February 21, 2017

"Rambling and long-winded anecdotes could be an early sign of Alzheimer’s disease..."

"... according to research that suggests subtle changes in speech style occur years before the more serious mental decline takes hold."
“Ronald Reagan started to have a decline in the number of unique words with repetitions of statements over time,” [said Janet Cohen Sherman, clinical director of the Psychology Assessment Center at Massachusetts General Hospital]. “[He] started using more fillers, more empty phrases, like ‘thing’ or ‘something’ or things like ‘basically’ or ‘actually’ or ‘well’.”

Worsening “mental imprecision” was the key, rather than people simply being verbose, however. “Many individuals may be long-winded, that’s not a concern,” said Sherman.
What about a blog that rambles on for 13 years?
Sherman and colleagues had initially set out to test the “regression hypothesis”, the idea that language is lost in a reverse trajectory to how it was acquired during childhood, with sophisticated vocabulary being the first thing to go.
I wonder what would happen if the words of this blog were analyzed in a computer — the growing/shrinking/stable vocabulary, the frequency of repetition, the drift to or from imprecision. You'd first have to extract all the quoted material....

As I said 4 years ago — oh, no, I'm repeating myself — if I got Alzheimer's, I'd blog right through it, like the man in this Washington Post article. Ah! Now, I'm looking to see whatever happened to this man — he's a retired doctor named David Hilfiker — and I see he published this a year ago:
I stopped writing this blog in October 2014 because I'd discovered that I did not, in fact, have Alzheimer’s disease.... Cognitively I've been stable now for almost two years and over the past six months certain abilities have actually improved: I'm able to concentrate a bit more, and I don't get confused as much as I did.  I still have significant deficits in memory, in word-finding, in organizing my thoughts, in multi-step cognitive processing, and in certain kinds of computation.  Aside from my memory decline and my difficulty word-finding, however, most people don't recognize anything wrong or they think that it's just a result of aging.  I believe it has to be more than aging, but whether it is or not is no longer important to me....
Fascinating!

ADDED: Maybe the blogging cured him. The blog was titled "Watching the Lights Go Out." Maybe the real/secret title is Keep Turning Lights On.

35 comments:

MisterBuddwing said...

I thought it was hugely sad when President Reagan failed to recognize his Secretary of State, George Shultz, but the real bottom was when he stared at a snow globe containing a miniature model of the White House - he knew he had something to do with it, but he couldn't figure out what.

Ann Althouse said...

The anecdote I remember — correctly? — is that he looked at his books and searched for the word and called them "trees."

n.n said...

Chaos precludes prediction. The path life follows can only be estimated (e.g. forecast) with accuracy inversely proportional to the product of time and space offsets from an observer's frame of reference (i.e. scientific domain).

EDH said...

Why did the article specifically mention "anecdotes" without further explanation?

Is there something particularly relevant to Alzheimers about the language used to recount stories?



Lyssa said...

Interesting. My grandfather was always known for being enthusiastically verbose, with funny, absurd, rambling stories. When I was a kid, my dad picked up a t-shirt for him at the shore that said "Help, I'm Italian and I can't shut up!" and we all had a good laugh.

When they first started to get worried about him, I recall my mother suggesting that he had always been like this, but as he was getting older, perhaps he was just becoming even more "himself." Sadly, of course, within a year, he was mentally gone, and a year later, physically as well.

Bob Boyd said...

Maybe Laslo has a rare case of Venereal Alzheimer's

roesch/voltaire said...

I have observed the signs of early dementia in a number of people including my mother who was a champ in scrabble and suddenly started cheating to win by looking up words that slipped her mind. This started at age 80 and she went on to live until 94, but my neighbor who retired from a UW publication began showing sighs last year when we shared neighborhood news, but apparently the type of Alzheimers she had progressed rapidly and she passed last week. Just remember,there can be no definitive diagnosis of Alzheimers until an autopsy has been performed, and depending on the person the brain can decline in a number of different ways.

traditionalguy said...

Refreshing our knowledge base is as needed as food and air, especially as we age.

As I age, I am spending more time around older people. And as friendly as they are, many of them seem to have quit learning anything new or reading good history. That is disappointing. One thing they do have in common is a strong aversion to ipads and iphones. They see such devices as if they are bad. Yet that is where most of the knowledge they need resides today.

The library that we once boxed up and shipped in a truck of its own when we moved, now stays in our Kindle and Audible Library. But that concept frightens the old folks.

I am personally indebted to Althouse for many new ideas and creative resources she generously shares, especially since a heart incident slowed me down.

David said...

I sometimes have trouble recalling familiar words. I know that I know the word I am looking for but it does not arrive when it is supposed to. The word will show up eventually, usually within a short while, but sometimes longer. It's like part of my brain has shifted from being a dog to a cat. I think if I just inject a little tuna fish into my head it will be ok.

Dust Bunny Queen said...

Ridiculous. Some people are able to think and speak in a linear style. Others, like myself, tend to think about several things at once and leap from topic to topic mid stream as the idea occurs to me based on the drift of the conversation.

I use/used the linear style when I'm dealing with a particular detailed subject or in a sales presentation because it is too confusing to the clients to jump around. Even so, a bit of digression in the course of the presentation is warranted to keep it from becoming a boring lecture, to add visual imagery, throw in personal anecdotes, add some humor, make similes and keep the presentation interesting. It is how you draw your customer's in and close a sale.

This is what Trump is doing. It isn't (necessarily) a sign of Alzheimer's or dementia. It is a speaking style.

My father is 87 and is beginning to show some signs of slippage. He is aware of it and frustrated. He says he can't remember some peoples names or dates. I'm like: "Dad! you could never remember names...When is MY birthday? You could never remember."

I don't remember some dates because.. why bother? I've got other things to think about. My husband and I have been married for almost 25 years (I think...maybe 24) and neither of us know our exact anniversary date. Sometime around Memorial Day is close enough. Because...so what? who cares? It doesn't matter. Not a sign of Alzheimer's. Just priorities.

Now, if we start forgetting each other's names or where we live....that would present a problem.

Dust Bunny Queen said...

David said: I sometimes have trouble recalling familiar words. I know that I know the word I am looking for but it does not arrive when it is supposed to. The word will show up eventually, usually within a short while, but sometimes longer.

We (hubby and I) have a similar thing. Watching a movie we see an actor and try to remember what the name is or other movie we saw that person in. Trying to remember the name of a song or artist who did the song. That information is there somewhere in the archives of our brain but not immediately available.

So...we just forget about it for a while and eventually the data will surface. Sometimes even days later and one of us will triumphantly exclaim....Mungo Jerry! With no explanation and we both know what we are talking about. Aha. That's IT!! We call it using the mental rolodex. While our brain is occupied doing other things, another part of the brain is frantically flipping through the rolodex or digging through the archives to get the information.

William said...

I am lucky enough to have lived long enough to worry about the Last Altz. It's insidious I have memory lapses, and you wonder if that's the early warning sign. I've no reason to believe that my mental acuity is greater than Churchill's or my overall fitness is better than Reagan's, but both those men were afflicted with dementia. I suppose if you stay active, eat right, and read the occasional book in Spanish, then you diminish the odds, but who really knows. In the end, it's just a matter of luck. And, as first noted, if you're old enough to worry about Alzheimer's, you've already had your fair portion of luck.

MisterBuddwing said...

A really infuriating news story was about an Ohio clinic that, it's been alleged, falsely told dozens of people they had Alzheimer's. One patient committed suicide; the autopsy, we're told, showed no sign of Alzheimer's. The thing is, these people were experiencing cognitive issues, which made them ripe for misdiagnosis.

http://hosted.ap.org/dynamic/stories/U/US_ALZHEIMERS_WRONG_DIAGNOSES?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT

hombre said...

Occasional inconsequential memory lapses like a name, a word, etc., is not abnormal for people in their 70s - even Ronald Reagan.

hombre said...

Once I had a near encyclopedic knowledge of actors and movies, singers and songs, including lyrics. I don't seem to remember the recent ones, although the earlier knowledge has stayed with me.

Given that the new artists and their crafts are all about "social justice" and other really important stuff, I guess it must be dementia. I'm having the same problem with the NFL, except for Brady.

mockturtle said...

What about 'like', as in, "I was, like, really blown away."

Yancey Ward said...

Ann's blog is still YUUUUGELy good. Unsad!

tcrosse said...

It's common to walk into a room and forget why. It's all part of growing up.
The term of art for such a mental lapse is Brain Fart.

Luke Lea said...

Makes me worry about Trump.

Dust Bunny Queen said...

Once I had a near encyclopedic knowledge of actors and movies, singers and songs, including lyrics. I don't seem to remember the recent ones, although the earlier knowledge has stayed with me.

I don't pay any attention to most of the newer artist because
1. I don't like them.
2. I don't care to.
3. It is a generational thing. My parents (in their ages of 35/37 when I was a teen) didn't know the names of the rock and roll or psychedelic artists of the 60's. They weren't demented...they didn't care either.

Given that the new artists and their crafts are all about "social justice" and other really important stuff, I guess it must be dementia.

Nah. I chalk it up to....who cares? I've got better things to do and to think about.

Karen of Texas said...

It is entirely possible that some dementia/Alzheimer's is the result of medications, especially in the older population. And I don't mean the medication "creates" dementia per se. Statins are a prime example. They lower cholesterol. Guess what your brain needs to function? Your brain needs cholesterol.

As we age, our ability to breakdown the food we eat so that vital vitamins and minerals necessary to keep us alert and active is diminished - often times because we produce less stomach acid. Antacids/acid blockers aren't necessarily are good thing.

Also, B12 deficiency adversely affects the brain. Bigly.

Bruce Hayden said...

I think that dementia/Alzheimer's is one of our biggest fears as we enter our twilight years. We watched some in our parents' generation go this way. My father was in a rehab facility last year, and they had a locked Alzheimer's wing. Woman there in gen pop whom we wondered why she wasn't there too. She would wander around all day, go into other patients' rooms, and usually just sit there, until the nursing staff could be summoned to get her back home. Lost a fraternity brother a couple years ago to something that looked like aggressive Parkinson's, My partner worries obsessively about me, having lost her father to Alzheimer's a couple years ago. She managed to keep the diagnosis from her parents, out of fear of what her father might have done, if he had known. I told her not to worry about me in that respect - Reagan is my role model, should I ever have to face it.

The problem is that it is one of those things that we know so little about. We don't know how to prevent it. No matter how cleanly, and how healhily we live, it can still strike. One of my mother's friends ate organic and refused estrogen treatments (which reminds me - I need to head to the pharmacy to pick such up for said partner). My partner's father ate plenty of collesteral, but worked out, his entire lifetime, as a fiend. Even when he couldn't remember why (I won't mention it to her, but I do worry abot her, and her ability to survive an Alzheimer's diagnosis - she has a family history there, and I don't - besides, I have 2 iPhones and 3 iPads, and she refuses to learn to use any of them) . Others were middle of the road.

Boomers aren't aging gracefully. We were the original youth culture, and these ailments of the old are just reminders that we are no longer young, but rather several generations beyond that.

Jason said...

Glen Reynolds is gonna live forever.

stever said...

I lost a father with dementia (TIA related) and a step-father to Alzheimer's. These can be long, gradual losses. Its hard not to see death as a relief.

Kentucky Packrat said...

I've had several people in the family with dementia. It was hard to watch my grandmother not be able to play bridge. On the other side, my grandfather started getting that "far away stare", but fortunately he died of other issues before it could get bad. His brother doesn't look like he's going to be as lucky.

We still have very little understanding about what causes dementias, but it's incredibly clear that intellectual rigor is critical to fighting the disease. Working on what mental exercise is available to you appears to delay the start of symptoms, and makes symptoms take longer to develop and longer to progress. For most symptoms of growing old, you just have to keep doing something interesting to you.

Speaking of Reagan, I like a story from Michael Reagan. Michael was upset that Ronald hadn't hugged him since he was a child. A friend told Michael "Then just hug him once. I think you'll find that is all it will take." It was. From the first hug Michael initiated until Ronald couldn't move, Ronald always found him and hugged him at least once, no matter how bad the Alzheimers was or what other mental issues were going on.

jimbino said...

At the local bar we play Trivia once a week. The winners are mostly septuagenarians and octogenarians and we would win even more if questions concentrated around geography, history, math, science and English grammar. That might be because those haven't changed much in decades and our mastery of them was completed some years ago. Then again, it might be because our educational system has become so degraded that the young'uns haven't a clue. If it weren't for current sports, TV and film questions, they'd probably not get a single Trivia answer right.

StephenFearby said...

AGING, June 2016, Vol 8 No 6
Reversal of cognitive decline in Alzheimer’s disease

"...The therapeutic approach used was programmatic and personalized rather than monotherapeutic and invariant, and was dubbed metabolic enhancement for neurodegeneration (MEND). Patients who had had to discontinue work were able to return to work, and those struggling at work were able to improve their performance. The patients, their spouses, and their co-workers all reported clear improvements. Here we report the results from quantitative MRI and neuropsychological testing in ten patients with cognitive decline..."

https://s3-us-west-1.amazonaws.com/paperchase-aging/pdf/9R5JsRe8k4Jq7uTXj.pdf

The ingredients in the MEND protocol (of which not all are necessarily selected for each subject) are not provided in this paper. Instead, one must go to Table 1 on page 711 of this earlier paper:

AGING, September 2014, Vol 6 N0 9
Reversal of cognitive decline: A novel therapeutic program

https://s3-us-west-1.amazonaws.com/paperchase-aging/pdf/NjJf3fWGKw4e99CyC.pdf

...which lists 25 goals, to be achieved though a variety of interventions -- almost all dietary supplements -- but also brain training (Posit Science) and stress reduction).

References (sparse) are provided to support each of the interventions.

Interestingly, the supplements include coconut oil (which contains medium chain triglicerides).

Two recent papers on same (not in the articles above) are:

Nutr Hosp. 2015 Dec 1;32(6):2822-7
[COCONUT OIL: NON-ALTERNATIVE DRUG TREATMENT AGAINST ALZHEIMER´S DISEASE].
https://www.ncbi.nlm.nih.gov/pubmed/26667739

Br J Nutr. 2015 Jul 14;114(1):1-14.
The role of dietary coconut for the prevention and treatment of Alzheimer's disease: potential mechanisms of action.
https://www.ncbi.nlm.nih.gov/pubmed/25997382


The incentive to consider a multimodal approach (like the MEND protocol) is spurred by the significant gains in function reported in the 9 case studies (2016 paper above).

YMMV

mockturtle said...

Kentucky Packrat asserts: but it's incredibly clear that intellectual rigor is critical to fighting the disease.

I thought that notion had been debunked. If 'intellectual rigor' had been the answer, my dear husband would not have succumbed to Lewy Body Dementia.

Erica Verrillo said...

The problem with Trump's speech isn't just that it is rambling, or that the lexicon is reduced. To really get a handle on neurodegeneration, you have to look at syntax. Syntax for first language acquisition is laid out very early in life. The process is unconscious. (Nobody "teaches" children their first language.) When Trump says things like he came from a "churched" background, or is looking for people with "brain" he is transforming parts of speech. (Noun to verb in the first case, and noun to adjective in the second.) That can only be accomplished in three circumstances 1) Trump is a poet and he has spent a great deal of time and effort coming up with ways to distort English, 2) Trump is plastered, or 3) Trump has progressive neurodegeneration. Given that Trump was speaking spontaneously on both occasions, and not visibly inebriated, I'd have to go with number 3.

mockturtle said...

Erica, go fuck yourself with a rusty rake.

HoodlumDoodlum said...

YT Still Alice - trailer 2016

HoodlumDoodlum said...

Quote from BBC.com article discussing the book "The Elements of Eloquence" (which is on my Amazon list and can be purchased through the Professor's Amazon portal):

The order of adjectives, according to the book's author Mark Forsyth, has to be: opinion-size-age-shape-colour-origin-material-purpose.
"If you mess with that word order in the slightest you'll sound like a maniac, he warns in the extract. "It's an odd thing that every English speaker uses that list, but almost none of us could write it out. And as size comes before colour, green great dragons can't exist."

Tyrone Slothrop said...

Telling rambling stories is just what old people do.

Sammy Finkelman said...

What's the order for adverbs?

Carol D. Angeles said...

Why are you talking about Trump when article is all about Alzheimer. I may not understand it whole but for me this is huge. Nearly whole my family is suffering from Alzheimer. I know everything it does, all the symptoms, I know everything what Wikipedia saying about it. I even got myself "lucky" to write
an assignment about it. And again - for me this is Huge.