Since I had a stroke five years ago, I've been worried about dementia. I remember a task and then immediately forget it. You pour water and then it comes out. You walk into a room and then can't remember why. You take pills. Or do you?
In a “60 minutes”A while ago, a researcher explained the science of losing your mind. He had been studying high-functioning nonagenarians in California for years. The brain scans on her”Study 90+”might show evidence of trouble (bright bands of red and yellow indicating plaque and tangled tissue, known harbingers of dementia) and yet participants might never show symptoms of decline. A neuromystery.
I am 62, not 92. My brain had been through its own disasters. Was something worse coming?
Actually, my stroke was not a crippling catastrophe. I couldn’t speak at first, but a miracle drug removed the blockage almost immediately, and my brain began to recover within days. I had my voice back within a week, and soon afterward I began putting sentences and paragraphs together. My doctors were pretty sure I would never be able to write professionally again, but I did. I even recorded part of the audio version of my memoir a year after the stroke, which, given what I’d been through, was perhaps more meaningful to me than writing it. It seemed like I was out of the woods.
But these memory lapses still occurred, almost daily. How could I write a publishable essay without remembering that, seconds earlier, I had grabbed half-and-half for my coffee? I began discounting and then hiding the mistakes from my wife, including the times I left the stove on or the car running.
I decided to take a cognitive test, worried about the possibility of progression. I knew something of what to expect. In 2014, I had undergone successful surgery for spinal cancer, and then my doctors wanted me to answer the test questions. I then protested because I saw it as an indignity: I just had cancer surgery and you want me to do what? I finally relented.
Now I wanted to get tested, even though the results could mean I would lose my driver's license, or worse. The therapist assured me that they would be kept private and would only be shared with my doctors. Still, I hesitated and canceled once.
The three-hour test was not fun. Participants in the “90+ Study” took a similar test annually as part of their protocol, and I saw myself in the “60 Minutes” footage of a frustrated, unsuccessful 90-year-old. It was humiliating. He wasn’t lacking in broad areas of recall, but there were more nuanced things: He couldn’t repeat three words that had been said to him 40 seconds earlier, and he couldn’t remember number sequences. The researchers gave him a second chance at some of the questions, as did the person who administered my test to me. No, nothing, I had to tell them. No, I don’t remember.
The report was 14 pages long. When it arrived in my inbox, I ignored it for several days. I wondered if I really wanted to know what they had discovered. What if keeping my lapses in the background (a kind of strategic denial, I know) was critical to my functional self?
It was terrifying, but I finally read the exhaustive report. Dozens of cognitive tasks were rated on a scale ranging from “exceptionally poor” to “above average.” My scores weren’t great. I was found to be deficient in “executive function,” a term that refers to planning and carrying out work that the brain routinely performs. The psychology clinical fellow who tested me made practical suggestions for daily living (like putting up sticky notes with reminders) and recommended follow-up appointments with a speech-language therapist and my neurologist.
Perhaps not surprisingly: I read the report and then forgot about it. And I didn't follow up. That was three years ago.
My first nonfiction book in 10 years will be published in a few days. I started researching it a few months after seeing my cognitive test report. It includes notes on sources and an extensive bibliography of the books I read for research. Due to various family emergencies, I started writing late, but I met the book deadline and finished most of it within three months.
And as I prepare to publish, I know there will be times when I walk into a room and wonder: what am I doing here?
Todd Balf's new book, “Three kings: race, class and the rivals who broke barriers and launched the modern Olympic era,”will be published on July 2.
