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Brain Advance Access published online on December 1, 2004
Brain, doi:10.1093/brain/awh341
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Received April 2, 2004
Revised September 14, 2004
Accepted October 4, 2004

Article

The effects of very early Alzheimer's disease on the characteristics of writing by a renowned author

Peter Garrard 1*, Lisa M. Maloney 2, John R. Hodges 3, and Karalyn Patterson 3

1 Institute of Cognitive Neuroscience, London
2 Defence Services Medical Rehabilitation Unit, Headley Court, Epsom, Surrey
3 MRC Cognition and Brain Science Unit, Cambridge, UK

* To whom correspondence should be addressed.
Peter Garrard, E-mail: p.garrard{at}ucl.ac.uk; garrard@cnbc.cmu.edu


  Abstract

Summary Iris Murdoch (I.M.) was among the most celebrated British writers of the post-war era. Her final novel, however, received a less than enthusiastic critical response on its publication in 1995. Not long afterwards, I.M. began to show signs of insidious cognitive decline, and received a diagnosis of Alzheimer's disease, which was confirmed histologically after her death in 1999. Anecdotal evidence, as well as the natural history of the condition, would suggest that the changes of Alzheimer's disease were already established in I.M. while she was writing her final work. The end product was unlikely, however, to have been influenced by the compensatory use of dictionaries or thesauri, let alone by later editorial interference. These facts present a unique opportunity to examine the effects of the early stages of Alzheimer's disease on spontaneous written output from an individual with exceptional expertise in this area. Techniques of automated textual analysis were used to obtain detailed comparisons among three of her novels: her first published work, a work written during the prime of her creative life and the final novel. Whilst there were few disparities at the levels of overall structure and syntax, measures of lexical diversity and the lexical characteristics of these three texts varied markedly and in a consistent fashion. This unique set of findings is discussed in the context of the debate as to whether syntax and semantics decline separately or in parallel in patients with Alzheimer's disease.

Keywords: Alzheimer's disease; creative writing; concordance; syntax; lexical frequency.
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