Why does Mom manage to pass her cognitive tests?

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Yesterday we went to the neurologists for the big appointment. He asked her the date (she just filled out forms where she had to write it down 3 times), the president, what town we were in, what county (she paused over that one) and to remember 3 items. Then he asked her to name all the animals she could think of in 1 minute. The minimum is 15 - she was able to come up with 16. Last time she came up with 30 something as I recall.
So he says that he doesn't think she has Alzheimers. That she might have some mild cognitive impairment. Mom was surprised.
Then I told him a couple stories about things she has done, said, or not remembered, like when she was talking about giving POA to my brother the lawyer to sell the house in Richmond when we moved back east. Except my brother was 13 then.
He then gave us a sample pack of Namenda to titrate onto. Mom reads the info pack on the way home, and it's for people with moderate to severe Alzheimers. First he says he doesn't think she has it, then gives her meds for moderate to severe Alzheimers???

Answers 1 to 10 of 28
She could pass the cognitive tests, in my opinion, because those particular tests do not rule out dementia. If someone fails them, then, yes, something is definitely wrong, but passing in not an assurance of a clean bill of health. I know this from tests given to both my husband and my mother.

Doctors know that these tests are suggestive but not definitive, and even with a diagnosis of MCI many doctors will try a dementia drug. If it works, awesome, if not, it can be discontinued.

Dementia is not like heart disease. There are no definitive tests or scans to tell absolutely what is happening in the brain. There are no clear-cut guidelines as to when a pacemaker or certain drugs should be suggested. Doctors have to to the best they can with what they know.
All patients have good days and bad days in the early stages. Obviously she was tested on a good day. Maybe NOT Alzheimer's, maybe vascular dementia or vitamin B1 depletion or polypharmacy. You pushed for the meds, that is why you got them.
What he gave her was called a minimental. My mother has vascular dementia and can no longer dial a phone, use a remote control or dress herself in the correct order. She consistently scores almost perfectly on those tests. However, on a complete neuro psyc battery (intelligence tests, tests of reasoning etc) given BEFORE her stroke, she scored in the level of Mild Cogntive Impairment; this perfectly explained her constant panic, inability to pay bills or manage not to use both immodium and a laxative on the same day. Get her a comprehensive workup!
eguillot, some people do very well with tests like that, others might pause or freeze up. Sounds like your Mom was able to concentrate for the test... but in every day at home life, there are too many distractions.

My primary doctor gave such a test to me, but my OCD was too busy wondering why the air conditioner in the exam room was making a funny noise :P Of course, I don't have dementia or Alzheimer's [yet] but there are days when my brain will take a detour..... my doctor says it's stress related.
Hmmm. Mom can longer work the tv remote control, she's going to give up her cell phone, she used to email friends all the time, but hasn't gotten on email in months. She loves her Nook, but now I have to connect to the library for her and help her download books, and she'll frequently lose them because the Nook "isn't working right". She panics if I leave her. Her bills are paid pretty much automatically, but any time we start to go over finances, she gets stressed and shaky. She does have an appt with a geriatric psychiatrist the end of next month. That's the first available appt.
equilot, reading about the remote, cell phone and email the common issue is using one's hands. Could it be your Mom's fingers are starting to bother her, thus pushing the buttons on the remove, cell phone, and keyboard are too much for her now? My Mom has this issue due to arthritis in her hands.
She can't remember which buttons to push. I can tell her 20 times, but she'll forget, or mix them up. She does have arthritis in her hands, but the only thing that bothers her with that is opening jars and door knobs and grasping small items. She has trouble with all technology, basically. She used to be really good with it when she was in her 70's - very proud her - one hip grandma! Now that part of her brain just doesn't function properly.
Top Answer
My mom with vascular dementia did pretty much the same things. And we were ready to get incapacity letters but she still scored in the low 20s on the MMSE...we still got the letter because though that was a "mild" score, she had delusions and evidenced a lot of confusion, even when she was not delirious with an infection. Bless her heart, when we went for the exam, she made a big point to memorize the correct date off a calendar first! There is one called the SAGE with info at patienteducation.osumc.edu/documents/sage.pdf that might be of some help too, but a full neuropsych is ideal.

I felt so sad about the phone...she made many, many, MANY annoying and inappropriate calls that I ALWAYS answered and tried to help and reassure...and though it was less of a hassle to so often figure out how to duck out of whatever I was doing at work to do that when they stopped, I hated what it meant for her. She would assume the phone or whatever didn't work, not that she could not remember how to dial, but that was it, you'd go check the phone and the errors were real obvious. And she didn't have the cognition to problem solve and ask someone to help her dial either.

I think the short tests are better for Alzheimer rather than other types of dementia. And at least you got the MCI (mild cognitive impairment) diagnosis and know to start preparing for things getting worse, which they probably - though not certainly - will do. It turns out Namenda does help with vascular dementia as well as with Alzheimer type and is probably worth a try.
Good to know Namenda does help with vascular dementia, too. Looks like I need to start reading up on that more.

Mom is pretty good at accepting what we tell her. She knows things aren't right with her, and she trusts us, so if we tell her that the phone isn't working because she's pushing the wrong buttons, she'll think about it a minute, then say, "Well, I guess that could be it", especially if she sees us able to get it working right away.

Mostly, she just wanted an explanation for WHY she couldn't do what she used to do. If it was dementia, she was ok with that. It was the uncertainty of not knowing that's bothering her. Mind you, she's been in Al-Anon for close to 50 years, so accepting the things you cannot change is built into Mom long term.
Mother passed too, though her judgement about some things and ability to handle her finances was slipping in several areas. She was tested extensively and they found vascular dementia, though I she still scored pretty well in the minitest. She had increasing paranoia and started having some psychotic episodes. She is "iffy" with the telephone, though managed a call recently, but I don't know if she had help with dialing, loses things (the remote) and stopped using the computer over a year ago, when I had to buy her a new one and it had Windows 8 - sufficiently different from XP to cause her problems. Some of it was her memory as she could follow instructions when I was there, but didn't remember them for the next time. I don't think she could follow instructions now and has shown no interest in it. The "grey" period when they pass tests, but to close family are obviously slipping, is a difficult time. ((((((hugs))))) Hope the Namenda helps.

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