Iris Murdoch’s last novel reveals first signs of Alzheimer’s disease

The last novel written by author Iris Murdoch before she died reveals signs of the first stages of Alzheimer’s disease, according to a study published in the latest online issue of Brain.

As part of their on-going research into the effects of Alzheimer’s disease on language, scientists at University College London and Medical Research Council’s Cognition and Brain Sciences Unit decided to compare three of Dame Iris Murdoch’s works, including her final novel written just before she was diagnosed with the disease.

The team found that, while the structure and grammar of Murdoch’s writing remained roughly consistent throughout her career, her vocabulary had dwindled and her language simplified in her very last novel. This unique opportunity to study someone’s writing style over their lifetime could help researchers improve current diagnostic tests for Alzheimer’s.

Under the Net, Murdoch’s first published work, The Sea, The Sea which was written during the prime of her creative life and her final novel, Jackson’s Dilemma, written just before Murdoch was diagnosed with Alzheimer’s disease, were all converted to digital format and analysed using specialised software. The complete texts were also transformed into word lists showing the frequency of each word by word-type.

The number of word types within a text is a measure of the variety of vocabulary used, and when examined at successive points in a text, reflects the rate at which the author introduces new words. In Murdoch’s works, the smallest number of word-types occurred in Jackson’s Dilemma and the largest in The Sea, The Sea. The rate of introduction of new word types was also strikingly greater in both earlier books compared with Jackson’s Dilemma.

The findings suggest an enrichment in vocabulary between the early and middle stages of Murdoch’s writing career, followed by an impoverishment before the composition of her final work. An examination of the characteristics of individual words appearing in the three texts shows that the vocabulary of Jackson’s Dilemma was the most commonplace and that of The Sea, The Sea the most unusual. These differences contrasted with the grammatical characteristics of the three books, which remained largely unchanged.

The results are consistent with the early stages of Alzheimer’s, in which many sufferers experience word-finding difficulties, particularly for less commonly used abstract terms such as “equanimity” or “discretion”, while retaining the ability to produce impeccably well-formed sentences.

Dr Peter Garrard of UCL’s Institute of Cognitive Neuroscience says: “Iris Murdoch was known to write only in longhand, with few revisions of passages, sending the completed longhand manuscripts to her publishers with little allowance for editorial interference. Her manuscripts thus offer a unique opportunity to explore the effects of the early stages of Alzheimer’s disease on spontaneous writing, and raises the possibility of enhancing cognitive tests used to diagnose the disease, for example by comparing correspondence or diary entries collected over someone’s life.

“Alzheimer’s is known to disrupt the brain’s semantic system, but this can happen subtly before anyone has the remotest suspicion of intellectual decline. Intriguingly, Murdoch experienced an intense and unfamiliar feeling of writer’s block during this period. It would appear that the disease was already beginning to disrupt her cognitive abilities, which may go some way to explaining why critics were disappointed with the strangely altered quality of her final novel.”

Reviews of Jackson’s Dilemma included A.S. Byatt’s comment that the structure of the novel was akin to an “Indian Rope Trick” in which the characters “have no selves and therefore there is no story and no novel”. Penelope Fitzgerald said that the economy of the writing made it appear “as though Murdoch had let her fiction wear through”, while Hugo Barnacle described it as reading “like the work of a 13 year-old schoolgirl who doesn’t get out enough”.

Dame Iris Murdoch was diagnosed with Alzheimer’s disease at the age of 76, shortly after the publication of her final novel in 1995. Neuropsychological assessments in 1997 showed that she was losing a range of cognitive abilities including arithmetic, spelling, and word production. A brain scan performed in June 1997 showed profound shrinkage in the part of her brain associated with memory, the hippocampus – a finding typical of Alzheimer’s disease. The diagnosis was confirmed after her death in 1999, where a post mortem found a high density of plaques and tangles throughout her brain, with particularly severe involvement of the temporal lobes, areas critical for the storage of word meaning.

John Bayley, Iris Murdoch’s husband, says: “Iris donated her brain to medical science to help in the search for a cure for Alzheimer’s disease. We are still a long way off from that cure, but every study that sheds light on how Alzheimer’s develops will ultimately help scientists to diagnose and treat patients at the earliest possible stages of this disease.

“When I was first contacted about this study by the research team, I told them that I had felt all along that there was something different about Iris’s last novel, that it was moving but strange in many ways. I felt sure that Peter Garrard would find something unusual in her writing.”