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Does the MMSE take low IQ into account when testing for dementia? My DH is a genius at mechanical things. He can fix just about everything and even investigate and find a hard to detect issue (like a short in our RV that took him 2 days to track down to a very unlikely source but he did it!). However, at everything else...he is fairly clueless. He struggled through school and barely graduated from high school. He has a hard time following plot lines on TV shows and movies, he does not read unless it is about RV's or cars or camping, he gets confused about his doctor appointments and medications, has a hard time following conversations, cannot cook or do laundry or plan a dinner or host friends or family. I do all of that plus our finances. How can he be brilliant at mechanical things but barely get by on almost everything else? His MMSE score was 25. The neuro says he is "borderline" and wants to see him in 6 months and perhaps every 6 to 12 months thereafter. I am concerned that he may score lower at his next exam and test but that it is his IQ and not necessarily a cognitive issue that causes the low score.

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Just want to clear something up.

People with autism DO NOT generally have one thing that they are good at - because they were born with a “gift” in that area. It is because when an individual with autism becomes interested in something - they are all in. Focusing to the obsessive extreme is common. That’s why they are good at a particular subject.

It is true that there is a higher rate of savant-ism among individuals with autism than is typically found among other groups. But being a savant is waaaayyy different than merely being good - or even very good at something. Ergo- just because someone has a talent AND they are socially awkward- do not jump to an autism conclusion. Think the movie Rainman. He was a mathematical genius- a savant. And, that is the exception not the norm. Only 10% of individuals with autism are savants.

For other symptoms of autism - beyond the stereotypes- please go to an informed autism web site. Autism Speaks and Autism Now are both good.
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Monica19815 Jun 10, 2019
Thank you for the excellent information. When I started noticing cognitive changes in DH and tried to talk with him about it he shot back at me that he only cares about things he is interested in. If he isn't interested, he won't listen/respond/remember/engage, etc. These were HIS words. Wow. I have a lot to consider right now.
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Your saying your husband has always had these problems? You have proof showing his IQ is below normal, which I think is 85, a low normal. Are u sure he isn't autistic and has never been tested. Testing is fairly recent. It would not have been done when ur husband was in school. I say this because he is so good mechanically. Those suffering from autism usually have one thing they are really good at.

You may want to contact an Autistic agency in ur area. Ask them what they think. Maybe they can do some testing. Just read that Autism is a neurological disorder. May want to call his doctor and tell him husbands history. It may make a difference in his diagnosis.
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Monica19815 Jun 9, 2019
I have NEVER considered this!! Thank you so much for your reply. Wow. We have only been together for 7 years, married for 5. But I do know that his first wife, over 40 years ago, told him, "The only thing you are good at is turning a wrench." I do need to call his doctor. I do not want him misdiagnosed. Thank you!!
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What an interesting subject for study your husband would have been!

To my mind, he just shows how pitifully inadequate our methods of assessing intellectual ability are. The range of skills and the brain processes involved are complex and poorly understood, and most means of assessment are therefore rather clumsy.

"Word blindness" is a phrase you may hear when he trips over on that "spell world backwards" poser - but visualising the letters is only half the game, at best. There are also all kind of auditory elements that go into a process that most people manage so naturally they're never aware of what their brains are doing.

Your husband probably missed out on the attention that is nowadays paid to the various dyslexias but I'd guess there is some form of that at play. We went through this mill with my son: long story short, when tested again at age 16 he had developed a wide range of "coping" strategies to compensate for whatever brain links were missing. Except one. He cannot, not to save his life, understand or do "Spoonerisms" - the word play where you swap initial letters, often to humorous effect, named after the Oxford professor who famously berated a student with "you have hissed all my mystery lectures, you have tasted two worms, and you must leave Oxford today by the town drain." I was told by the educational psychologist that this is the test they save up for last, because it is a dead giveaway. 3/30, he scored, and I suspect he guessed those three.

I also know a very successful Art Director who can't reliably spell his own name.

It is a crying shame that your husband's needs were not identified and addressed; but then again he hasn't done so badly, has he? :) He did find things he was good at, and he has enjoyed a worthwhile and productive life, and whatever his difficulties a low IQ seems not to be it.

As for how or whether this will affect his cognitive assessment and possible dementia diagnosis... If you're really uneasy, talk to the psychologist, neurologist or psychiatrist who's running the test and ask for a close look at where the gaps in function are. If he's *only* falling down on questions where his known difficulties are relevant, that wants taking into account. But in dementia, the big clue is when things a person did as second nature - using a familiar route, wiring a plug - are suddenly just not working right. You'll know it when you see it.
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My DH ticks every box on your list except graduation, TV & movies, conversations & appointments. He tricks people into thinking he has a good memory, either by keeping quiet or by solving their problem again the same way, and he gets a bit flustered if he sees water come to the boil in the kitchen. On the other hand, I forget where the brake is on the tractor and have to be retaught every time, I have no sense of balance (3 years to learn to ride a bicycle), or of where the corners of my car are spacially (an expensive failing). There is no way either of us have a low IQ, but we do have very different brains.

There are many different IQ tests, and lots of argument about them – do they favour vocabulary (most do, but is that fair?), or patterns, or mental arithmetic (same questions). Are they ‘culture fair’, even fair in requiring reading and writing skills (obviously not)! Rather than ‘low IQ’, it’s probably a better take to say that his intelligence is atypical, and that might make both of you feel better too. I hope you love each other, and manage to make as good a fit as DH and me. Best wishes.
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My son either does either exceptionionaly good or bad at tests depending on subject matter. It's like his brain has way more connections in the mechanical/IT/electrical area & less in social/planning/working memory.

Also, while his heaing tests are fine, his auditory processing tests were below average. This will skew any test given verbally.

Dx Autism (high functioning) but called Aspergers by others. Now called ASD Level 1 in DSM 5. Before that dx, some teachers & other parents had already labeled him: disruptive, uncooperative, hearing impaired, learning problems, a problem child.

He also used to spin in circles at 5pm & wander aimlessly about the house like a sundowners pt. It was caused by mental fatigue.

I agree with JoAnn29 - definately ask your Doctor what he knows about Autism. You want him dx correctly.
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Unless your DH was actually diagnosed with any sort of intellectual disorder, don't assume the traits you describe are low IQ. At last I was aware when my children with autism were being IQ tested, a score below 68 was needed for a full intellectual disability diagnosis. 68-84 is borderline intellectual functioning and 85-110 (or 115?) is in the typical range. This all may have changed as that was around 5 years ago. My son is borderline with an IQ of 70, my daughter is above average with an IQ 117...they both are superiorly good at what they love, struggle in the things that they don't particularly care for.

DH does sounds very much like he may be on the autism spectrum. I have two kids on the spectrum, and they are both extremely different in how it affects them. I haven't really come across any studies on how dementia may affect an individual on the spectrum...but something to perhaps look into. Society still kind of doesn't think about kids with autism growing up into adults and even potentially elderly while still with the autism. But getting diagnosed later in life is on the rise now that more people are becoming aware and getting their "quirks" checked out. I'm actually curious myself now about dementia and autism that I've seen your post. I definitely would suggest asking his neuro to test for autism (not IQ, it's kind of moot at this point) and then go from there.
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Monica19815 Jun 12, 2019
I did some reading on autism...and checked off a lot of boxes for my DH. Thank you so much for putting out this possibility. I never even considered this. I really need to call his neuro but can't talk with her in front of DH and do not want her to know I called at all
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I agree with others about autism. I know of an older man who was diagnosed with autism later in life. He exhibited the same characteristics that you described about your husband. If he has gotten this far in life, let him be. He obviously is smart enough to marry a wonderful wife like you.
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Monica19815 Jun 12, 2019
You are so kind, thank you. I certainly would prefer a diagnosis of high functioning autism - or ADHD - as opposed to dementia or alzheimer's. This is why I asked the original question. I need his neuro to consider all possibilities and not just focus on "memory loss." It is very hard for me to go to an appointment with DH and discuss these things in front of him. I hope his neuro is open to a phone discussion. Thanks for your reply!
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Your hubby probably doesn't have a lower IQ rather an undiagnosed learning ability [we have had this in our family for more than 1 person] - there is much discussion on how the IQ test are biased towards Anglo-Saxon descent males - even then those who learn differently like visual or audio learners [most systems are a combination] or are mechanically inclined not academically or even have English as a second language

The fact he graduated high school & if he has a learning disability then in fact he is quite smart but tests won't show this - the fact he can't cook is an example of how he can't grasp some ideas - he probably told you he wasn't very smart over & over again because that is what he was told as a student ... & you have bought into it from habit - schools generally had a track to get as many drs & lawyers & dentists as they could that they tend to ignore/under-rate other streams as 'not quite up to snuff' therefore not worthy of giving much attention

So please don't continue thinking he has a low IQ but rather take a little time to read up on learning disabilities with an open mind or even talk to someone who would know about it to narrow down the focus - he can't have as low as IQ as you say because he obviously held a pretty good job for a long time in order to be able to afford to get an RV! - you may have a new light on him after this

Also he is smart enough to have conned you into doing everything didn't want to do
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Shell38314 Jun 12, 2019
I would have to agree! What a great answer!
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Oh yes, his doctor should have been told about his dyslexia and hearing problem. My husband has had extreme hearing problems since he wss 3. He compensated for them so much that people did not kno he had the problem. Now he has lost hearing in one ear and the other is 20% with an aid, he can no longer compensate.

My cousin suffered from dyslexia. If it wasn't for his Mom pushing for him he never would have gone to college. Its not that he can't read, its how he sees the words. He was taught ways to overcome this. His strength, the gift of gab. His job, a salesman making 6 figures a year. My cousin will be 57.

Your husband fell thru the cracks. Sad to say, even now parents have to fight the school system to get what children, by law, have a right to have. Because, when there is a special needs student, the school has to pay out of their budget for what that child needs. The schools will fight not to have to do it. So parents have to know their rights.

There is no such thing as "no child left behind". Teachers have 25 to 30 students and you really think they r going to take time out for one student. No.

It would be so nice to find out what ur husbands learning disabilities are besides the dyslexia. But then that could be the main thing. He may feel so much better about himself if he finds he is not "dumb" and there are good reasons for his learning problem.

Please come back and tell us what u find.
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Monica,

You can choose whether this evaluation is helpful to your spouse.

What is the purpose? To get meds? To get admission into a nursing home?.

The Mini Mental is an old test and is only effective if the patient is willing and eager to please. A distressed, hard-of-hearing, apathetic, visually impaired, depressed or disinterested patient may not really “try” anyway —then they leave the appointment branded forevermore wiith dementia. They can go back every six months, like clockwork a pawn of automatic self-referral, to be administered the same or similar test, to be made to feel less than adequate. Squeeze those appointments in with the hundreds of others and your retirement is spent in the misery of doctors’ repeated evaluations, scrutiny and criticism.

So Emma Thomason lives at 3497 Johnson Road in Somerville. She is an avid quilter and golfer who plays the lyre and reads about philosophy. Remember those facts. Focus on those facts. Wait through two minutes of awkward silence. What’s Emma’s address? Huh? What does this prove? Zero.

i took Dad to doctor after doctor and therapist after therapist following his stroke. He was getting speech, physical and occupational therapy. He was having necessary dental work. Dad was on Coumadin for which he needed monitoring and saw a cadre if other specialists for monitoring for other reasons. Dad thrived with positive feedback. He regained reading (after losing the ability following a stroke). Trips to the neurologist were depressing, caused emotional and mental setbacks and proved no other useful purpose. We tried two different neurologists, but it seemed like a useless and humiliating exercise.

Dad only received care at home and was never prescribed the drugs that purportedly are supposed to enhance or preserve memory.

There was no need for him to endure this semi-annual humiliation. Otherwise, he was doing quite well. So with the blessing of our primary care (and other specialists) we opted out of the neurologist.
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