In Losing It: Staging the Cultural Conundrum of Dementia and Decline in American Theatre, Dorothy Chansky takes on the loss many of us fear the most: cognitive impairment. In this extensive study, Chansky proposes to do three things: historicize representations of dementia and (cognitive) decline on the mainstream American Stage; analyze the link between neuro conditions and age as presented on the stage; and address the importance of bodily presence in theatrical representations (4). To this I would add that Losing It also functions as a call to action. To accomplish her stated intentions, Chansky utilizes medical, social, and cultural data, historical research, and age studies scholarship, as well as textual and performance analysis of eleven American plays ranging from the early twentieth to the early twenty-first century, examining such works as Alice Brown's Joint Owners in Spain, Peggy Shaw's Ruff, Jordan Harrison's Marjorie Prime, and Stephen Karam's The Humans.

For the most part, the text is arranged chronologically but primarily presents its arguments thematically. In Part I, Chansky educates readers about dementia, Alzheimer's, and aging, as well as engaging in a lengthy exploration about bodies in the theatre both on the stage and in the audience. This part is not only informational but also contextualizes the argument about the actor's performance of age and the spectator's perception of such performances. Part II analyzes two lesser-known works, together with one known well in contemporary scholarship, illustrating the representation of dementia and the attention to psychodynamics during the first half of the twentieth century. The discussion of Brown's Joint Owners in Spain (1913) and Hardie Albright's All the Living (1938) focuses on seniors with dementia. While Brown's play is one of the earliest featuring a character with dementia, its trio of female characters represent senior women described by Chansky as a “demographic in decline” – an observation of senior aged women that remains relatable to this day (57). Albright's work is based on Victor R. Small's memoirs of working with institutionalized individuals living with dementia. This play offers a male representation of cognitive decline, but in both works the plight of aging and dementia are medicalized and remain an individual struggle. This part concludes with a necessary extended analysis of Arthur Miller's Death of a Salesman (1949) that addresses why this canonical play is and is not a play about cognitive decline. Chansky does not offer a definitive answer, perhaps urging all of us to read the play again, together with this section of the book, to reach a personal conclusion. Significantly, this play provides readers and audiences the opportunity to bring issues of aging and cognitive impairment to the forefront for discussion. Chansky's matter-of-fact presentation of the social and cultural concerns of men who were aged out of the workforce in the mid-twentieth century is equally, if not more, worrisome today from psychosocial, medical, and financial perspectives.

Part III shifts focus to plays written after Alzheimer's awareness and activism increased during the 1970s. The most nuanced analysis in this section is that of Peggy Shaw's Ruff (2013), where Chansky skillfully avoids conflating aging with disability and aging with (inevitable) cognitive decline. Here, the focus is on the disabled body, and the cognitive impairment that happened to coincide with aging, to highlight Shaw's continued and remarkable work with the body as archive. While the analysis is astute and poignant, it is equally celebratory—albeit missing the voice of Ann Cvetkovich, whose theoretical work in An Archive of Feelings advocates for using the body in ritual and performance to shift us away from the grip of pathology and toward testimony, performance, and witness so as to generate awareness and healing.

The final part of the work begins with a chapter that thoroughly discusses medical as well as social, cultural, and political data on the topic of dementia and Alzheimer's disease from 1960 (when cognitive decline research shifted away from psychodynamics to biology) to the present (228). In Chapter 9 Chansky applies her usual scrupulous attention to detail, pellucid writing style, and insider perspective to condensing fifty years of data into comprehensive lay-friendly terms. While the cultural, political, and financial information is thorough and interesting (particularly for age studies scholars) and sets the foundation for Chansky's later analysis of The Waverly Gallery (1999/2018) and The Humans (2015), the chapter feels lengthy. Nevertheless, the analysis of The Waverly Gallery and The Humans illustrates the shift in representations of dementia from earlier plays. Although the more recent plays are about “living with dementia” (171), they do grapple with the concerns and anxieties of those diagnosed with dementia or cognitive decline, as well as those who might become responsible for their care—personally and as a matter of public concern.

A Columbia University study published in 2022 showed that 10 percent of US adults over sixty-five have dementia and 22 percent have mild cognitive impairment (JAMA Neurology 79.12:1242–9). Losing It is thus timely and relevant, making it a significant contribution to age studies and theatre studies. The merits of Losing It are palpable, and the breadth of the study is impressive. The subject matter is long overdue for this kind of historical overview, as well as the textual and performance analysis and insight Chansky provides. She is a thorough historian, a perceptive critic, and exceedingly knowledgeable on the topic of dementia medically, socially, financially, and personally. The importance of discussing and understanding representations of dementia and its medical, social, cultural, and financial implications is exceedingly clear: as Miller noted, “attention must be paid” (121). Chansky calls upon us—audiences, scholars, and at the conclusion of her work, playwrights—to pay attention, in the hope that theatre might increase awareness, understanding, and action.