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Profiles in Dementia: Muhammad Ali (1942 – 2016)

Muhammad Ali (1942-2016)Muhammad Ali is remembered as one of the greatest boxers of all time. His physical strength and abilities, his agile footwork in the ring, and his witty and intelligent – and sometimes boastful – running commentaries about himself and his opponents made Ali compelling and appealing to a much wider segment of the population than just those who liked to watch boxing.

But as Ishmael Reed so poignantly points out in his New York Times article about Ali, none of this came without a cost. A very high cost. An eventually fatal cost. Continue reading

Profiles in Dementia: Harper Lee (1926 – 2016)

To Kill A Mockingbird was Alabama author Harper Lee's only published novelNelle Harper Lee wrote a seminal work of fiction in the 20th century: To Kill A Mockingbird. It would be the only published work the Alabama author would give to the world, but it was more than enough.

The book was ground-breaking in so many ways. Published at a time (1960) when the eyes of America, and indeed the world, were focused on civil rights in the South, where the shameful ugliness of racism was brought front and center into the living rooms of millions of people and its dastardly proponents – Strom Thurmond, George Wallace, and the Ku Klux Klan, to name just a few – spewed their vitriol in thick-tongued, ignorant voices that I sincerely hope (a lot of this happened, including this book, before I was born) embarrassed and discomfited most Southerners, To Kill A Mockingbird showed a decent South, a fair South, a kind South, and a principled South in stark contrast to what was played out as the South in the rest of the media. Continue reading

Profiles in Dementia: Ronald Reagan (1911 – 2004)

Ronald Reagan Younger PortraitFor reasons that I cannot logically remotely fathom, except that perhaps we humans are highly susceptible to creating sanitized and palatable versions of our recollections of “the good old days,” which in fact were never as good as we remember them to be and may have been downright horrible, United States President Ronald Reagan is continually held up as a hero and a paragon of virtue, wisdom, and good governing.

The reality then and now could not be further from the truth in any of these categories.

Even before Ronald Reagan was president, his mental status was a source of concern. He often made contradictory statements, had frequent difficulty remembering names and people, and regularly seemed to be prone to absent-mindedness.

I was very young when President Reagan came into office, but I have clear recollections of how bad the economy was during his tenure (President Reagan was the “trickle down economics” president, promoting the pie-in-the-sky idea that if the United States gave financial preferences to the very wealthy, then they would in turn create jobs and juice up the economy down through the poorest people in the nation) and how much wrong-doing occurred during his presidency.

Don Henley’s “End of the Innocence,” depicting pervasive corruption, dishonesty, greed, and despicable behavior that touches every part of life and written during President Reagan’s presidency has become, in my mind, the most honest and enduring description of the United States, from its politicians to its businesses to its people, has a couple of verses that deeply resonate with me every time I think of President Reagan’s years in office:

“O’ beautiful, for spacious skies
But now those skies are threatening
They’re beating plowshares into swords
For this tired old man that we elected king

Armchair warriors often fail
And we’ve been poisoned by these fairy tales
The lawyers clean up all details
Since daddy had to lie”

Henley’s song refers to the Iran-Contra affair, which, in more detail than ever before, exposed the truly despicable and seedy underbelly of how the American government, military, and intelligence services have always manipulated, by whatever means were deemed necessary (the end justifies the means), world geopolitics to attempt to give the United States the upper hand in outcomes.

It is very likely that the real principles – Colonel Oliver North threw himself on his symbolic sword as the fall guy when it came to light – in this scandal took advantage of  President Reagan’s already-apparent cognitive impairment.

Evidence that President Reagan was already into his progressive slide into dementia includes his often-confused testimony during the Iran-Contra hearings and the unprecedented number of times, with obvious confusion on his face, he said “I don’t recall.”

President Reagan had already begun his descent into dementia when he took office in his first term as the president of the United StatesWhile this statement is a standard in legal defenses, what made President Reagan’s more than a legal maneuver was that it was clear that he really didn’t recall much at all.

This year, a study was done by researchers at the University of Arizona on President Reagan’s speech patterns during his eight years (1981 – 1989) as president of the United States.

What the researchers found were subtle changes during those eight years that revealed the tell-tale signs of the change-in- communication step of the journey through dementias and Alzheimer’s Disease.

These included searching for words, substituting generic terms like “thing” for specifics President Reagan could not remember, and a decreasing range of vocabulary as his time in office progressed.

Although President Reagan’s dementia was not publicly announced until 1994 – a move I believe was calculated to give enough time after his presidency to remove suspicion that President Reagan had dementia while in office – it has since become clear that his dementia gave the people around him the leeway to set in motion the kind of governing (and it does nobody except people and institutions with a lot of money and a lot of blackmail-type secrets any favors, while getting sleazier and sleazier by the minute) we live with and take for granted as “normal” today.

President Ronald Reagan died on June 5, 2004.

Profiles in Dementia: Franklin D. Roosevelt (1882 – 1945)

Franklin D. Roosevelt experienced cognitive impairment from vascular dementia the last several years of his presidency of the United StatesWhile it is well known now that President Franklin D. Roosevelt suffered from partial paralysis from polio (he was stricken with the disease when he was 39 years old) that was hidden from the United States during his twelve years as president of the country, what is hardly known is that in the last several years of his life, President Roosevelt’s diastolic hypertension grew significantly worse and he began suffering symptoms of vascular dementia as a result.

Beginning in 1939, President Roosevelt was diagnosed with hypertension, with blood pressure readings averaging between 180/100 and 190/110.

The president’s medical team was never able to get his blood pressure consistently lowered, and, in fact over the next six years, it was more normal for President Roosevelt’s blood pressure to be in the 230/120 to 300/140 range when it was checked (which, surprisingly, given his condition, was not often).

Before President Roosevelt ran for his last term, signs of vascular dementia in terms of cognitive impairment had already materialized.

In addition to the president’s other worsening health problems, he was in no shape for and never should have run for a fourth term as president of the United States.

However, despite the evidence that everyone around him saw and was well aware of, no one stopped President Roosevelt’s last election and no one questioned the wisdom of having someone with cognitive impairment manage the last days of World War II.

History has shown that President Roosevelt’s cognitive impairment was fully apparent at the Yalta conference with Joseph Stalin and Winston Churchill in February 1945 (two months before President Roosevelt died after suffering a massive cerebral hemorrhage in Georgia).

President Roosevelt's cognitive impairment was a deciding factor is how Yalta turned out and what the world looked like geopolitically for the next 44 yearsMany of the factors that should have been addressed with Stalin and the Soviet Union at this conference by President Roosevelt (as the leader of the world’s strongest nation, which the United States emerged as in World War II) were not.

These critical and strategic omissions/concessions directly contributed to the vise-like grip that the Soviet Union – and the spread of Communism – had on eastern Europe after the war and the ensuing Cold War that lasted for almost 50 years.

It is clear in retrospect that President Roosevelt’s dementia played a crucial role in how the geopolitical landscape of the world shaped up, detrimentally, for the next half century.

President Roosevelt died at the age of 63 in Warm Springs, Georgia on April 12, 1945. His last known words were “I have a terrific headache.” He lost consciousness and was dead within two hours.

 

Profiles in Dementia: Woodrow Wilson (1856 – 1924)

President Wilson had suffered from arteriosclerosis since 1906 and was showing signs of vascular dementia by 1917.I have been, over the last couple of months, reading a lot of books about the history of World War I – before, during, and after – and the last book I’ve read in this series so far gave intimate and detailed portraits of the four world leaders who were ultimately responsible for the Treaty of Versailles, which may have been the most-poorly and ignorantly (in some cases, deliberately) constructed end-of-war agreement ever made. Continue reading

Profiles in Dementia: Norman Rockwell (1894 – 1978)

1945 Photo of Norman RockwellNormal Rockwell’s artistic creations are an entrenched part of Americana. He captured everyday life with a unique emotional component that seemed and seems to touch the American soul deeply.

Rockwell is best known for the 47 years that his iconic cover illustrations graced The Saturday Evening Post, but his body of work also included other magazines, several books, and prints for both the common man and collectors.

Norman Rockwell: Artist and Illustrator BookGrowing up, I remember frequently picking up the oversized, hardcover edition of Norman Rockwell: Artist and Illustrator that my parents had purchased and immersing myself in a thoughtful journey through the large body of his work. There were some that stand out in my mind still. A sampling of those include:

But the four-part Freedoms From… illustrations that Rockwell did in 1943 (during World War II to shore up and promote American involvement in the war) are probably the ones that tug, even today, at American heartstrings.

In part, I believe, the Norman Rockwell - Freedom from Want (1943)reason is they represent an ideal that we all wish existed, but which, in fact, never did and never will in our lifetimes.

They invoke a nostalgia for our imagined past as a nation, as families, as people. And I suppose that we want to be those people is a good thing, but the reality that we’re not is, for me, quite disheartening.

But I still love the pictures even in my discouragement at how far we all fall short of the ideals they portray. My hope lies in a better fulfillment in another life, while my despair comes from knowing it won’t be this one.

Rockwell struggled with severe depressive episodes, as it seems most creative people do, throughout his life, but it rarely, if at all, is seen in his art, which is, frankly, amazing and admirable.

In the last decade of his life, Rockwell developed dementia and for the last six years of his life lost the ability completely to do any artwork or illustrations at all.

Rockwell died in 1978 at the age of 84 from emphysema. 

Profiles in Dementia: Rita Hayworth (1918 – 1987)

Rita Hayworth Alzheimer's Disease Alcohol-Related DementiaRita Hayworth was an American actress whose career peaked in the 1940’s as Columbia Pictures’ most lucrative female lead, with a career that included 61 movies over a 37-year span.

One of Hayworth’s most acclaimed performances was in 1946’s Gilda, starring opposite leading man Glenn Ford. Hayworth also starred in two movies with Fred Astaire, who said she was his favorite dancing partner on screen.

However, fame and fortune could not stave off Hayworth’s personal demons, one of which was alcoholism.

By the late 1950’s, Hayworth’s chronic abuse of alcohol had ravaged the beauty of her younger years and had aged her considerably, making her no longer as attractive to Columbia as a leading lady even though she wasn’t 40 years old yet.

Alcoholism also created havoc in Hayworth’s personal life – she married and divorced five times (to men who in their own rights were not good choices).

By the 1970’s, when Hayworth was in her mid-50’s, the ravages of years of alcohol abuse began to also affect her brain. From 1972 until her death 1987, Hayworth’s cognitive impairment, memory loss, and repetitive outrageous behavior were what kept her name in the news headlines.

Rita Hayworth as an older womanHayworth died in February 1987 at the age of 68. Although she was the first public face of Alzheimer’s Disease (then a relatively-unheard-of form of dementia), there is absolutely no doubt that Hayworth also had alcohol-related dementia (also in 1987, mixed dementias and the many types of dementia were relatively unheard of as well), which probably hastened both her neurological decline and her death.

Profiles In Dementia: Winston Churchill (1874-1965)

Winston Churchill Vascular DementiaWinston Churchill had a health profile most of his adult life that pointed to the inevitability of cognitive impairment in his later years.

Churchill was an alcoholic (during War War I and II, when the British needed strategic decisions to be made in the middle of the night, an inebriated Churchill was in the thick of things because even drunk he apparently was a better strategist than most of his sober peers).

Churchill also had chronic and worsening hypertension, in part from stress and in part from an unrestrained diet of much rich and artery-clogging food.

As early as 1947, Churchill’s physician, who was complicit in the lies about Churchill’s health all the years he held public office and who propped him up with amphetamines and calmed him down with depressants, noted in his diary that “[Churchill] is no longer fertile in ideas…his once-teeming mind has run dry.”

Beginning in 1948, Churchill began to regularly experience TIA’s in different parts of his brain. Accompanying the mini-strokes, at times, was temporary numbness on one or the other sides of his body, which resolved in a few hours or a few days.

Churchill would also experience the temporary dysphasia in the 30 minutes to an hour afterward that is characteristic of TIA’s, but the language center of his brain was spared permanent damage until his last major stroke in 1953.

With amphetamines and carefully scripted speeches, therefore, Churchill was able, at least from a verbal aspect, to hide the neurological damage and the cognitive decline that those closest to him were aware was progressing rapidly.

But the signs were everywhere in retrospect. Churchill’s speeches and governing were rooted in the first and second world wars. He was glaringly oblivious to post World-War-II politics, issues, and legislation.

He was literally in the-all-too-common vascular dementia time warp of the past and increasingly unaware of the present and had no concept of the future.

With his doctors and his staff carefully concealing his progressing dementia from the public, Churchill managed to limp along in office through continuous TIA’s and three major strokes, until 1955, when he finally resigned because his cognitive impairment and the physical effects of the strokes and dementia were impossible to conceal anymore.

Churchill lived for 10 more years, but vascular dementia was his constant companion and as it progressed, he retreated and regressed until he remembered no one and nothing and it was impossible to see the man he’d been at the zenith of his life.

 

 

Profiles in Dementia: Miss Daisy of “Driving Miss Daisy”

Driving Miss DaisyDriving Miss Daisy, the 1990 Academy Award-winning movie, is one of those rare movies that is both expansive and intimate as we take a journey through 25 years of the elderly life of Miss Daisy.

Miss Daisy, portrayed by one of the finest actresses I’ve ever seen, Jessica Tandy, is both a student and an educator (she’s a former schoolteacher) in this multilayered drama that takes her and us through the sweeping political and social changes in the three decades following the end of World War II.

The unlikely, and initially unwanted, relationship and friendship that develops between the 72-year-old lively and independent Miss Daisy and the calm and steady Hoke Colburn, portrayed by Morgan Freeman, who is hired by Miss Daisy’s son, Boolie, portrayed by Dan Akroyd, as Miss Daisy’s driver after she wrecks her car for a second time in a short time span is both poignant and endearing.

Although they come from completely different worlds in every sense of the word, they learn a lot from each other and they grow because of each other.

When Hoke comes in one morning after 23 years with Miss Daisy and finds her frantically running around the house because she believes she’s late for school to teach her students, he calls Boolie, who immediately puts Miss Daisy in a nursing home.

Hoke, who now depends on others to drive him around, isn’t able to visit Miss Daisy often, but he goes to see her in the nursing home when he gets the chance. 

Boolie has a mostly hands-off relationship with his mother: he loves her and takes care of the practical things she needs, but she’s mainly a nuisance who often gets in the way of the rest of his life.  Watching their interaction – and the lack of time Boolie has for Miss Daisy – is reminiscent of what many of us see in our own family dynamics with caregiving in general.

Hoke, on the other hand, is nurturing and compassionate and provides the time and the companionship that is missing from Boolie’s relationship with his mother.

We see the difference in these relationships with Miss Daisy, as well as the rapid decline of dementia, near the end of the movie when Boolie and Hoke go to see her in the nursing home on Thanksgiving Day.

Miss Daisy looks and acts like a shell of her former self. She is unable to communicate and doesn’t seem to recognize either Boolie or Hoke. 

Boolie makes quick contact and disappears, while Hoke goes in to the dining room to sit with Miss Daisy while she mostly doesn’t eat Thanksgiving dinner.

Hoke talks with her, both about the past and about his present life. He notices that a piece of pumpkin pie sits in front of Miss Daisy uneaten.

Miss Daisy dementiaSensing that Miss Daisy may not remember how to eat the pie, Hoke cuts it into pieces and feeds it to her. We see just the briefest of sparkles return to Miss Daisy’s eyes as she savors each bite and the brief glimpses of recognition Miss Daisy has for her old friend Hoke even through the mostly impenetrable walls of dementia that have enveloped her mind.

I highly recommend Driving Miss Daisy. It is a tear-jerker at unexpected places throughout the movie, so grab the tissues because you’re going to need them, but it’s well worth it. 

 

 

 

Profiles in Dementia: King George III (1738 – 1820)

George IIIKing George III was the monarch of England from 1760 to 1801 and the first King of Great Britain and Ireland from 1801 until his death in 1820.

For the United States of America, King George III played a prominent role in both establishing colonies here and instituting the unpopular policies, particularly with regard to taxation, that caused the colonies to rebel, declare their independence from England in 1776, and led to the Revolutionary War that handed the British an unthinkable defeat.

He was known both in England and in the colonies as “Mad King George.”

King George III came to the throne in 1760 at the age of 22, but as early as 1765, he showed signs of cognitive impairment. Although his cognitive decline was gradual and his “mad” bouts were episodic for the next 30 years, King George III showed every sign of neurological decline associated with dementia, as the times when he was completely incapacitated increased and worsened during those 30 years.

King George III’s neurological condition was advanced enough by 1788 that Parliament passed a regency bill to be able to quickly and immediately hand the reins of government over to his son, George IV, at any time.

Although King George III managed to hold on to power in name only for another 23 years, his dementia was so pronounced by 1801 that he was largely unable to govern.

More likely than not, King George III had frontotemporal dementia (an early-onset dementia) and that was responsible for the erratic and irrational behavior that characterized his “madnesses” that are recorded in both the histories of England and the United States.

The damage appears to have been slower than most instances of frontotemperoral dementia, but it is easy to see the the progression of the journey he traveled through dementia.

It is also entirely possible that King George III had developed other types of dementia as he aged. Some of the historical accounts of his later years suggest that King George III also had vascular dementia and Alzheimer’s Disease.

One of the interesting things that occurred to me is the question of whether the United States of America would have ever existed as an independent country if King George III had not had frontotemporal dementia.

While it’s conceivable that at some point the United States would have sought independence as a nation in its own right, you can’t help but wonder if it might have been delayed for decades or even a century or more and it might have been under more peaceable conditions had King George III not been on the throne.

Dementias affect everything and dementias change everything.

For most of people, the sphere of influence affected and changed is relatively small.

In the case of King George III, it affected and changed the world.