S1E9. When Words Hide

I was 45 and they were 22 the first time I met informally with my 6 new classmates in the clinical psychology Ph.D. program at the University of Connecticut. They were all incredibly bright and I couldn’t help but marvel at how fast they talked. For the first time in my life, I had to concentrate to follow the conversation…and I frequently discovered that they had moved on to a new topic by the time I had formed a thought I wanted to express.

It was my first encounter with the normal decline in brain processing speed as one ages. I, of course, attributed it to my having so many more experiences and neural connections than they did so that it took my brain longer to sort through all the information I had stored up before responding. 

That was a soothing theory to which I clung, but the fact is that our processing speed slows down as we age.

Fast forward 25 years. I no longer have to compete with 22 year olds in the classroom, but I’m sure my processing speed has continued to slow. There are some television shows where the rapid-fire dialogue is a challenge. I’m convinced they are written for a younger demographic.

Even among my peers, there are times when I listen and follow the conversation, but nothing witty or relevant occurs to me that is worth sharing. 

On the road to nowhere, this subject is known as ‘verbal fluency’ and it is one of the abilities that is measured to test for problems with language, 1 of the 6 domains in which impairment may be the basis for a diagnosis of mild neurocognitive disorder or dementia.

We all know its most common symptom: difficulty with word-finding. You know what you want to say, you can see it in your mind’s eye, you can recall any number of facts about it, but the word eludes you.

If you pause in mid-sentence while you search (which is uncomfortable for everyone), someone invariably tries to fill in the blank. Or worse yet, a guessing game erupts!

Or you don’t pause and instead try to work your way around it: ‘You know, that thing you hit with a stick at a party and candy comes pouring out.’

Worst of all, though, is when you just try to muscle your way through and the wrong word comes out: pinball; pintail; pintata.

There are simple tests that have been developed to detect problems with verbal fluency. In general, you are given a short period of time (e.g., 1 minute) to come up with as many words as possible that meet a certain criteria, such as names of animals or words that start with the letter ‘y.’ 

I just gave myself 1 minute to list words that begin with ‘y.’ Here’s what I came up with:

Yacht, yen, yin, yang, yank, yankee, yawl, yam, yak, young, youth, yap, yahoo, yard, yardarm, yikes, yipes, yarmulka.

As I took this make-believe test, I noticed that I began quickly with several words at the ready, but then my production tapered off. By the end of the minute, I was staring at an empty room in my brain. 

It’s now several minutes later and a few additional words have come out of hiding: yarrow, yes, yell, yellow, year, yearling, yield.

If I were being evaluated, the psychologist would compare the 18 words I found with the number found by 70 year old men with more than 16 years of education. If my score was below the average range, I would be on my way to meeting one of the criteria for a diagnosis.

But I’m not ready to take the test just yet.

Post script:

I went for a walk and came up with: you, your, yourself, yeti, yoga, yogi, yogurt, yew, yenta, yearly, yearn, yearning, yore, yurt… Where were all of these words when I needed them? Where were they hiding?

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