Not in Love With AAMI - Excerpt
David Goldblatt

Might as well begin with the latest one: This morning, walking the beagle and thinking how to start this article, I began to pass the springhouse (a little shed over a cinderblock tank at the top of our hill), which I rebuilt last year in preparation for piping water to the outbuilding where I have my office. Sparky, deep in his world of smells, was having his usual good time but-just back from a quick trip to San Diego and a long beach stroll that compared favor-ably with dogwalking in the chill of a January morning in upstate New York-I was not. I owed my stepson, Ricky, for his good care of my cats while Ann and I were away, but was wishing that my volun-tary repayment had not taken the form of walking his dog for him. Hurrying as I was, I had already passed the springhouse before I stopped, recalling Ann's comment of the night before that it would be good to check the water level, now that the water project was nearing completion in a time of relative drought in our area. Maybe we'd get all through with the work, only to discover that the source was dry.

Hopping cautiously over the ice crust on the drainage ditch, I entered the woods, removed the access panel on the north side of the springhouse, lifted and set aside the screen that is supposed to keep mice and other small creatures from drowning in the water beneath, then found a pole, poked it through the surface ice, and ascertained that a recent heavy snow and subsequent thaw had indeed helped to raise the level of the water. Pleased with the information I had obtained, I put down the pole, replaced the panel, twisted the four pieces of hardware into place to hold it, recovered the dog's leash, and started down the hill.

Then I stopped, decided I had to go back to recheck, renegoti-ated the frozen ditch, reopened the panel, and, sure enough, found that I had not repositioned the varmint screen over the top of the holding tank. As I closed up the shed, I asked myself if I had now got everything right, and I wondered whether, in a few years, I might instead be asking questions like, "Now tell me, are you Ricky or Sparky?" And would I be addressing my question to my stepson or his dog? Or perhaps to a shed? I wasn't really ready to think about that, but I couldn't help it. I had a more general question on my mind that was shaping my thinking and is the subject of this essay: Does my age-associated memory impairment (AAMI) represent the insidious onset of Alzheimer's disease (AD), or is it something I can continue to live and function with? It is a question that many people ask in an aging America.

* David Goldblatt, M.D., is Professor Emeritus of neurology and the medical humanities at the University of Rochester School of Medicine and Dentistry. He lives outside of Penn Yan, N.Y., on 17 acres of land, mostly former vine-yards, much of which he keeps mowed in order to be able to find his way home more easily.