reduce frustration and isolation; understanding that the person’s intelligence and awareness are intact is important. Support for the emotional impact of aphasia (which can include frustration, low mood, and isolation) is also important, for both the person and those close to them. Support organisations for aphasia (and for stroke, a common cause) provide information, strategies, communication support, and community, which can be very valuable. For progressive causes of aphasia, support is provided as part of managing the underlying condition. The reassuring messages are that aphasia is a difficulty with language, not a loss of intelligence, that speech and language therapy and communication strategies help people to improve their language and to communicate effectively, that recovery and improvement are often possible (particularly after a stroke), and that support for the person and those around them makes a real difference; so accessing speech and language therapy and communication support, and understanding and patience from others, are the keys to living with aphasia.