Journey into Alzheimerland

Abstract

I would probably not have asked for a referral to the local memory clinic if I had not at one stage been a clinical psychologist with my own experience of assessing people for dementia. I also knew that early diagnosis was important and that new drugs were available which could at least slow down the deterioration associated with the disease. At the age of 76, I wanted to know one way or the other. I went for tests in the first place because my wife and I were concerned about an increasing number of lapses of memory, such as my not bringing home the right shopping, forgetting to do routine things like switching off lights and not being as reliable as I used to be in planning a journey. The experience of being on the ‘other side of the table’ was a bit strange at first, especially when I realized that I had used some of the memory tests 50 years earlier. I remembered feeling uncomfortable at that time because test findings did not always correspond to what people could or could not do in real life situations. My psychological tests showed – and still show more than four years later – normal or above normal functioning in most cognitive areas, with the exception of tasks involving immediate recall of strings of unrelated words or pictures. I expected this finding because my small children could always beat me at games involving recall of upside down pictures. All this sounds like rationalization and denial but the brain scan evidence showed a greater degree of cortical atrophy than might be expected at my age. After reviewing all the evidence, including a detailed account of the concerns expressed by my wife, my consultant told us that although Alzheimers could only be fully confirmed at autopsy by the presence of plaques and tangles in the brain, he felt that the balance of probability lay with a diagnosis of ‘early, very mild Alzheimer’s Disease’. Fortunately, the deterioration which I was expecting has not materialized so far and, in many respects, my everyday functioning remains normal for my age and background. I would even say that the quality of my intellectual life has developed considerably since I retired from the university and ceased to be a professor. My recent A* in GCSE Italian provided reassuring evidence that some neurones are still firing and I am now moving on to an Open University module. I have also published a memoir (Mittler, 2010). My wife and I now think of Ageing and Alzheimer’s as conjoined twins embedded not just in my central nervous system but in our way of life. I cannot tell them apart and can only speculate which of them has leaped out to cause mischief. The last time for me was in Italy when I forgot to move our car from the town square before market day, only to come across