Famed British author Iris Murdoch suffered from Alzheimer's disease before her death in 1999, and her final novel contains evidence of her increasing disability, according to an analysis by Peter Garrard, M.D., of University College, London, and his colleagues.
The last final work, “Jackson's Dilemma,” published in 1995, was characterized by simplified language and a dwindling vocabulary, at least compared with “Under the Net,” her first novel, published in 1954, and “The Sea, the Sea,” the Booker Prize-winning novel published in 1978 at the height of her creative powers, wrote Dr. Garrard of the college's Institute of Cognitive Neuroscience (Brain [online] 2004;www.brain.oupjournals.org/cgi/reprint/awh341v1
Critics' reaction to “Jackson's Dilemma” proved lukewarm, and the author later revealed that she had struggled with “writer's block” while writing it.
The investigators digitized portions of the three books and used specialized software to analyze, among other things, the frequency of words by word type. Of the three books, “Jackson's Dilemma” used the fewest word types, “The Sea, the Sea” used the most, and “Under the Net” used an intermediate number of word types. This suggests that her vocabulary was enriched between 1954 and 1978, and impoverished between 1978 and 1995.
In contrast to the relatively impoverished lexical characteristics of “Jackson's Dilemma,” the investigators found no difference in its syntactic characteristics–its grammar and structure. This is consistent with other studies of early Alzheimer's disease, in which many sufferers have trouble finding words while producing perfectly well-formed sentences.
Dr. Garrard and his colleagues wrote that their findings have clinical and theoretical implications. “From a clinical point of view, the results support the idea that the occurrence in the brain of Alzheimer's disease pathology may predate the onset of the earliest overt symptoms by years, or even decades,” they wrote. “This in turn raises the possibility that an intellect of exceptional premorbid quality and/or a lifetime's engagement with intellectual work may either protect against cognitive deterioration or enable it to be masked.”
Soon after the publication of “Jackson's Dilemma,” Ms. Murdoch was diagnosed with Alzheimer's disease at the age of 76. She died 3 years later, and the Alzheimer's diagnosis was confirmed post mortem.