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| TX: 26.07.05 - Alzheimer's and early diagnosis PRESENTER: LIZ BARCLAY |
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| Downloaded from www.bbc.co.uk/radio4 THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE BBC CANNOT VOUCH FOR ITS COMPLETE ACCURACY. BARCLAY Alzheimer's Disease is the most common cause of dementia. There are between a half million and a million people with the condition in the UK. Diagnosis is often difficult, particularly in the early stages, the disease can take hold months or even years before the symptoms become identifiable. Now by looking at the work of authors and orators affected by Alzheimer's scientists may be able to trace the progression of the disease. The Iris Murdoch Study has revealed how Alzheimer's started to affect the author's language before she become aware of it. One of the most acclaimed and prolific writers of the 20th Century Iris Murdoch was diagnosed with Alzheimer's at the age of 76 and died three years later in 1999. Rachel Schofield went to meet her husband John Bayley and his second wife, Iris's great friend, Audi Villers, they described Iris's passion for writing. BAYLEY She loved living in separate worlds and when she created the world of a novel it was extremely real to her, for the time when she was writing it and then it disappeared and something else would occupy her. VILLERS I don't think she could imagine life without the writing. BAYLEY No I quite agree. VILLERS It was so much part of her and the sort of routine she had. And she got up quite early in the morning, I think she had a cup of tea in the morning, then she wrote and then she had breakfast later on and then she wrote again and then she would write again in the afternoon. SCHOFIELD So she never stopped? VILLERS No she never stopped. She always carried a little piece of paper and then if she got an idea she would write it down and her pocket was stuffed with little ideas - things she'd seen or things she just thought about. SCHOFIELD Her vast supply of ideas led Dame Iris Murdoch to write over 30 books in just four decades. But in 1994, working on her last novel, Jackson's Dilemma, the ideas seemed to dry up and Iris complained of writer's block. When the novel was published some critics were harsh, comparing it to the work of a 13 year old schoolgirl who doesn't get out enough. But it was only two years later that Iris sought medical advice from John Hodges, professor of behavioural neurology, based at Addenbrookes Hospital in Cambridge. HODGES By the time I saw her she had very poor understanding of word meaning and her ability to name even simple objects. It became apparent that yes she did have this severe loss of vocabulary but in addition to that had telltale signs of Alzheimer's with very severe loss of memory for her own life and recent events. She had great difficulty retaining new information, so she would ask me were I was from and I would say I've come over from Cambridge and she would say - Oh yes, you know, Cambridge it's a lovely city, I remember being there. And then five minutes later would ask the same thing. SCHOFIELD Iris underwent a series of brain scans and verbal tests, including some devised by Professor Hodges and his colleagues based on her own work. HODGES We took titles of her books and we took characters from the books, we'd take Cuthbert Peterson and match it with the appropriate book or we'd match it with the inappropriate book or we'd take names of people who didn't exist, who were sort of friends of ours and get her to choose which were the appropriate characters and which books they appeared in. And actually as her disease worsened we took titles of books that she'd written and titles of books that other people had written or that we made up and she just had to choose the books that she had written and put them in order, for instance, and had great difficulty. SCHOFIELD In 1997 Professor Hodges diagnosed Alzheimer's, two years later Iris Murdoch died aged 79. But it was not until last year that Dr Peter Garrard, a self-confessed Murdoch fanatic, based at the Institute of Neurology in London began to take a renewed interest in her work. GARRARD It was clear reading Iris's final book, Jackson's Dilemma, that it was very unlike the earlier books - the structure of the plot and the characters and the way the action progressed. And what I saw as the lack of any significant action in it at almost any time. SCHOFIELD John Bayley and his second wife, Audi, are still loyal fans of the book but admit it stands apart from her other work. VILLERS It's a funny book because it doesn't hang together very well, I mean people haven't got the same edge, they change their names ... BAYLEY She was so good on plot normally. VILLERS Yes. She couldn't remember what she called her characters, she kept saying - I cannot remember what this person is doing. SCHOFIELD Dr Garrard was intrigued by the change in her writing, which he suspected occurred long before the Alzheimer's diagnosis. He designed a study comparing Jackson's Dilemma with Iris's very first novel - Under the Net - published in 1954. He also included a novel from the height of her career - 1978 - called The Sea, The Sea. His analysis was helped by Murdoch's highly consistent approach to writing. BAYLEY She planned it meticulously and then she wrote it. Because I remember saying to her - How's the novel going? And she'd say - It's going alright, I've finished it. I said - Finished it! But you haven't started to write it yet. She said - No, but all the work's been done. SCHOFIELD Put simply Garrard's study involved scanning the three books into computer and running a program to spot trends in the range and type of vocabulary. Could the changes that occur in the spoken language of Alzheimer's sufferers also emerge within the written texts? READING I'd been delayed by the strike. I hate the journey back to England anyway and until I've been able to bury my head so deep in dear London that I can forget that I have ever been away, I'm inconsolable. GARRARD We choose a passage from the first book - Under the Net - and we can see that there's much more variation in the vocabulary, the use of abstract rather than concrete terms is much more evident, there's much less repetition even of common words like "the" and "a". READING Edward Lannion was sitting at his desk in his pleasant house in London in Notting Hill. The sun was shining. It was an early morning in June, not quite mid-summer. Edward was good looking - he was tall and slim and pale. He was very well dressed... GARRARD Whereas if we go to Jackson's Dilemma the words appear to have more concrete meanings, there's less of a variety of vocabulary, the words are repeated more often, the words that are used are much more commonplace in general usage. READING ... his beautiful mother had died of cancer when he was 10. He had seen her die. When he heard his father's sobs ... GARRARD It's an exception for people to leave this paper trail of their natural cognitive abilities but it's not by any means an isolated case, a lot of people leave diaries and written or even these days video or audio recorded records of their spoken output. SCHOFIELD The next potential case study for Dr Garrard is from the world of politics. CLIP FROM HAROLD WILSON SPEECH It has been laid down by constitutional authorities at all levels, including the former Lord Chancellor, the noble lord Lord Hailsham ... GARRARD Harold Wilson died in 1995, 10 years after the diagnosis of Alzheimer's Disease was made, and yet for 25 years before that everything he said in the House of Commons would have been recorded, pretty much verbatim. So again this is another example where an early middle and late sample from his output could be compared to one another. And actually it's still an unanswered question why he resigned so abruptly in 1976 and there have been suggestions that although this predated the diagnosis of Alzheimer's Disease he was losing his grip and this would represent a very good opportunity to provide for the political historians some evidence to show that that is indeed what was happening. SCHOFIELD Dr Garrard now plans to undertake a Harold Wilson study on the same lines as that for Iris Murdoch. But however such research contributes to our understanding of Alzheimer's Disease the scientific will rarely overshadow the personal. BAYLEY One of the reasons why I like Jackson so much - or Jackson's Dilemma - is that it has such a wonderful ending. She didn't have any sort of self pity at all but then she makes Jackson say that he's come to a place where there's no road and this is very much what she felt herself you see, she wrote in her diary - I've come to a place where there isn't anywhere to go. ROBINSON Professor John Bayley. Back to the You and Yours homepage The BBC is not responsible for external websites |
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