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Aphasia

What is aphasia?

Aphasia is a language disorder that makes it hard for you to read, write, and say what you mean to say. Sometimes it makes it hard to understand what other people are saying, too. Aphasia is not a disease. It's a symptom of damage to the parts of the brain that control language.

The signs of aphasia depend on which part of the brain is damaged. There are four main types of aphasia:

  • Expressive aphasia is when you know what you want to say, but you have trouble saying or writing your thoughts.
  • Receptive aphasia affects your ability to read and understand speech. You can hear what people say or see words on a page, but you have trouble making sense of what they mean.
  • Global aphasia is the loss of almost all language ability. You can't speak, understand speech, read, or write.
  • Anomic or amnesia aphasia is when you have trouble using the right words for certain things, people, places or events.

In some cases, aphasia may get better on its own. But it can be a long-term condition. There's no cure, but treatment may help improve language skills.

What causes aphasia?

Aphasia happens from damage to one or more parts of the brain involved with language. The damage may be from:

  • Stroke, which is the most common cause of aphasia
  • Brain tumor
  • Brain infection or inflammation
  • Brain injury
  • Other brain disorders or neurologic diseases that affect the brain and get worse over time, such as dementia
Who is more likely to develop aphasia?

Anyone can have aphasia at any age, but most people with aphasia are middle-aged or older. Most aphasia happens suddenly from a stroke or brain injury. Aphasia from a brain tumor or other brain disorder may develop slowly over time.

How is aphasia diagnosed?

If a health care provider sees signs of aphasia, the provider will usually:

  • Test the person's ability to understand language and speech. This includes asking questions and checking to see if the person can follow simple commands.
  • Order an imaging scan to see if there's a brain injury and what part of the brain is damaged. Possible tests include:
    • MRI
    • CT scan

If imaging shows signs of aphasia, more tests may be needed. These tests measure how much the brain damage has affected the ability to talk, read, write, and understand. In most cases, the tests are done by a speech-language pathologist or speech therapist (a specialist who treats speech and communication disorders).

What are the treatments for aphasia?

Some people fully recover from aphasia without treatment. But most people should begin speech-language therapy to treat aphasia as soon as possible.

Treatment may be one-on-one with a speech therapist or in a group. Therapy using a computer may also be helpful.

The specific therapy depends on the type of language loss that a person has. It may include exercises in reading, writing, following directions, and repeating what the therapist says. Therapy may also include learning how to communicate with gestures, pictures, smartphones, or other electronic devices.

Family participation may be an important part of speech therapy. Family members can learn to help with recovery in many ways, such as:

  • Using simpler language
  • Including the person with aphasia in conversations
  • Repeating or writing down key words to help communicate more clearly

How much a person recovers depends on many things, including:

  • What caused the brain injury
  • What part of the brain was hurt
  • How badly and how much of the brain was hurt
  • The age and health of the person
Can aphasia be prevented?

You can help prevent aphasia by:

  • Making heart-healthy lifestyle changes to lower your chance of having:
    • A stroke
    • Heart disease
    • Vascular disease (problems with your blood vessels)
  • Protecting your brain from injury:
    • Wearing the right helmet for sports safety, such as when riding a bike
    • Taking action to prevent falls
    • Always wearing your seatbelt and driving safely

NIH: National Institute on Deafness and Other Communication Disorders

Assisted Living

Assisted living is housing and services for people who need some help with daily care. They may need help with things like dressing, bathing, taking their medicines, and cleaning. But they do not need the medical care that a nursing home provides. Assisted living allows the residents to live more independently.

Assisted living facilities sometimes have other names, such as adult care facilities or residential care facilities. They vary in size, with as few as 25 residents up to 120 residents or more. The residents usually live in their own apartments or rooms and share common areas.

The facilities usually offer a few different levels of care. Residents pay more for the higher levels of care. The types of services they offer may be different from state to state. The services may include:

  • Up to three meals a day
  • Assistance with personal care, such as bathing, dressing, eating, getting in and out of bed or chairs, moving around, and using the bathroom
  • Help with medicines
  • Housekeeping
  • Laundry
  • 24-hour supervision, security, and on-site staff
  • Social and recreational activities
  • Transportation

The residents are usually older adults, including those with Alzheimer's or other types of dementia. But in some cases, residents may be younger and have mental illnesses, developmental disabilities, or certain medical conditions.

NIH: National Institute on Aging

Atrial Fibrillation

What is atrial fibrillation (AFib)?

Atrial fibrillation, also known as AFib or AF, is one of the most common types of arrhythmias. Arrhythmias are problems with the rate or rhythm of your heartbeat. They can cause your heart to beat too slowly, too fast, or in an irregular way.

If you have AFib, your heart beats irregularly and sometimes much faster than normal. Also, your heart's upper and lower chambers do not work together as they should. When this happens, the lower chambers do not fill completely or pump enough blood to your lungs and body. This can cause symptoms such as dizziness, fatigue, and a pounding heartbeat.

AFib may happen in brief episodes, or it may be a permanent condition. It's very important to treat it, since AFib can put you at risk for stroke and other heart conditions.

What causes atrial fibrillation (AFib)?

AFib is most often caused by changes to the heart's tissue or the electrical signaling that helps the heartbeat. These changes can happen due to different conditions and factors, such as high blood pressure, coronary artery disease, congenital heart defects, infections, and aging. Sometimes the cause is unknown.

Who is more likely to develop atrial fibrillation (AFib)?

Anyone can develop AFib, but there are certain things that raise your risk for it:

  • Aging. The risk of atrial fibrillation increases as you get older, especially when you are over age 65.
  • Family history and genetics. AFib can run in families. So can heart disease, which raises your risk of AFib.
  • Some lifestyle choices. Your risk is higher if you drink a lot of alcohol, use certain illegal drugs such as cocaine and methamphetamines, or smoke.
  • Having certain health conditions, such as:
    • High blood pressure
    • Diabetes
    • Heart failure
    • Heart valve diseases
    • Obesity
    • Hyperthyroidism
    • Chronic kidney disease
    • COPD and other lung diseases
    • Sleep apnea
  • Race. AFib is more common in people with European ancestry.
  • Recent surgery. You may be at risk of atrial fibrillation in the early days and weeks after surgery on your heart, lungs, or esophagus.
What are the symptoms of atrial fibrillation (AFib)?

Some people who have AFib don't have any symptoms and don't know they have it. If you do have symptoms, you may only notice them once in a while. Or you may have symptoms that are more frequent. And in some cases, the symptoms might be severe. If you have heart disease, you are more likely to notice your symptoms. And those symptoms could get worse if your heart disease gets worse.

The symptoms of AFib can include:

  • Extreme fatigue, which is the most common symptom
  • Heart palpitations (the feeling that your heart is skipping a beat, fluttering, pounding, or beating too hard or too fast)
  • Trouble breathing, especially when lying down or when exercising
  • Chest pain
  • Dizziness or fainting
  • Low blood pressure
What other problems can AFib cause?

If AFib is not treated, it can lead to serious health problems (complications) such as:

  • Stroke
  • Heart failure
  • Blood clots
  • Sudden cardiac arrest (SCA)
  • Cognitive impairment and dementia

To help prevent these problems, it's important to contact your health care provider if you are having symptoms. If you do have AFib, the sooner you are diagnosed and treated, the better.

How is atrial fibrillation (AFib) diagnosed?

To find out if you have AFib, your provider:

  • Will ask about your medical history, including your symptoms, lifestyle, and any other health conditions you may have
  • Will ask about your family history, to find out if you have relatives who have or had AFib
  • Will do a physical exam
  • May order blood tests
  • Will likely order heart tests, such as an electrocardiogram (also called an EKG or ECG) and echocardiogram
  • May ask you to wear a heart monitor device that records your heart's electrical activity
What are the treatments for atrial fibrillation (AFib)?

The treatments for AFib may include:

  • Blood thinner medicines that help prevent blood clots from forming.
  • Medicines to control your heart's rhythm and rate.
  • Following heart-healthy lifestyle changes, such as:
    • Following a heart-healthy eating plan that limits saturated fats, salt, and cholesterol. An example is the DASH eating plan.
    • Limiting or avoiding alcohol, because it can increase your heart rate.
    • Aiming for a healthy weight.
    • Getting regular physical activity.
    • Managing stress.
    • Quitting smoking.
  • Procedures such as:
    • Electrical cardioversion, which restores your heart rhythm using low-energy shocks to your heart.
    • Catheter ablation, which scars the tissue that is causing the arrhythmia. The scar tissue blocks the abnormal heart signals.
  • Surgeries such as:
    • Surgery to put in a pacemaker to help control the arrhythmia.
    • A Maze procedure, which creates scar tissue in a maze-like pattern in certain parts of the heart.
    • Left atrial appendage closure, a surgery on a small sac in the muscle wall of your left atrium (the upper left chamber of your heart). It helps prevent blood clots and can reduce your risk of stroke. This surgery is for people who are not able to take blood thinners.
Can atrial fibrillation (AFib) be prevented?

There are steps you can take to help lower your risk of atrial fibrillation, such as:

  • Making heart-healthy lifestyle changes:
    • Following a heart-healthy eating plan
    • Limiting or avoiding alcohol
    • Aiming for a healthy weight
    • Getting regular physical activity
    • Managing stress
    • Not smoking
  • Avoiding illegal drugs, such as cocaine and methamphetamines
  • Taking antiarrhythmic medicine (medicine to treat arrhythmia) if you are having heart surgery
  • Treating any health conditions that could raise your risk of AFib

NIH: National Heart, Lung, and Blood Institute

Brain Diseases

Your brain is the control center of your body. It controls your thoughts, memory, speech, and movement. It regulates the function of many organs. It's part of your nervous system, which also includes your spinal cord and peripheral nerves. The nervous system sends signals between your brain and the rest of the body. Your nerves take in information from your senses and send it to the brain to be processed. Your brain and nerves also communicate to help you move and to control your body's functions.

When the brain is healthy, it works quickly and automatically. But when you have a brain disease, it may affect how well you can function and do your daily activities. Some common brain diseases include:

  • Brain tumors, which can press on nerves and affect brain function.
  • Degenerative nerve diseases, which can affect many of your body's activities, such as balance, movement, talking, breathing, and heart function. Types include Alzheimer's disease and Parkinson's disease.
  • Encephalitis (inflammation in the brain), which can lead to problems such as vision loss, weakness, and paralysis.
  • Genetic brain disorders, which are caused by changes in genes (also called variants or mutations). These disorders can affect the development and function of the brain.
  • Strokes, which can cause a loss of brain cells and can affect your ability to think clearly.
  • Traumatic brain injuries (TBIs), which can affect brain function. They may range from mild to severe. The effects of a TBI may be temporary or permanent.

The symptoms of brain diseases vary widely, depending on the specific problem. In some cases, damage is permanent. In other cases, treatments such as surgery, medicines, or therapies such as physical, occupational, and speech therapies, may cure the disease or improve the symptoms.

Caregivers

A caregiver gives care to someone who needs help taking care of themselves. The person who needs help may be a child, an adult, or an older adult. They may need help because of an injury or disability. Or they may have a chronic illness such as Alzheimer's disease or cancer.

Some caregivers are informal caregivers. They are usually family members or friends. Other caregivers are paid professionals. Caregivers may give care at home or in a hospital or other health care setting. Sometimes they are caregiving from a distance. The types of tasks that caregivers do may include:

  • Helping with daily tasks like bathing, eating, or taking medicine
  • Doing housework and cooking
  • Running errands such as shopping for food and clothes
  • Driving the person to appointments
  • Providing company and emotional support
  • Arranging activities and medical care
  • Making health and financial decisions

Caregiving can be rewarding. It may help to strengthen connections to a loved one. You may feel fulfillment from helping someone else. But caregiving may also be stressful and sometimes even overwhelming. You may be "on call" for 24 hours a day. You may also be working outside the home and taking care of children. So you need to make sure that you are not ignoring your own needs. You have to take care of your own physical and mental health as well. Because when you feel better, you can take better care of your loved one. It will also be easier to focus on the rewards of caregiving.

Dept. of Health and Human Services Office on Women's Health

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