Authorial Alzheimer's again

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In reference to my post "Literary Alzheimer's", Mark Seidenberg points out that the NYT might have chosen an earlier example of the same sort of investigation as one of the "Most Interesting Ideas" of 2005: Peter Garrard, Lisa M. Maloney, John R. Hodges and Karalyn Patterson, "The effects of very early Alzheimer's disease on the characteristics of writing by a renowned author", Brain 128(2):250-260, 2005. (This work was of course cited and discussed by Lancashire and Hirst.)

Garrard et al.'s abstract:

Iris Murdoch (I.M.) was among the most celebrated British writers of the post-war era. Her final novel, however, received a less than enthusiastic critical response on its publication in 1995. Not long afterwards, I.M. began to show signs of insidious cognitive decline, and received a diagnosis of Alzheimer's disease, which was confirmed histologically after her death in 1999. Anecdotal evidence, as well as the natural history of the condition, would suggest that the changes of Alzheimer's disease were already established in I.M. while she was writing her final work. The end product was unlikely, however, to have been influenced by the compensatory use of dictionaries or thesauri, let alone by later editorial interference. These facts present a unique opportunity to examine the effects of the early stages of Alzheimer's disease on spontaneous written output from an individual with exceptional expertise in this area. Techniques of automated textual analysis were used to obtain detailed comparisons among three of her novels: her first published work, a work written during the prime of her creative life and the final novel. Whilst there were few disparities at the levels of overall structure and syntax, measures of lexical diversity and the lexical characteristics of these three texts varied markedly and in a consistent fashion. This unique set of findings is discussed in the context of the debate as to whether syntax and semantics decline separately or in parallel in patients with Alzheimer's disease.

As for why the Gray Lady elevated Lancashire & Hirst into its yearly pantheon of interestingness, I suspect (aside from the considerable random factor involved in all top-N lists) that it has something to do with the fact that Agatha Christie's novels sold something like four billion copies worldwide, while Iris Murdoch's works (though justly celebrated) did not.


  1. Mark P said,

    December 15, 2009 @ 10:27 am

    This is an interesting topic to me, since one of my in-laws recently died with dementia (not necessarily Alzheimer's but something similar), and we struggled to understand what his speech patterns indicated about his internal life. But it seems to me that there are some issues that would need to be addressed before conclusions could be drawn about the cause of any identified changes in Murdoch's writing. For example, it's not really sufficient to say, "Anecdotal evidence, as well as the natural history of the condition, would suggest that the changes of Alzheimer's disease were already established in I.M. while she was writing her final work." Alzheimer's progresses differently in different people, and there should certainly be some information about how far the disease had progressed at the time she wrote her last book, and how long it took to write the book. It wold also be relevant to know how the changes identified compare to those observed in other writers' work as they age.

    I'm also not sure why they would say, "The end product was unlikely, however, to have been influenced by the compensatory use of dictionaries or thesauri, let alone by later editorial interference."

    Maybe they address issues like this in the full article.

    [(myl) The journal makes the full article available, for free, here.

    There's quite a bit of research on the linguistic effects of Alzheimer's in people who are not published authors — I'll add to my to-blog list a note to review it some day. Also relevant is the "Nun study" literature.]

  2. rpsms said,

    December 15, 2009 @ 2:04 pm

    It seems to me that sampling from 3 works would hardly be sufficient to draw any conclusions at all.

    [(myl) In this case, the background includes a lot of normative research on the linguistic changes associated with normal aging, and with Alzheimer's and other neurodegenerative diseases; and also information about the progress of the disease in a particular writer. So it made (and makes) sense to examine her writing in that context.]

  3. slobone said,

    December 16, 2009 @ 1:39 pm

    A few years ago, I started making mistakes with common homophones — there, their, they're; you're, your; even the dreaded it's, its — while typing on the computer. This is something I had almost never done before, but it became (and remains) very frequent. I found a study somewhere (unfortunately I can't seem to find it again) that found that this is an early warning sign for Alz., which needless to say alarmed me quite a lot.

    The next stage was confusing similar words — left for lost. This has been happening while reading as well as writing.

    The interesting thing about it is that I still almost never spell words incorrectly — I just retrieve the wrong word. Some very specific brain cells must be going…

  4. Mark P said,

    December 16, 2009 @ 10:42 pm

    I see that the article does largely address the issues I raised.

    The apparent differences between lexical and grammatical errors is interesting, as is the question about whether such differences might be more or less relevant in verbal or written language.

    We noticed fairly late in my in-law's case that he could produce appropriate verbal responses to routine questions (how are you today?) that were sometimes fairly elaborate, but when asked other questions (is there a game on TV today?), he could produce essentially no response. It was almost as if he had recorded responses to certain types of conversation and could recognize when they were appropriate, but could not produce new responses to even simple questions.

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