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Ageing has always been a prominent theme for many authors, who wrote about the physical and cognitive changes that accompany it. Japanese literature, in particular, is rich in examples, especially from the pen of Yasunari Kawabata. In The Sound of the Mountain, Kawabata narrates the old age of Shingo Ogata, who begins the book manifesting only lapses in episodic memory, in a manner compatible with what we would call mild cognitive impairment. After detailed descriptions of other ailments of old age, Shingo comes to realise that a new deficit has appeared: apraxia. Unable to tie his own tie, he realises his own decline to what we could call an initial form of dementia, with this added cognitive deficit impacting his daily life. In short, Kawabata elegantly delineates a disease progression familiar to all neurologists, in a way that leads us to consider with new lenses the neurological challenges of ageing.

A likely case of progression from mild cognitive impairment to dementia in Yasunari Kawabata's The Sound of the Mountain