Young feet in older shoes

Emma Healey's insight into how a dementia sufferer in her 80s feels is astounding.

Nicky Pellegrino loses herself in this quietly absorbing study of a retreating mind.

The whole point of a mystery novel is piecing together the clues. When the main character is suffering from dementia, and can barely recall a clue or its significance from one moment to the next, reading it becomes a rather different experience.

Elizabeth Is Missing by Emma Healey (Penguin) is the story of Maud, whose mind is failing. In her 80s, she still manages to live at home with the help of carers and her daughter. Her thoughts are fleeting things, in her head one moment; gone the next. But there is one thing Maud knows for sure, her best friend Elizabeth has disappeared.

Elizabeth collects majolica ware and is losing her sight. She never, ever goes away. Now her phone remains unanswered and there's no sign of her at home.

Haphazardly, Maud sets out to investigate, writing notes to herself to jog her failing memory. She attempts to alert the police and her daughter, but it seems she is the only one concerned about the mysterious disappearance.

This anxiety about a missing friend churns up old memories. Almost 70 years earlier, Maud's older sister Sukey disappeared and no traces of her were ever found.

So many of the events of that distant time and the people she knew are still clear in Maud's otherwise muddled mind. She remembers her sister's dodgy husband, her family's enigmatic lodger and the local mad woman who always seemed to be hanging round.

Elizabeth Is Missing moves back and forth between Maud's unhappy past and her confusing present.

The clues are all there but, just like her, we aren't sure how they link together or even how they can be important. Why is Maud obsessed with the growing of marrows, for instance?

When I'd finished the book I had to leaf through it again to see how neatly Healey has seeded the signs and hints amid the confusion of Maud's stream of thoughts and forgetfulness.

This isn't the first mystery told from the point of view of a character with dementia. Alice La Plante's excellent Turn Of Mind has a similar premise. Both are disorienting, with unpredictable twists, however Turn Of Mind is more of a tense thriller and this one is a quietly absorbing study of a retreating mind.

Maud is a feisty heroine and there are moments where her struggle with everyday life is wryly amusing. But mostly there is layer on layer of loss and sadness. Ultimately, the greatest tragedy is not the disappearance of a friend or sister, but Maud's gradual, unstoppable loss of the person she once was.

Elizabeth Is Missing is insightful and affecting. Most of all it is mature.

Somehow, talented and young UK novelist Healey has managed to think herself into the head of an old woman and create a character that is as authentic as she is heartbreaking.