Wanna play?

MARIE: I promised to write about Jon’s recent assessment by a neuropsychologist. Well, it was a really thorough affair, over three hours of playing one game after another. There was mental arithmetic to test working memory, Rorschach-like images to test pattern recognition, alphanumerical mazes to test planning and analytical skills, drawing test for visual acuity, odd-one-out tests for logic and reasoning, Q&As to test orientation and understanding, naming games to test language skills, and much more besides. Most tests came in several variants, so Jon would complete a test, go on to something else, and then be returned later to a similar test for confirmation.

I was there, trying to be unobtrusive in the background and following Jon’s every answer. Many were unsurprising: yes, he knows perfectly well who the US President is but no, like many a retired person he’s not entirely sure about today’s date. Yes, he’s very good at pattern recognition (image analysis was a big part of his job) and yes, he’s always been hopeless at mental arithmetic.

However. The tests also clearly show that Jon’s working memory – what people generally call short-term memory – is very poor. His ability to learn and retain new information is also much deteriorated, as is his ability to plan a task and carry out the plan. On the other hand, Jon’s language is possibly better than he thinks – he has complained of frequently being unable to find the right word, but the tests showed that he can when he focuses.

Several times along the way, Jon was told that “this is quite typical for Parkinson’s”, where not just the body but also the thought processes become slow and “stiff”. For instance, Jon had to name as many animals as he could in one minute. He started out in typical Jon-style with aardvark, which I see as a flash of brilliance, but then attempted in vain to continue with one animal staring with a B, one with a C and so on. He soon got stuck, and here comes the Parky bit: he couldn’t seem to shift gears and mentally go “okay, drop that and move on to zoos or farmyards or pet shops or …”. That kind of rigid thinking is very familiar from our everyday life, and probably as frustrating for him to live with as it can be for me to live next to

Of course these issues haven’t arisen overnight. Just like the physical symptoms of Parkinson’s, these cognitive symptoms progress so slowly that it’s quite unnoticeable from one day to the next, but pretty clear from one year to the next. Having the test show up areas of concern is actually a kind of non-event, just confirmation of what we have suspected for a little while.

As Jon said: "My brain is turning to custard, which is ironic as I happen to be a world expert on custard". We are now waiting for the written report with detailed results. Next come follow-up consultations, first with the neurologist to see if further tests are needed and if medication can improve things, and then with the neuropsychologist to hear about home therapies that may help slow the development of symptoms.

More of that next time.