First, the personal:

In some ways I am not as quick as I was, and I am only 52!

I know that I have more lapses in areas that always gave me problems:

-connecting faces with names for people you haven't seen or thought about for a while (high school classmates and the like – I haven't lived in my hometown for 28 years)

-remembering which eponym goes with which disease – eg, which eponym for a “microabscess” goes with which disease, psoriasis or mycosis fungoides, I know what's different about the two, but not always whether Joe Dermatopathologist “Munro” or J.D. “Pautrier” deserves credit

-spelling, especially of certain foreign names

–annoying tendency to transpose numbers if not paying close attention

-less able to remember things quickly if chronically short on sleep

-less able to juggle dozens of projects without memos.

I remember when I was in college – I absorbed information without effort – other people's phone numbers mentioned in my presence and of no real interest to me – of course, there was “more space”.

On the other hand, if I am highly motivated, I learn new and complex topics as fast as ever. My conceptual scaffolding is much more sophisticated now than at age 18, even if my memory on items of peripheral importance is slipping slightly. But I can't learn and function as easily when sleep deprived. No way would I want to be an intern again, or “pull all-nighters” to meet a serious writing deadline (yep, I do it once in a while, but boy is it ever painful!).

*********************

Now for the medical aspects:

 I am not about to diagnose McCain's problem – possibilities are numerous, some treatable or subject to “work-arounds”, some not.

-Alzheimer's dementia
-Multi-infarct dementia
-Drug-related obtundation (common when taking many drugs)
-Sleep deprivation, especially chronic
-Depression
-Chronic residua of:
a. recurrent severe depression currently in remission
b. some PTSD
c. long-standing schizophrenia under control
d. long history of severe drug or alcohol abuse
-Parkinson's disease
-Hydrocephalus of the type seen in elderly people
-Hypothyroidism
-Cerebral amyloidosis
-Plain old atherosclerosis of cerebral vasculature, combined with poor heart function
-Multiple types of genetic syndromes
…and I could continue, but…

…

…

I can't remember more  😉