"Where did I leave the car keys?"; "I came upstairs to fetch something, but what was it?"; "I'm aware I know this person but her name has gone out of my head..."
All these dilemmas will be familiar to anyone over 50. The memory declines with age. Not entirely, of course. The paradox is that at the very time when vivid images of a childhood event come unexpectedly to mind, we aren't able to recall the address of a friend we visited yesterday. On the one hand we can wallow in a nostalgia for Proust-like walks below the hawthorn blossom, but the next moment we have to apologise for some stupid lapse of a familiar name or fact that makes us both embarrassed and foolish.
But when exactly should we worry? One of the early symptoms of Alzheimer's disease is forgetfulness, and a survey published this week at a conference in Rome on dementia finds that the British are the slowest to report their symptoms and thus have the longest time between noticing the first symptoms and a diagnosis of Alzheimer's. From first symptoms to diagnosis takes about 10 months in Germany; in Britain it takes 32 months. That's far too long. The sooner symptoms are reported, the sooner available drug treatments can be used. If diagnosis happens late, the drugs aren't effective.
Dr David Wilkinson, a consultant old-age psychiatrist from Southampton, puts this down to British stoicism, which he sees as a public health problem where Alzheimer's is concerned. Older people battle on without telling anyone, believing their symptoms are part of normal ageing, and close family are fearful and awkward about suggesting tests. Wilkinson thinks an unspoken ageism keeps funding low in this area of medicine.
But what is part of normal ageing, and what is a treatable disease? I am almost neurotically alert to such changes. Some years ago I sped off to the doctor complaining of a bad memory and was dispatched for some fancy tests. Among other things, I was given very long numbers to recite backwards; next I was shown a vast spread of photographs of different physiognomies, and then given a complex quiz about them. After this and more, my results were analysed and I was told I had nothing to worry about. That didn't stop me, of course. Apparently, again according Wilkinson, there is something he calls "memory neurosis" among perfectly healthy 50- and even 40-year-olds, who are simply worried about their declining powers. What I want to know is, how can you tell one condition from the other?
I also recently went to have my hearing tested. I was put through the tests and shown the chart of my hearing. There it was, a line for each ear that slid down the page where a young and buoyant ear would have held steady. "Oh my God, I'm going deaf!" No, no, I was reassured, I was merely experiencing the decline considered to be customary for my age. It seems a fine distinction, and one to keep an eye - or ear - on. I continue to monitor my performance in loud, crowded places.
We have to be brave about this. It is something we need to confront before it gets too bad. A couple of years ago I had a minor part in the film Iris, in which Judy Dench played the part of the novelist Iris Murdoch as she declined into Alzheimer's. I played the television interviewer asking the question at just the moment when Iris has her first confused lapse of memory. It was a brief and poignant moment that presaged all that was to come.
The film's director, Richard Eyre, had a parent who suffered from Alzheimer's and I believe he felt that making the film would familiarise us all with its symptoms and enlist our sympathy for its sufferers. From the conference in Rome, comes further news that this is essential.
British stoicism may be one explanation why we take so long to seek a diagnosis. The other is that Alzheimer's carries a stigma, people are ashamed of being sufferers. They would rather tell themselves, "Oh, it's just getting old," as a comforting response to fears about having the disease we all dread. But Alzheimer's is a specific condition. The medics are working on it. There are drugs to help. We shouldn't hold out. Society may want to dodge the issue, but we can't afford to. And while we're about it, we could subscribe to Alzheimer charities too. If the old don't, who will?
