A likely case of progression from mild cognitive impairment to dementia in Yasunari Kawabata's The Sound of the Mountain

ABSTRACT Ageing has always been a prominent theme for many authors, who wrote about the physical and cognitive changes that accompany it. Japanese literature, in particular, is rich in examples, especially from the pen of Yasunari Kawabata. In The Sound of the Mountain, Kawabata narrates the old age of Shingo Ogata, who begins the book manifesting only lapses in episodic memory, in a manner compatible with what we would call mild cognitive impairment. After detailed descriptions of other ailments of old age, Shingo comes to realise that a new deficit has appeared: apraxia. Unable to tie his own tie, he realises his own decline to what we could call an initial form of dementia, with this added cognitive deficit impacting his daily life. In short, Kawabata elegantly delineates a disease progression familiar to all neurologists, in a way that leads us to consider with new lenses the neurological challenges of ageing.

【摘要】衰老是诸多作家笔下经久不衰的核心主题，他们常会描绘衰老伴随的生理与认知变化。日本文学中此类佳作不胜枚举，尤以川端康成的创作为代表。在《山音》（The Sound of the Mountain）中，川端康成讲述了主人公尾形新吾的晚年境遇：小说开篇，他仅表现出情景记忆（episodic memory）的减退，症状与我们所称的轻度认知障碍（mild cognitive impairment）相符。在细致描摹了新吾罹患的其他老年病症后，他逐渐意识到新的认知缺陷已然出现——失用症（apraxia）：当他发现自己无法自行系领带时，便认清自身已衰退至痴呆（dementia）的早期阶段，这种新增的认知缺陷严重影响了他的日常生活。简言之，川端康成以优雅的笔触勾勒出所有神经科医生都耳熟能详的疾病进展历程，令我们得以以全新视角审视衰老带来的神经学挑战。