Alzheimer’s Patient Reverted Back to Earlier Writing Style after Diagnosis, Reveals Analysis of Woman’s Long-term Journals

The writing style of a woman’s diary entries over 31 years has given researchers a glimpse into the progression of her cognitive decline from Alzheimer’s disease, revealing a relationship between language use and the transition from healthy to severe dementia.

University of Toronto (UT) researchers specializing in language variations and change studied Toronto resident Vivian White’s journals and discovered that, around the time she was diagnosed with Alzheimer’s disease, she began using the first-person pronoun “I.”

“This suggests that individuals may revert back to a more formal, fundamental writing style when they experience cognitive decline,” Sali Tagliamonte, PhD, a UT linguistics professor and department chair, said in a news release.

The journal entries span the years 1985 to 2016, when White was 60 to 90 years old. Through the first 24 years, she omitted a subject up to 76% of the time in her writing. For example, in an entry dated March 23, 1985, she wrote, “Made cranberry muffins.” But after her Alzheimer’s diagnosis at 84, she included the pronoun “I” in her writing: “I made cranberry muffins,” she wrote on Jan. 1, 2016.

“Diary writing is a style, and one that is known to have complex constraints in which the subject ‘I’ is often omitted in specific locations,” said Tagliamonte. “It’s a learned behavior acquired at a later stage than more basic writing or acquisition of the vernacular language. Research on bilinguals with probable Alzheimer’s disease has shown that languages learned later in life tend to be lost earlier. Our results suggest that the same might be true for styles acquired later in life.”

At least one study has also indicated that bilingualism appears to protect the brain from Alzheimer’s symptoms.

Noting the rarity of discovering so many continuous journals — 97 — across such a lengthy timespan, Tagliamonte said the results demonstrate how longitudinal research can shed light on key aspects of cognitive development. She also said that the findings call for further studies to investigate language variation and change in people with Alzheimer’s and other dementia.

Most of the research about language change has been focused on younger speakers, with comparatively few studies conducted on language change across lifespans and among older adults, said project collaborator and doctoral candidate Katharina Pabst. Researchers from related fields have shown that language use can and does change as people age, she added.

Because White began journaling while still healthy and continued after she was diagnosed with Alzheimer’s, her diaries offered an excellent opportunity for investigators to explore a possible relationship between language and gradual cognitive decline, the researchers said.

The findings were presented at the recent annual New Ways of Analyzing Variation conference in Oregon.