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      Gena Rowlands Has Alzheimer’s Decades After ‘The Notebook’

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      Rowlands, 94, played an older woman with dementia in the 2004 movie directed by her son, Nick Cassavetes.Gena Rowlands has Alzheimer’s disease, a late-life challenge for the Oscar-nominated actor who captivated Hollywood in the 1970s with her performance in “A Woman Under the Influence” and later portrayed a character with dementia in “The Notebook.”Rowlands’s son, Nick Cassavetes, the director of “The Notebook,” revealed the diagnosis in a recent interview with Entertainment Weekly, telling the magazine that she had been living with the disease for five years.“She’s in full dementia,” he said. “And it’s so crazy — we lived it, she acted it, and now it’s on us.”A former theater and television actress, Rowlands, 94, made 10 films across four decades with John Cassavetes, the independent film pioneer who was also her husband. She was nominated for the Academy Award for best actress for two of them: “A Woman Under the Influence” (1974), in which she plays a wife and mother who cracks under the burden of domestic harmony, and “Gloria” (1980), about a woman who helps a young boy escape the mob.When Rowlands received an honorary lifetime achievement Oscar in 2015, Laura Linney praised her as an actor who “smashed and destroyed the female stereotype of her time.”“Her work declares: You want to see a modern woman? Here is a modern woman,” Linney said.In 2004, a new generation of filmgoers came to know Rowlands for her portrayal of the older version of Allie in the romance drama “The Notebook.” (Rachel McAdams played the character in her younger years.)Rowlands’s tearful performance in a pivotal scene moved audiences and critics alike. Jessica Winter of The Village Voice credited Rowlands with “locating the terror and desolation wrought by the cruel betrayals of a failing mind.”In an interview with O magazine published the year “The Notebook” was released, Rowlands said her own mother had experienced Alzheimer’s.“I went through that with my mother, and if Nick hadn’t directed the film, I don’t think I would have gone for it — it’s just too hard,” she said.After “The Notebook,” Rowlands made several more appearances in films and television shows, including in “The Skeleton Key” and the detective series “Monk.” Her last appearance in a feature film was in 2014, when she played a retiree who befriends her gay dance instructor in “Six Dance Lessons in Six Weeks.” More

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      How Your Body and Mind Change in Midlife

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      Midlife, typically defined as ages 40 to 60, is an inflection point. It’s a time when our past behaviors begin to catch up with us and we start to notice our bodies and minds aging — sometimes in frustrating or disconcerting ways. But it’s also an opportunity: What our older years will look and feel […] More

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      Alzheimer’s Takes a Financial Toll Long Before Diagnosis, Study Finds

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      New research shows that people who develop dementia often begin falling behind on bills years earlier.Long before people develop dementia, they often begin falling behind on mortgage payments, credit card bills and other financial obligations, new research shows.A team of economists and medical experts at the Federal Reserve Bank of New York and Georgetown University combined Medicare records with data from Equifax, the credit bureau, to study how people’s borrowing behavior changed in the years before and after a diagnosis of Alzheimer’s or a similar disorder.What they found was striking: Credit scores among people who later develop dementia begin falling sharply long before their disease is formally identified. A year before diagnosis, these people were 17.2 percent more likely to be delinquent on their mortgage payments than before the onset of the disease, and 34.3 percent more likely to be delinquent on their credit card bills. The issues start even earlier: The study finds evidence of people falling behind on their debts five years before diagnosis.“The results are striking in both their clarity and their consistency,” said Carole Roan Gresenz, a Georgetown University economist who was one of the study’s authors. Credit scores and delinquencies, she said, “consistently worsen over time as diagnosis approaches, and so it literally mirrors the changes in cognitive decline that we’re observing.”The research adds to a growing body of work documenting what many Alzheimer’s patients and their families already know: Decision-making, including on financial matters, can begin to deteriorate long before a diagnosis is made or even suspected. People who are starting to experience cognitive decline may miss payments, make impulsive purchases or put money into risky investments they would not have considered before the disease.“There’s not just getting forgetful, but our risk tolerance changes,” said Lauren Hersch Nicholas, a professor at the University of Colorado School of Medicine who has studied dementia’s impact on people’s finances. “It might seem suddenly like a good move to move a diversified financial portfolio into some stock that someone recommended.”Tell us about your family’s challenges with money management and Alzheimer’s. More

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      How to Care for Yourself as a Caregiver

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      Forget yoga or weekend escapes. There are more realistic tools to put in place, experts say.Once a quarter, Bich Le, 52, travels from her home outside of Minneapolis to St. Augustine, Fla., where she moves into her father’s guest room for three weeks.The health care executive is one of five siblings who take turns caring for their widowed 90-year-old father, who has lung cancer and requires constant assistance. While she’s in Florida this month, she will miss her daughter’s final high school prom; she missed it last year, too, due to her caregiving duties.The drugs Ms. Le’s father takes to manage pain can “negatively impact how he treats people,” she said. When he becomes volatile, Ms. Le said, she mostly tries to ignore it and “not add to the stress of the situation.” She tells herself to “just care for him and just let it go.” But sometimes, when she’s exhausted, his temper grates.“What runs through my brain is: ‘A simple thank you would really go a long way,’” she said. “‘You have me, or you have a nursing home.’”Caregiving can be fraught for the estimated 53 million Americans who assist family members and friends. And factors like financial strain and isolation can add to psychological distress. In a 2017 survey of 1,081 caregivers conducted by AARP, 51 percent of respondents reported feeling worried or stressed. But there was a surprising upside: The majority — 91 percent — also reported feeling pleased that they were able to help.How can caregivers hold on to that feeling amid the stress, fatigue and resentment that also come with the role? There are strategies for feeling “less burdened or stressed by the daily problems” they encounter, said William Haley, a professor of aging studies at the University of South Florida.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      How to Tell an Older Person It’s Time to Stop Driving

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      The “car key conversation” can be painful for families to navigate. Experts say there are ways to have it with empathy and care.Sherrie Waugh has been yelled at, insulted and wept upon in the course of her job administering driving tests. Typically these extreme reactions happen when she is forced to render an upsetting verdict: It’s time to hang up the car keys.Ms. Waugh, a certified driving rehabilitation specialist with The Brain Center, a private neuropsychology practice in Indiana, often works with older drivers, putting them through an assessment that measures things like visual skills, reaction time and processing speed.“I had one gentleman, who had early onset dementia, who was just sitting here crying,” Ms. Waugh said. “His wife was out in the car and she was crying. And we all came back, and we were all crying. Because it’s so hard.”Decisions about when an older person (or someone whose physical or mental circumstances make operating a vehicle dangerous) should stop driving are often agonizing. They can rock the driver’s sense of independence and identity, and add to the responsibilities that many family caregivers shoulder.“It’s a major, major loss for older people,” said Lauren Massimo, an assistant professor at Penn Nursing. “It’s been described to me as dehumanizing.”But it is important to raise concerns as soon as you have them, experts said, and there are ways to make the car key conversation less painful for older drivers and their loved ones.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Memory Loss Requires Careful Diagnosis, Scientists Say

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      A federal investigator said that President Biden had “poor memory” and “diminished faculties.” But such a diagnosis would require close medical assessment, experts said.A lengthy report by the Department of Justice on President Biden’s handling of classified documents contained some astonishing assessments of his well-being and mental health.Mr. Biden, 81, was an “elderly man with a poor memory” and “diminished faculties” who “did not remember when he was vice president,” the special counsel Robert K. Hur said.In conversations recorded in 2017, Mr. Biden was “often painfully slow” and “struggling to remember events and straining at times to read and relay his own notebook entries.” So impaired was Mr. Biden that a jury was unlikely to convict him, Mr. Hur said.Republicans were quick to pounce, some calling the president unfit for office and demanding his removal.But while the report disparaged Mr. Biden’s mental health, medical experts on Friday noted that its judgments were not based on science and that its methods bore no resemblance to those that doctors use to assess possible cognitive impairment.In its simplest form, the issue is one that doctors and family members have been dealing with for decades: How do you know when an episode of confusion or a memory lapse is part of a serious decline?We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      I Clerked for Justice O’Connor. She Was My Hero, but I Worry About Her Legacy.

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      When I learned that Justice Sandra Day O’Connor had died, I felt not just the loss of a world historical figure but also the loss of someone who formed a part of my identity.As a young woman, I was in awe of Justice O’Connor. Her presence on the Supreme Court offered an answer to any doubts I had that I belonged in the law. As a young lawyer, I was lucky enough to work for a year as her law clerk.While clerking for her, I came to understand and appreciate not only her place in history but also her vision of the law. She refused opportunities to issue sweeping opinions that would substitute her ideals for the democratic process. This made it all the more tragic that toward the end of her career, she joined in a decision — Bush v. Gore — that represented a rejection of her cautious approach in favor of a starkly political one.For me, she stands as a shining example of how women — everyone, really — can approach life and work. I witnessed her warmth, humor and humanity while experiencing the gift of learning and seeing the law through her eyes. Those personal and legal impressions have left an enduring mark on me as a person and as a lawyer.At the time Justice O’Connor became a lawyer, women in that role were rare. As has now become familiar lore, after she graduated near the top of her class from Stanford Law School in 1952, she was unable to find work as a lawyer. As a justice, she made sure that opportunities denied to her were available to others. Shortly after I graduated from law school, I joined two other women and one man in her chambers, making a rare majority-woman chamber when just over a third of the clerks for Supreme Court justices were women.I always found it remarkable that I never heard Justice O’Connor talk with any bitterness of the barriers she faced pursuing her career. Instead, she worked hard and without drama to overcome them. Remarkably, that experience did not harden her.She had a wicked sense of humor. The door to our clerks’ office held a photocopied image of her hand with the words “For a pat on the back, lean here.” Her face transformed in an almost girlish way when she laughed, which she did often.When she met with the clerks on Saturday to discuss upcoming cases, she brought us a home-cooked lunch — often something inspired by her Western roots. (One memorable example was tortillas and a cheesy chicken filling, to make a kind of cross between a burrito and a chicken quesadilla. It was a bit of a mess to eat but delicious.) She insisted that we get out of the courthouse and walk with her to see the cherry blossoms, and she took us to one of her favorite museums; once we visited the National Arboretum and lingered at the bonsai exhibit. She believed firmly in the benefits of exercise, and she invited us to join daily aerobics sessions with a group of her friends early in the morning in the basketball court above the Supreme Court chamber, which she delighted in calling the “highest court in the land.”She was also a hopeless romantic, and she was well known for trying to find partners for her single clerks. She met her husband, John, in law school, and they married shortly after graduation. He had received an Alzheimer’s diagnosis when I clerked for her, though that knowledge was not yet public. He often came by her chambers as she worked to maintain a sense of normalcy. She retired in 2006 largely because of his progressing dementia. In a powerful lesson of what it is to love, she was happy for him when he struck up a romance with a fellow Alzheimer’s patient. It was devastating to learn that she was subsequently diagnosed with dementia herself.When I clerked for her in 1998 and ’99, she was at the height of her powers. She was the unquestioned swing justice, and some called her the most powerful woman in the world.But she approached the role with humility. Considered a minimalist, she worked to devise opinions that decided the case and usually little more. She was sometimes criticized for that approach. Justice Antonin Scalia made no secret of his frustration. When she refused to overturn Roe v. Wade, in the 1992 case Planned Parenthood v. Casey, he snarlingly referred to the opinion as a “jurisprudence of confusion.” She was criticized by many academics for failing to articulate a grand vision of the law.What they missed was that this was her grand vision of the law — or at least of the Supreme Court. She had spent the formative part of her career before she entered the court as a member of the Arizona State Legislature, where she rose to become the first female majority leader of a State Senate.She believed that the most important decisions about how to govern the country belonged to the political branches and to state legislatures, not to a court sitting in Washington. Seeing the law through her eyes during the year I worked for her, I realized that she was not looking for a sweeping theory that would change the face of the law. She wanted to decide the case before her and provide a bit of guidance to the lower courts as necessary but leave the rest to the democratic process.In December 2000, this made reading the opinion she joined in Bush v. Gore all the more heartbreaking. Her vote made a 5-to-4 majority for the decision to halt the recount in Florida rather than allow that process to play out, throwing the election to George W. Bush, who became the first president since 1888 to be elected without winning the popular vote. The decision, widely criticized for its shoddy reasoning, was the opposite of the careful, modest decisions she had spent her career crafting. It disenfranchised voters whose ballots had been rejected by ballot-counting machines in the interests of finality — in the process substituting the judgment of the court for the expressed will of the people.The court showed that it could — and would — behave in nakedly political ways. It had given into the temptation to engage in ends-driven reasoning that was utterly unpersuasive to those who did not already share its view of the right result. In doing so, the court might have opened the door to what has now become something of a habit.Justice O’Connor retired just over five years later, and she was replaced by Samuel Alito. It has been painful to watch as, in decision after decision, he has voted to undo much of the legacy she so carefully constructed. The blunt politics of Bush v. Gore now look less like an embarrassing outlier and more like a turning point toward a court that has cast aside Justice O’Connor’s cautious minimalism for a robustly unapologetic political view of the law. Unsurprisingly, public opinion of the court has fallen to a near historic low.Justice O’Connor remains a transformative figure in the law, a woman who charted a path that I and so many others have followed. If the court is to regain the public trust, it should look, once again, to her shining example, which embodied a powerful ideal: the court is not a body meant to enact the justices’ vision of what the law should be. Its role is, instead, to encourage our imperfect democracy to find its way forward on its own.Oona A. Hathaway is a professor of law and political science at Yale University and a nonresident scholar at the Carnegie Endowment for Peace.The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: letters@nytimes.com.Follow the New York Times Opinion section on Facebook, Instagram, TikTok, X and Threads. More

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      Compassionate Release for Those Aging Behind Bars

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      More from our inbox:Living Well, and Pursuing One’s Passion, With Parkinson’sThe ‘Absurd Contradictions’ of the Migrant SystemA Civilized Argument A Debate QuestionCecilia CarlstedtTo the Editor: Re “Inside a Dementia Unit in a Federal Prison” (Opinion guest essay, Aug. 13):Katie Engelhart vividly describes the absurdity and cruelty of incarcerating frail elders with debilitating dementia. It would be a mistake, though, to conclude simply that expanding compassionate release is the answer. Certainly, that’s warranted, but policymakers should be proactive, not just reactive.As a former parole commissioner, I know that dementia is just the tip of the iceberg of the problem of mass aging behind bars.Countless people (not just men) effectively face a slow death penalty behind bars because of extreme sentences or repeated denials of parole release despite these individuals’ complete transformations. Far from being helpless, many are violence interrupters, mentors, scholars and artists, including people previously convicted of causing serious harm. They have changed.Enacting elder parole bills, which do not guarantee release based on age but rather allow older adults to be individually considered for release by a parole board, can help resolve the crisis of aging behind bars, save substantial money, and return people to the community to repair the harm they long ago caused — before they are on death’s doorstep.Carol ShapiroNew YorkTo the Editor:Dementia units in prisons should primarily serve as a conduit to helping achieve compassionate release. As physicians volunteering with the Medical Justice Alliance, we review the medical care of numerous patients with dementia who are undiagnosed and untreated in the prison system. Patients wake up unsure why they are in prison, hoping that President Nixon might pardon them.We must consider the high cost of normalizing the imprisonment of elderly patients with dementia. Financially, developing “dementia-friendly” prison units incurs significant costs; that money could instead be used to improve community resources such as nursing facilities. Ethically, we must grapple with punishing people who do not pose a threat to others and are unable to understand why they are being punished.Compassionate release laws at the state and federal levels should make dementia an explicit criterion for early release. Facilities should also screen older patients for dementia on a regular basis and develop protocols for requesting compassionate release and expediting placement in memory care facilities. The U.S. prison population is aging and change is urgently needed.Caitlin FarrellNicole MusheroWilliam WeberTo the Editor:As a person who has served three federal prison terms for antiwar protests for a total of almost three years, I found myself shaking my head that the Federal Bureau of Prisons maintains Federal Medical Center Devens to hold men with dementia.The essay noted that most of the men in the dementia unit have no memories of their crimes or why they are incarcerated, yet few are deemed eligible for compassionate release. The United States incarcerates nearly two million people in our thousands of jails and prisons. The U.S. prison system is primitive, lacks redemption and only metes out punishment. The term rehabilitation is simply not part of this cruel system.In my time in more than a half dozen federal prisons, I never met a man I would not have to my home as a dinner guest. Our jails and prisons are filled mostly with people convicted of nonviolent crimes. Many — perhaps the majority — of incarcerated people are poor, mentally ill or substance abusers. Most need medical treatment, not incarceration.I agree with F.M.C. Devens’s clinical director, Dr. Patricia Ruze, who thinks it would be “totally appropriate” to release the whole unit on compassionate grounds and relocate the men to community nursing homes.I’d go one step further: Let’s release all nonviolent people from prison with appropriate community support to help them prosper and avoid recidivism, as well as offer programs of human uplift to the remaining prisoners using the money we save by closing the prisons we will no longer need.Patrick O’NeillGarner, N.C.Living Well, and Pursuing One’s Passion, With Parkinson’sThe pianist Nicolas Hodges has continued to perform and record — with alterations and tough decisions — after receiving a Parkinson’s disease diagnosis.Roderick Aichinger for The New York TimesTo the Editor: Re “Pianist Adapts His Life to Parkinson’s” (Arts & Leisure, Aug. 13):Thank you for demonstrating how the pianist Nicolas Hodges is adapting to life with Parkinson’s disease. Mr. Hodges is testament to the fact that it is possible to continue to live well with Parkinson’s, and the article highlights two key ways to manage symptoms: consistently taking medications (dopamine) and reducing commitments or stress. Exercise and physical activity are also critical to managing symptoms.Recent research published by the Parkinson’s Foundation shows that the number of people in the U.S. diagnosed with Parkinson’s annually has increased by 50 percent, from approximately 60,000 to 90,000. This means that every six minutes, someone in the U.S. is diagnosed with the disease and may encounter similar challenges to those faced by Mr. Hodges.Further funding to support research and drug development are needed in order to find a cure, and the Parkinson’s Foundation and other organizations work tirelessly to advance this.In the meantime, we applaud Mr. Hodges for speaking about his experience with the disease and continuing to pursue his passion. Play on, Mr. Hodges.John L. LehrNew YorkThe writer is president and C.E.O. of the Parkinson’s Foundation.The ‘Absurd Contradictions’ of the Migrant SystemTo the Editor: We have millions of square feet of office space no longer being used and tens of thousands of homeless people and displaced immigrants needing shelter. Many employers cannot fill open jobs while the talents and proven determination of immigrants sit untapped in detention.We can strengthen our economy and confirm our commitment to human dignity and decency by correcting these absurd contradictions.It would be far more cost-effective to use the migrant detention system funds to create a system where people can be quickly helped and trained to be productive contributors to society instead of expensive drains on us all.Even if common decency is not a motivation, pure selfish economic need dictates that we end the waste and do the right thing.Michael E. MakoverGreat Neck, N.Y.A Civilized Argument Christopher Smith for The New York TimesTo the Editor: Re “Imagining the Face-Off in Trump’s Jan. 6 Case,” by David French (column, Aug. 12):I started feeling odd as I read Mr. French’s column. It was so quiet! Two measured, rational voices speaking through the ink, each backing up their arguments with researchable references and free of bitter, ad hominem jabs. A few bits of pique and tooth grinding to humanize both the defense and the prosecution, but all for the sake of clarifying a complex position.How civilized! How rare! It’s a shame that the essay was the voice of one man working his careful way through a thicket of legal complexity and not a real-life exchange of ideas in search of a mutually arrived at truth.Leslie BellDavenport, IowaA Debate QuestionTo the Editor: At the Republican debate I would like to see the moderator ask each of the participants if as president they would pardon Donald Trump if he is convicted of federal crimes.Walter RonaghanHarrison, N.Y. More