Lost in the fog of Alzheimer’s

Getting literally lost in the fog is a terrifying experience.  It happened to me about thirty years ago while sailing in the San Juan Islands, an archipelago that lies between Vancouver Island in British Columbia and northwest Washington State.  We left shore with clear skies, but about an hour later a fog bank suddenly rolled in limiting visibility to no more than fifty feet. Our chartered boat had neither GPS nor radar so we were almost instantly disoriented.  Our only source of reference was the compass. I found it surprisingly difficult to steer a straight course by compass alone as every time I took my eyes off the compass, the boat would head off in another direction.  We inched along blowing our fog horn frequently and listening for the horns of other boats nearby. One of those horns was on a very large ferry that seemed to be getting closer all the time despite our frantic attempts to head away from it. The fog finally lifted after an hour, but I think those sixty minutes were among the most stressful of my life.

The fog of Alzheimer’s is a commonly used metaphor, and I think it’s a pretty good one. It refers to the loss of mental acuity, disorientation, and forgetfulness that are common in Alzheimer’s.  But one aspect of the metaphor that is not emphasized is that like the fog bank on the ocean, the fog of Alzheimer’s can come and go. It does for me. Sometimes there is an obvious cause such as running a fever or getting too tired.  On the day after I got my second Covid-19 vaccination I was not mentally sharp and had trouble concentrating despite not having any other side effects.  Once or twice a week on first awakening in the morning, I think I am in my childhood bedroom.  It only takes a few seconds to get reoriented, and it actually is a pleasant rather than scary experience.  Sometimes the fog comes in for no apparent reason, lasts a few minutes or a few hours and then goes away.  I wonder what is behind these mysterious, seemingly unprovoked but temporary episodes of cognitive impairment.  Abnormal brain wave activity is very common in people with Alzheimer’s disease, and seizures are not particularly rare.  My thought is that some of these temporary brain fogs might be caused by tiny, non-convulsive seizures.  It’s just a hypothesis for now, but I’ll ask my dementia specialist when I see him next and write an update if I learn more.