Are Humor and Word-Play Lost Skillls for Those with Alzheimer's?

Does the ability to crack jokes disappear when you have Alzheimer’s disease?  Recently a psychiatrist friend said that a sophisticated sense of humor was a clear sign that Alzheimer’s was not present.  No matter how forgetful you are, he said, if you can crack clever jokes like that, you don’t have Alzheimer’s. 

I wondered about this because the one thing my father seemed to keep to his grave was his sense of humor.  He had advanced dementia to the point where he couldn’t remember a conversation past a couple of sentences, had no idea where he lived or what year it was—in short, he would not pass the typical test for Alzheimer’s.  Yet he still made jokes.

When I said to him one day as we were walking down the hall of his assisted living facility, “How are they treating you, Dad?”  He answered, “Like an old man.”  When an administrator told us they were having Irish music, Irish drinks and Irish food for a St. Patty’s Day celebration, he said, “How about some Irish girls?” 

One day as I drove him back to his place after dinner at our house, Dad said, “The trouble with being old is that you just get worse, you don’t get well.”

            “You’re right, Dad.”

            “And in my case, I can’t get any worse.”

            “Right,” I said again absentmindedly. 

            “You don’t have to always agree with me, you know,” he quipped.  “Stop and think about it for a few minutes before you answer.”

Can one still be clever with words after losing so many of them because of Alzheimer’s or other forms of dementia? It seems that one can. In her book, The House on Beartown Road, Elizabeth Cohen says that while her father’s speech was now pared down and skeletal, it was eloquent:

There is undeniable beauty in the way he is losing language, the way he substitutes different words when he cannot find the ones he wants. He calls toast “the singed bread,” and apples “the crackly, magnificent, sweet ones.” Sometimes he calls me and Ava “the beautiful big one” and “the beautiful little one. (p. 55)

Because of my experience, Elizabeth Cohen’s experience, and evidence from other sources, I wonder what made my psychiatrist friend so sure that clever humor could not be made by someone with Alzheimer’s? I didn’t argue with him, however. He was speaking to me and my husband at the time, and I think maybe he was simply trying to reassure Adrian that his mind was fine.

I think his mind is fine, too.  Most of the time.  Just like mine.