His family sent a letter to former players and coaches Saturday, discussing the 79-year-old Hall of Famer's health after generally declining to comment for privacy reasons. Smith's condition was described as a "progressive neurocognitive disorder that affects his memory."
"He may not immediately recall the name of every former player from his many years of coaching, but that does not diminish what those players meant to him or how much he cares about them," the letter said. "He still remembers the words of a hymn or a jazz standard, but may not feel up to going to a concert. He still plays golf, though usually only for nine holes instead of 18."
Smith had largely kept a low profile in retirement, consistent with his habit of trying to deflect credit to his players while never seeming comfortable with the attention that followed him during the peak of his coaching years. He has maintained a campus office, frequently coming in to meet with former players, sign autographs or return fan mail.
According to the letter, Smith "insists" on watching North Carolina's televised games to cheer for the Tar Heels and Roy Williams, an assistant to Smith for 10 years before spending 15 years at Kansas.
Smith's health became a question after The Fayetteville Observer recently reported he had occasional memory loss. A week later, author John Feinstein posted on his blog that he backed off an effort to collaborate with Smith on a book in the past year because of related issues.
The family letter states that Smith has had two hospital procedures in the past three years, one for knee replacement and the other for an abdominal aortic aneurysm. His wife, Linnea, said following the knee replacement surgery in December 2007 that there had been some "cardiological and neurological complications," though she didn't elaborate at the time.
"It's a stark contrast," the letter states of Smith's memory loss, "because he is widely known for remembering a name, a place, a game, a story - it's what made other people feel like they were special, because our dad remembered everything.
"Coach Smith wanted to keep his professional and personal life separate. But as we all know, the personal and professional life can sometimes overlap, and we understand that many fans, former players and friends are concerned about his well-being."
Smith retired in 1997 after 36 seasons in Chapel Hill as the winningest coach in Division I men's basketball with 879 victories, a mark passed a decade later by Bob Knight at Texas Tech.
Smith won 13 Atlantic Coast Conference tournaments, reached 11 Final Fours and won the NCAA championship in 1982 and 1993. But his imprint on the game goes beyond numbers, from the creation of the Four Corners slowdown offense that ultimately helped lead to the creation of the shot clock to the simple gesture of pointing to the passer after a made basket.
In addition to coaching some of the game's biggest names - Michael Jordan among them - Smith oversaw a program that graduated more than 96 percent of its lettermen.
Smith made a handful of public appearances during the program's centennial season last year, first for a game featuring alumni playing in the NBA or overseas. Smith's presence in the building bearing his name drew a standing ovation from a roaring sellout crowd, prompting him to quickly acknowledge the crowd before pointing several times at the players as they applauded him.
During the game, Smith sat at the scorer's table between Jordan and Charlotte Bobcats coach Larry Brown, who played for Smith in the 1960s. He appeared again in February during halftime of the North Carolina State game in which the Tar Heels honored more than 200 former players.