Ronald Reagan’s Alzheimer’s Disease

On November 5, 1994, former President Ronald Reagan released a letter to the world announcing he’d been diagnosed with Alzheimer’s disease. He was 83 and it had been five years since his presidency ended. He’d kept a low profile. Now everyone knew why. True to his nature, Reagan expressed a positive outlook:

I now begin the journey that will lead me into the sunset of my life… At the moment I feel just fine. I intend to live the remainder of the years God gives me on this earth doing the things I have always done. I will continue to share life’s journey with my beloved Nancy and my family. I plan to enjoy the great outdoors and stay in touch with my friends and supporters.

Reagan’s youngest son Ron Jr. published a book in 2011 titled My Father at 100. (President Reagan died in 2004 but 2011 would have been his 100th birthday.) Ron Jr. claimed that his father’s struggle with Alzheimer’s began while he was president. He recalled his dad’s 1984 presidential debate with Walter Mondale.

My heart sank as he floundered his way through his responses, fumbling with his notes, uncharacteristically lost for words. He looked tired and bewildered.

Ron Jr.’s fears increased over time.

Three years into his first term as president… I was feeling the first shivers of concern.

Reagan’s staff noted the changes as early as 1985 as Reagan stumbled over his words, expressed weak memory and often fell asleep in public. In 1986, President Reagan himself expressed concern over his cognitive state. Ron Jr. wrote that his father “might himself have suspected that all was not as it should be. [He] had been alarmed to discover, while flying over the familiar canyons north of Los Angeles, that he could no longer summon their names.”

Reagan’s second presidency ended in January 1989. Six months later, the 78-year-old ex-president was thrown from a horse on a hunting trip in Mexico. Doctors initially said Reagan’s injuries were minimal. A few days later they noticed swelling on Reagan’s brain. Reagan had emergency surgery and his skull was opened to relieve pressure. That’s when doctors first “detected what they took to be probable signs of Alzheimer’s disease.”

The official account from Reagan’s handlers was much different. White House doctors concluded “there is no evidence that Reagan had suffered any of the symptoms of dementia while in office.”

The causes of Alzheimer’s remain a mystery. It was once thought that aluminum found in cooking utensils and cans of food cause the disease. Genetics, diet and cardiovascular health are likely factors. In a book titled When the Body Says No, Dr. Gabor Maté speculates that Alzheimer’s might be an autoimmune reaction to early childhood trauma.

Maté referenced a year 2000 study about a group of elderly nuns. Journals kept by the nuns as young woman were studied and compared to the nuns’ health symptoms in their final years. Researchers concluded that nuns who had access to early life emotions “were less likely to succumb to Alzheimer’s as they aged.” Conversely, those who didn’t express emotion in their journals were more likely to suffer from dementia.

Reagan was a child of an alcoholic father and a disinterested mother. He learned to detach and suppress his emotions at an early age. Maté writes “that Reagan’s need to cocoon himself against reality can be understood as the responses of a sensitive child to the trauma of living with an alcoholic, unreliable father and an emotionally absent mother.”

In a haunting passage, Maté writes:

In an atmosphere of severe psychological stress, a young child’s brain may perform an evasive maneuver: It shuts down awareness of painful feelings. The brain can never defend us against being wounded, but it can suppress our sense of hurt, forcing it into the unconscious.

Maté believes these protective mechanisms might be associated with later development of Alzheimer’s disease and dementia.

Neurologist Oliver Sacks also saw a connection. He wrote about an incident where aphasia patients convulsed with laughter while watching a speech from President Reagan’s first term. Aphasia is a condition where people are unable to process spoken language, often because of a stroke. “To this group,” Sacks wrote, “The Great Communicator was communicating something he had not intended… Aphasiacs, it turns out, have a finely honed capacity to distinguish emotional truth from fiction. Just as the blind learn to pay close and nuanced attention to sound, so aphasiacs compensate for their impairment by reading astutely a speaker’s body language, facial expression and tone of voice.”

Dr. Sacks’ patients couldn’t understand Reagan’s words, but they detected a lack of authenticity in his manner that escaped most viewers. “Either he is brain-damaged or he has something to conceal,” a patient told Dr. Sacks.

Dr. Gabor Maté further theorized that Reagan found ways to mitigate his failing mind. As Alzheimer’s slowly robbed him of his thought, speech and movement, Reagan relied on his trademark smile in lieu of language and turned to catch all phrases such as “there are no words.”

Ron Reagan Jr. told interviewers that his father didn’t know for certain that something was wrong. “I’ve seen no evidence that my father (or anyone else) was aware of his medical condition while he was in office. Had the diagnosis been made in, say 1987, would he have stepped down? I believe he would have.”

The situation has historical precedence. In 1976, British Prime Minister Harold Wilson resigned his post at 60. He’d experienced memory loss, speech difficulties and a general loss of enthusiasm. He knew something was wrong and was later diagnosed with Alzheimer’s. (He died of Alzheimer’s and colon cancer at 79.) Margaret Thatcher also suffered from Alzheimer’s after serving as prime minister.

No one can know for certain when Reagan first showed signs of Alzheimer’s. But as Ron Jr. wrote in his book:

Today, we are aware that the physiological and neurological changes associated with Alzheimer’s can be in evidence years, even decades, before identifiable symptoms arise. The question… of whether my father suffered from the beginning stages of Alzheimer’s while in office more or less answers itself.