She’s gone from New York City shock jock, to television talk show host. But, Wendy Williams isn’t in today’s headlines because of her work in the spotlight. Instead, it is her medical conditions that have gossip columns buzzing. As a documentary “Where Is Wendy Williams?” releases on Lifetime, many are seeking to know more about her condition, treatment, and well being.
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Medical Conditions Explained
According to multiple reports, Williams, a 59-year-old, was diagnosed in 2023 with primary progressive aphasia and frontotemporal dementia (FTD). This same condition was in the spotlight recently, as it also affects the actor Bruce Willis.
What Is Frontotemporal Dementia?
FTD is the result of damage to neurons in the frontal and temporal lobes of the brain. The frontal lobe is right behind your forehead and helps you manage planning, decision making and communication. The temporal lobe is below and a little bit behind the frontal lobe and helps process language and emotions. FTD can cause a broad range of symptoms, according to the National Institute on Aging (NIA), including unusual behaviors, emotional problems, trouble communicating, difficulty with work, or difficulty with walking.
“It’s a really tough diagnosis, I have to tell you,” said Johns Hopkins University cognitive scientist Brenda Rapp via a PBS Newshour report. “Maybe you’re doing things that are bothering people, and you don’t really understand why they’re bothering people.” That can be frustrating for everyone involved, Rapp said.
People start to experience symptoms of FTP in their 40s, 50s, and 60s. It is a rare condition, and tends to strike earlier than other types of dementia.
“Roughly 60% of people with FTD are 45 to 64 years old,” says the NIA.
What Is Primary Progressive Aphasia?
Primary progressive aphasia is a condition that slowly damages the parts of the brain that control a person’s speech and language on the left side. It’s not clear how that damage happens, but it gets progressively worse over time.
“People with PPA usually have difficulty speaking, naming objects or understanding conversations,” says the Weill Institute for Neurosciences’ Memory and Aging Center.
Three Types of PPA
There are three types of PPA, grouped by specific constellations of symptoms. Those variants include:
- Semantic (svPPA): increased trouble naming people, objects, facts, and words
- Nonfluent/agrammatic (nfvPPA): often begins with complaints over a difficulty pronouncing words
- Logopenic (lvPPA): word-finding difficulties are the most prominent feature in patients with logopenic PPA
Many patients with PPA, like Wendy Williams, have it alongside or as a result from FTD or Alzheimer’s disease.
Probable Treatments for FTD and PPA
Neither FTD nor PPA can be “cured.” However, therapies and medications may help with certain symptoms.. For example, those that struggle with speaking may benefit from speech therapies, while those with trouble walking or standing may want to try physical therapies to work on necessary skills.
Some studies have shown that simple lifestyle changes, such as increased socialization can benefit patients with dementia by providing “positive effects on cognition and overall wellbeing.” Some with FTD find it useful to carry aphasia identification cards like these to notify those they are interacting with of their struggle.
There are currently no medications that have proven beneficial in treating either FTD or PPA. Some may find it helpful to manage some subsequent symptoms, such as depression or anxiety, with medications for those particular conditions.
Some PPA patients have found success in managing symptoms with:
- Antidepressants:
- Trazodone can reduced behavioral symptoms
- Selective serotonin reuptake inhibitors (SSRIS) can fight associated depression
- Some SSRIs such as Celexa (citalopram), Lexapro (escitalopram, and Zoloft (sertraline) fight depression
- Antipsychotics:
- Olanzapine (Zyprexa) or quetiapine (Seroquel) have sometimes been used to treat behavioral symptoms of FTD
Potential Side Effects of FTD and PPA Treatment
All medications come with possible benefits, as well as potentially harmful side effects. Medicines can help, heal, or harm. You should discuss with your doctor before adding any new prescribed medications, as well as any new supplements, dietary changes, or vitamins to your routine.
If your doctor does suggest a new medication, be sure you understand its risks and benefits. Ask your doctor about the side effects of the medication, along with other helpful questions to be sure you (or your caregivers) are making educated decisions about your healthcare choices.
Antidepressant Side Effects
Antidepressants are often used to treat a variety of mental health disorders. The most common type of antidepressants are SSRIs (selective serotonin reuptake inhibitors). They work by preventing your brain cells from recycling a neurotransmitter called serotonin, leaving more of it available to act in your brain.
Scientists have long suggested that people with depression often have lower levels of serotonin, which is known to be involved in satisfaction and happiness. However, the idea that raising levels of serotonin is sufficient to treat depression is currently being debated in the scientific community.
Other types of antidepressants, including SNRIs (serotonin norepinephrine reuptake inhibitors,) such as Cymbalta (duloxetine) MAOIs (monoamine oxidase inhibitors), such as Nardil (phenelzine) and tricyclic antidepressants, such as amitriptyline, all similarly increase the availability of serotonin in your brain. Some also work by raising levels of another neurotransmitter, norepinephrine, along with serotonin.
Side effects of antidepressants include:
- Decreased sexual desire, arousal, and function
- Raised risk for hip fracture in seniors (from about a 2.8% to 3.5% chance)
- Increased risk of emergency room visits or death for seniors who also have COPD (15% and 20%, respectively)
- Weight gain
- Excessive sweating
- Nausea
- Drowsiness
- Jitteriness
- Rise in blood pressure (venlafaxine, specifically)
- Suicidal thoughts
To read more about the risk of suicidal thoughts and actions, read “MedShadow’s” SSRIs and Suicide Risk in Those With Depression.
Antipsychotic Side Effects
Everyone should be cautious with antipsychotic medicines, but it’s especially important to monitor people with dementia who are prescribed antipsychotics. The drugs can have serious side effects, including an increased risk of death.
Both first and second generation antipsychotics come with an FDA “black box warning,” the most serious warning of potential harm or death that the FDA publishes. The warning applies only to seniors with dementia because they have 1.6 – 1.7 times the risk of death of those who are not taking antipsychotics.
Most of the deaths linked to antipsychotic use are cardiovascular (heart failure, sudden death) or infections like pneumonia. It is not yet clear why the elderly are at higher risk of death or even if the drugs are to blame.
Over the years, the FDA has also warned of dangerous skin reactions and impulsivity associated with the use of certain antipsychotics.
Though the antipsychotic side effect is rare, people who have been prescribed antipsychotics may experience impulsivity in different ways. It can manifest as a gambling addiction, inappropriate sexual behaviors, or binge eating.
Side effects can take weeks to resolve after discontinuing the drugs, and some impacts last long term. No medication of this nature should be immediately stopped, as difficult withdrawal symptoms, including insomnia, tremors, and psychotic symptoms can be destabilizing.
Early Warnings Signs of FTD and PPA
The warning signs for these conditions can be very subtle. Doctors often see patients come in complaining of small inconveniences, such as the inability to think of the proper word, or a brief inability to say a word they want to say. They may seem like harmless characteristics of aging.
Other changes in a person may take the shape of new dietary preferences. A person may suddenly develop a frequent taste for sweet snacks that they’d never had before. They may also experience a push to repeat actions, such as gambling or risky behaviors, when there were no such drivers to do so previously. Still others may reduce their hygiene habits, or appear lazy to some, lapsing in cleanliness.
Genetic testing can determine a likelihood for the condition, however nothing can be done to stop its onset, nor its progression. Once the dementia takes hold, there is little that can slow it. The symptoms will progressively worsen.
What may start as a simple wobble will likely lead to an inability to walk or stand upright. What may begin with a loss for the “right word” may soon develop into a complete inability to string together thoughts. Some patients lose the ability to swallow, “forgetting” how to do so, making eating impossible without the aid of tubes.
Can I Prevent FTD or PPA?
While science has yet to find conclusive evidence of any preventative measures being completely effective, some experts recommend that living a healthy lifestyle can reduce your risks for developing additional conditions.
Medical experts note that there is no way to prevent these conditions, but that lifestyle choices such as:
- Eating a healthy diet
- Getting frequent exercise
- Stimulating the brain with activity
- Stopping smoking
are beneficial in improving overall health and have little to no harmful side effects. For more on preventing dementia, read “MedShadow’s” article here.
