S1E23. Why Am I Writing This?

It was a fair question that my nephew Zach (Sally’s sister Lynn’s son) asked me over cake at the graduation party for my great nephew Nate (Sally’s brother Tad’s daughter Skye’s son). 

I had already explained my motivation back in December in Episode 3: My Life Is Now An Experiment (https://tinyurl.com/4epzfffc), and so it seemed like a good time to reflect back on a half year of blogging to see if I still felt the same about this project.

Zach (a political science professor at Haverford College) had raised the question in the broader context of the meaning (or lack of it) of the things we do and the notion of ‘legacy’ or what will be remembered about us (if anything) two, three or four generations from now.

We had already agreed that not much of what we do in our lifetimes will last very long into the future (to whit: think about what you know about your great grandparents)…but that that didn’t really matter. We do things that have meaning for today…and that’s enough.

My primary reason for writing this blog is to provide data that might be helpful to researchers trying to diagnose and treat age-related cognitive decline and dementia. My hope is that by tracking and reporting my mistakes over the course of a decade, I will leave a record that either describes normal aging or the onset of dementia, and no matter how it turns out, that such a first-hand report will have value.

That assumes an awful lot, though. What are the odds that such a researcher will (1) stumble across my notes, (2) discern a meaningful pattern in what I recorded, and (3) convert that insight into a useful tool for diagnosis or treatment? As Sally is fond of saying in these situations, the likelihood lies “somewhere between zip-a-dee and doo-dah!”

Over these first 6 months, though, one thing I’ve learned about myself is that I also do this—and I’m being brutally honest here—for the clicks. It appears I’m a click junkie!

Each week, I spend money to advertise the new post on Facebook and Google. Whenever someone clicks through to the site, I can see on my WordPress blog dashboard not who they are, but which episodes they read and what country they are from. It’s exciting to know that there are folks all across America who have stopped by, and people from Ireland, Canada, India and Sweden who are frequent readers, too.

It’s comforting when they leave comments describing their own experiences that are similar to mine. They make my journey less lonely and it’s nice to know that I’ve made someone else’s journey a little less lonely, too.

I especially appreciate it when a reader signs up to follow the blog. It’s the ultimate validation for me as a writer: you liked the content enough to want to see more and to have it delivered directly to your inbox every Friday to make sure you don’t miss an episode.

And in the blogosphere, the number of followers you have is the gold standard for measuring success. Success would be nice, but I have a long way to go to achieve it and I don’t really expect it.

Managing the blog (e.g., rooting for content each week, writing a 600+ word episode, converting it to a podcast, refining and implementing the advertising plan, interpreting the results, and interacting with readers) keeps me busy in ways that push my cognitive envelope. In itself, it should provide a measure of protection against decline. But I also find it intriguing to monitor myself so I can catch as many errors as possible, try to better understand what causes them, and to divine what clinical implications (if any) they might have.

It’s work, but it’s fun.

Getting back to Zach’s question, after six months, several reasons for writing this blog have emerged: a desire to help in some small way, the rewards of having my work read and appreciated, and the joy of doing it.

Thanks for asking, Zach!

S1E22. Making Coffee Isn’t Hard…Is It?

One of the first lessons I learned when we opened our B&B on the 4th of July weekend in 1986 was that the coffee had to be good. It was a guest’s first culinary impression of the quality of our food and set expectations for the breakfast to follow.

I spent a good deal of time researching how to make good coffee, experimenting with various beans and brewing methods. I settled on dark French Roast beans that I grind fresh every morning. I learned that the strength of the coffee is determined by the amount of beans used, how long you grind them (grind them long enough and you get espresso!), and the volume of water you brew.

I buy my beans in a 5 pound bag, fill an air-tight glass container for use over the course of the next week or two, then put the rest in the freezer to preserve their flavor.

For 35 years now, my routine has been pretty much the same. I fill my coffee grinder with beans and then grind them for 15 seconds. Then I place a paper filter in the brewing basket and pour the ground beans into the basket, being oh so careful not to spill a speck. Next, from the tap, I fill the coffee maker’s carafe to the 8 cup line (which is really only 6 ½ cups), pour the water into the reservoir, set the empty carafe on the hot plate, press the ‘brew’ switch and wait.

It’s neither rocket science nor brain surgery nor difficult, yet this week, I found a way to screw it up.

Here in our new apartment, we noticed more chlorine in the water than we are used to, so we bought a Brita water filter to restore the taste. That introduced a very minor wrinkle into my coffee-making routine. Instead of filling the carafe from the tap, I take the Brita out of the refrigerator and use it to fill the carafe, returning it to the refrigerator before I continue making the coffee.

I went through my routine this past Monday morning, but to my disbelieving eyes, when I went to pour our coffee, the water was clear…not coffee at all!

I was baffled. How did the water pass through the ground beans and still remain clear? The ‘brew’ light was on, so I know I started the process. I lifted the lid to confirm the beans were there, and they were. I touched them and they were bone dry. I looked inside the reservoir to see if there was any possible alternative route for the water to travel. There was none.

Then I noticed that the water in the carafe was not hot. And I recalled that I had not heard the coffee maker percolating while it brewed, nor the gurgling, sputtering and steaming exhaust when it completed its cycle. Most importantly of all, I hadn’t smelled the glorious aroma of freshly brewing coffee.

And then it hit me:

“DOH! I never poured the water into the reservoir!” 

I had filled the carafe from the Brita and put it down on the counter while I returned the Brita to the refrigerator. That one distraction was enough to sabotage my routine. When I returned to the counter, I picked up the carafe and just set it on the hot plate, forgetting to first pour its contents into the reservoir.

Mystery solved. Explaining what happened to Sally and feeling incredibly foolish wasn’t the worst of it, though. I’m really bothered, not so much by my forgetting to pour the water into the reservoir, but by my thought process when I discovered the water was clear.

The second I saw that the coffee hadn’t brewed, my immediate reaction should have been, “Shit! I forgot to pour the water into the reservoir.” But it wasn’t. I had ignored clues (no aroma and no percolating sounds) that should have made things instantly obvious. Instead, I wrongly assumed that the fault rested with the coffee maker. That’s the bigger error here: assuming I am right and the world is wrong. It didn’t get me into trouble this time, but this kind of thinking is an accident waiting to happen.

On the brighter side, my sleuthing to discover what caused the failure was pretty well-organized and I did accept responsibility once the evidence identified me as the culprit.

Post script: Once the coffee was finally made, Sally and I thoroughly enjoyed it!

S1E7. A False Sense of Security

It’s both gratifying and reassuring when readers leave comments reporting that they, too, are making errors similar to the ones I describe in a post. If you are of a certain age, you worry about these things. It’s nice for all of us to know that there is a community out there that embraces us.

But I don’t want to mislead anyone. Just because I am making mistakes that I can write about doesn’t necessarily mean that they are not a problem…for me or for you. You see, I don’t know whether what I’m describing is normal aging, a mild neurocognitive disorder or early signs of dementia. I don’t want to scare you with this blog, but neither do I want to give you a false sense of security.

So now would be a good time to talk about what it takes to determine where one actually stands. In other words, to make a diagnosis.

A diagnosis is a traffic light on the journey to nowhere. Normal aging is green: full speed ahead. A mild neurocognitive disorder is yellow: proceed with caution. Dementia is red: stop and revise your travel plans.

The first criterion for earning a diagnosis is that the mistakes are disrupting your life in a meaningful way. If they are occasional and only mildly irritating, then it’s probably normal aging. If they are more frequent, have actual negative but minor consequences, and you have difficulty compensating for them, then it might be a mild neurocognitive disorder. If the errors are significant, disrupt your daily activities, place you in danger, or you are unaware of them, then they might reflect the onset of a dementia.

Unfortunately, the above paragraph isn’t really all that helpful. There are too many squishy, undefined adjectives like ‘meaningful,’ ‘mildly,’ and ‘significant.’ We need to drill down.

The second criterion is that the changes you are noticing in your thinking and behavior represent declines from your normal or prior levels of performance. I’ve never been good at remembering faces or last names, so not being able to do so now doesn’t necessarily tell me anything about my status today. It’s new problems that we’re looking for.

But satisfying these first two criteria alone won’t earn you a diagnosis. Your performance should also fall below what is considered average among your peers. ‘Peers’ are often defined as those of the same age, gender and educational background. ‘Average’ is defined as scoring between the 16th and 84th percentiles on standardized cognitive tests. If you score between the 2.5 and 16th percentiles, you will meet the criteria for a mild neurocognitive disorder. If you fall below that level, it is most likely indicative of a dementia. 

Finally, this isn’t just about memory. There are 6 broad areas of brain functioning that need to be evaluated. Significant problems in any one of them are sufficient to earn the diagnosis of mild neurocognitive disorder. Significant problems with memory and in at least one other domain are required for a diagnosis of dementia:

  1. Complex attention
  2. Executive function
  3. Learning and memory
  4. Language
  5. Perceptual-motor
  6. Social cognition

I hope to discuss them all in future posts. Meanwhile, here’s a link where you can learn a little more about these categories: https://rb.gy/xdhwnu.

Bottom line: The only way to know where you stand is to be tested. I have not yet been evaluated, so I don’t know where I stand. I can have no sense of security.


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