Using the number of books I read as measure of my cognitive impairment

Lois, my wife and a retired librarian, got me started keeping track of my book reading using the Goodreads website in 2008. It took me a couple of years to get it right, remembering to add books and/or the dates read, but by 2010, I was producing an accurate record of my pleasure book reading. Goodreads was developed and released in 2008 by Otis Chandler, a programmer then recently graduated from Stanford, who saw an unmet need for a way to manage a personal library. The website was immensely popular and was eventually sold to Amazon in 2013. Some users became upset with Amazon’s alleged heavy-handed control of reviews and data mining, but honestly, I haven’t had any problems. For me, it has been a very useful way to track my reading.

The chart above shows the number of books I read each year, starting in 2010. One can also get the chart to show pages read per year as well, but I prefer books read because I read a lot of books with pages and pages of notes at the end that artificially inflate my estimated reading volume. In 2010 I was still working. That year I left private practice to accept an academic position at Oregon Health and Science University seeing neurology patients half time and supervising neurology residents and medical students for the rest of my time.  I no longer had to take night call, and I finally had some free time to start reading. In 2013 I fully retired because of my mild cognitive impairment.  Suddenly I had a lot of free time, and my reading doubled to a mean ± standard deviation of 101 ± 4.36 books per year from 2013 through 2021. Then in 2022 there was the first significant drop to 82 books with no obvious external cause. So far in 2023 I have read only 44 books which would annualize to 66 books anticipated for the entire year. 

So what’s going on? I’m pretty sure that my drop in reading speed is due to a decreased efficiency of my memory, specifically working memory.  Working memory is used for temporarily storing, processing and retrieving information. It is distinct from long-term memory and short-term memory. “While hearing a phone number and writing it down is an STM [short-term memory] task, writing down the same number in reverse order involves changing the order and shape of the information, and is therefore a WM [working memory]-based task.” (van Boxtel, W,  Lawyer, L.  Sentence comprehension in ageing and Alzheimer’s disease. Lang Linguist Compass.  2021;e12430.) While issues with working memory are common in normal aging, they tend to be much more severe in Alzheimer’s, and they tend to be among the earliest deficits found in patients with early-stage Alzheimer’s.  For those interested in pursuing this topic in more depth, I recommend the open access review paper that I cited above. Here is the direct link that may be easier to use.

So what am I experiencing?  I still love to read, but it is indeed getting harder.  Every time I pick up a book, I have to re-read the preceding page or two to remind myself what is going on.  I can almost never recall the names of characters, so I have tried to steer clear of books with multiple people that I need to remember.  I still love to read whodunnits, but I enjoy them much more if there are only a few suspects to keep track of. I am reading more non-fiction than I used to because that seems generally easier for me to follow. Even though I usually can’t remember the name of the book, author, or main characters as I read, I enjoy the book in the moment.  Just don’t ask me to give a book report!