To the Editor.
—I read with great interest the article by Dr Snowdon and colleagues.1 They found that nuns whose autobiographies had high idea density and grammatical complexity when they were young were less likely to develop Alzheimer disease in later years. However, the analysis of writing samples appears to have a potentially important omission. Of the 2 detailed samples of writing provided, that of sister A who developed Alzheimer disease and that of sister B who had not developed Alzheimer disease at 80 years of age (published in their entirety in the New York Times2), sister A's writing contains no expressions of emotion and sister B's writing contains 5 direct expressions of emotion and 2 metaphorical expressions of strong feeling.It is possible that it is not merely cognitive complexity of thought at a young age that correlates with later health, but that having the ability to
Massie HN. Linguistic Ability in Early Life and Alzheimer Disease in Late Life. JAMA. 1996;275(24):1879. doi:10.1001/jama.1996.03530480021019