Ronald Reagan was never particularly admired for his memory. But in the late 1980s and early '90s, he slowly began to lose his grasp on ordinary function. In 1992, three years after leaving the White House, Reagan's forgetting became impossible to ignore. He was eighty-one.
Both his mother and older brother had experienced senility, and he had demonstrated a mild forgetfulness in the late years of his presidency. Like many people who eventually suffer from the disease, Reagan may have had an inkling for some time of what was to come. In his stable of disarming jokes were several about memory troubles afflicting the elderly. He shared one at a 1985 dinner honoring Senator Russell Long.
"An elderly couple was getting ready for bed one night," Reagan told the crowd. "The wife turned to her husband and said, 'I'm just so hungry for ice cream and there isn't any in the house.'"
"I'll get you some," her husband offered.
"You're a dear," she said. "Vanilla with chocolate sauce. Write it down--you'll forget."
"I won't forget," he said.
"With whipped cream on top."
"Vanilla with chocolate sauce and whipped cream on top," he repeated.
"And a cherry," she said.
"And a cherry on top."
"Please write it down," she said. "I know you'll forget."
"I won't forget," he insisted. "Vanilla with chocolate sauce, whipped cream, and a cherry on top."
The husband went off and returned after a while with a paper bag, which he handed to his wife in bed. She opened up the bag, and pulled out a ham sandwich.
"I told you to write it down," she said. "You forgot the mustard."
It seems clear enough that Reagan was increasingly bothered by personal memory lapses. In a regular White House checkup late in his second term, the President began by joking to his doctor, "I have three things that I want to tell you today. The first is that I seem to be having a little problem with my memory. I cannot remember the other two."
Did Reagan have Alzheimer's disease in office? Yes and no. Without a doubt, he was on his way to getting the disease, which develops over many years. But it is equally clear that there was not yet nearly enough decline in function to support even a tentative diagnosis. Reagan's mind was well within the realm of normal functioning. Even if his doctors had been looking intently for Alzheimer's, it is still likely that they would not have been able to detect the disease-in-progress. A slight deterioration of memory is so common among the elderly that even today it is considered to be a natural (if unwelcome) consequence of aging. About a third to a half of all human beings experience some mild decline in memory as they get older, taking longer to learn directions, for example, or having some difficulty recalling names or numbers.
Alzheimer's disease overtakes a person very gradually, and for a while can be indistinguishable from such mild memory loss. But eventually the forgetting reaches the stage where it is quite distinct from an absentminded loss of one's glasses or keys. Fleeting moments of almost total confusion seize a person who is otherwise entirely healthy and lucid.
By 1992, the signs of Reagan's illness were impossible to ignore. At the conclusion of a medical exam in September, as the New York Times would later report, Reagan looked up at his doctor of many years with an utterly blank face and said, "What am I supposed to do next?" This time, the doctor knew that something was very wrong.
Sixteen months later, in February 1994, Reagan flew back to Washington, D.C., from his retirement home in Bel Air, California, for what would turn out to be his final visit. The occasion was a dinner celebrating his own eighty-third birthday, attended by Margaret Thatcher and twenty-five hundred other friends and supporters.
Before the gala began, the former President had trouble recognizing a former Secret Service agent whom he had know well in the White House. This didn't come as a total shock to his wife, Nancy, and other close friends, but it did cause them to worry that Reagan might have problems with his speech that night.
The show went on as planned. After an introduction by Thatcher, Reagan strolled to the podium. He began to speak, then stumbled, and paused. His doctor, John Hutton, feared that Reagan was about to humiliate himself. "I was holding my breath, wondering how he would get started," Hutton later recalled, "Then suddenly something switched on, his voice resounded, he paused at the right places, and he was his old self."