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My 67 year old husband was determined to be "borderline" for cognitive impairment based on a SLUMS exam given by his neurologist this past spring. His follow up exam was today and the neurologist recommended he have the 4 hour diagnostic exam as soon as they can get him in in order to exclude other possible reasons for his cognitive impairment such as Aspbergers, ADHD, etc. She implies that this test would answer all our questions and give us a more definitive diagnosis. Does anyone else have experience with this test and is it truly accurate for diagnostic purposes? The neuro did NOT give him any further in-office cognitive exams at today's visit.

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It’s fantastic that there are a range of tests available today for our medical needs. Even better are the range of treatments compared to years ago. Of course, we still have a long ways to go.

Research is so important. New things are discovered all the time but it takes tremendous effort and an enormous amount of money. I feel donations to a foundation instead of flowers at a funeral is very meaningful.

I would rather know something early on if something is wrong. Early detection helps us to emotionally prepare.

When I was pregnant with my daughter my numbers were high in the category for Down’s.

Waiting for test results is truly a nerve wracking experience. I had an amniocentesis and the baby did not have any abnormalities.

Therapy helped me during the process because I was asked if I wanted to choose abortion.
I utilized therapy to cope and process everything that would be involved in raising a child with special needs. Therapy can help us prepare for the unknown.

My friend that has a child with Down’s helped me a lot. So don’t hesitate to speak to a therapist if you need to.
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Monica19815 Nov 21, 2019
Thank you SO much for your encouraging reply. I will definitely take your advice. You are so right...we are very lucky that we have early diagnosis of so many things these days. It helps a lot to be able to plan and the stressful "not knowing" time can be greatly reduced. I also know that therapy can be very helpful and will not hesitate to do that if I need to.
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So, when I did testing, I used to tell clients that this is not a test that you pass or fail. In school, your teacher teaches you a bunch of stuff and then gives a test, expecting that you've learned the "stuff".

These tests are not like that. It's kind of like we are pretending that you are a helium balloon; we want to see just how far you float up until you hit YOUR ceiling. And the only way we can tell that is if you get SOME answers wrong; EVERY SINGLE PERSON who has ever taken this test gets SOME answers wrong. It's built in to the design of the test, so try not to worry if you don't know the answer!
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Monica; I'm curious why he is saying he won't put his best effort forth?

Is this his way of being able to say latter on "no, it's not an accurate representation of my skills because I wasn't trying"?

I think that you should share what your husband is telling you with the referring doctor.
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Monica19815 Nov 21, 2019
He wants to think/insist everything is fine and he could not possibly have a cognitive impairmemt. He scoffs when asked to do certain things in the tests like "spell 'world' backward," count backward from 100 by 3's or do altermating finger taps (he could not do any of those things in the test) and claims he would never have to do those things in everyday life so why should he be able to do them at all? I did share his lack of trying and taking the tests seriously with his neuro. I know that is important information for her to know. BTW...my MIL is a harmless narcissist (not malignant)...neuro knows...and husband may have some of that in him, too.
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Monica19815 Nov 21, 2019
That is EXCELLENT information! Thank you so much. I will share this with my husband and we will be sure he is ready for the test. One item caught my eye that I have already admonished my husband about...his unwillingness to take these tests seriously and put his best effort forward. This article says this can affect the outcome of the test (and, I imagine, NOT to the benefit of the patient). I have already tried to get my husband to understand this, telling him he could get a false diagnosis if he does not try his best and take it seriously. Gosh, I hope they can schedule him for this sooner rather than later. I feel like I am in limbo.
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My LO was slated to have this evaluation done after she saw her neurologist and he, as well as her primary, diagnosed her with dementia. I wanted to know exactly what was going on though. He ordered this test and an MRI. Sadly, before we could have this evaluation, she had a series of falls and fractured her spine, hand, toes, etc. and was in a lot of pain and disability. She was not up for a 4 hour round trip commute to get the test done, plus, she was so progressed by that point that she didn't know the answers to any questions.

I was always curious as to what it was like. Please post if your LO has it. It's my understanding that it provides a good idea of where the deficits are and what type of damage there is at the time of testing.
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BarbBrooklyn - Thank you for your reply. It helps me to know this. We need a diagnosis, not just an "it might be this or that...," not only to plan our own future but also to plan my 92 year old MIL's future care. My husband is her only child now and he will certainly not be able to be her POA, caregiver, Executor, etc. if he is diagnosed with dementia or Alzheimer's. Our home is not conducive to caring for someone with those conditions and changes would have to be made. It eases my mind that we will be able to know what is going on after this comprehensive test.
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Yes, it is a very accurate way of assessing what is going on.

This type of neuropsych exam is routinely used to diagnose attentional difficulties, ASD and dementias. The pattern of neuro-cognitive deficits in each of these disorders, as well as the way in which the client does the tasks, is informative in trained hands.

I say go for it.
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