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???

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Good for you starting the namenda!
My mom was well into her alz and still passed the 'draw the clock' test and mini-mental. Also, she could still smell which 'they' say goes first!
They changed the test recently to be pointing at objects and asking her what they were and other things like that that were more helpful in diagnosis... and an MRI showing the plaques.
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These tests are, forgive me, silly. I might forget the date.

They need to ask more process-oriented questions, like, how do you get your money? How are your bills paid? How do you get cash when you need it?

My mom had no idea where to get cash and insisted that she didn't receive money every month. She had no idea what was going on or how she was living. She was incompetent to live on her own or handle her affairs. But she didn't do badly on the silly tests.

My heart goes out to people trying to figure this all out. Hugs!
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So much here is familiar from my mother: the 'show timing' at test time or with any doctor or visitor, the repetitive questions, eating the same thing every day, the roller coaster of abilities: here one day, not the next, back again the next.
My primary comment has to do with Namenda. 15 months later it has made a world of difference with few noticeable side effects. She can again use the phone, TV remote, prepare some food and clean it up, totally engage in meaningful conversations and more. She's just as stubborn and manipulative as ever as it also restored some bad behaviors, but she is much more often "with it" as a result. Power of suggestion or real benefit, who knows? I'm thankful and would suggest trying it as you have. More good time for our loved one makes it worth it even if we know the plateaus and decline are inevitable. Hugs.
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They do try so hard to do well on those verbal tests ... i think its embarrassing to them to not remember things in front of others and they can somewhat fake it at this stage in the real world but know when theyre being tested at the dr. I know my mother doesnt like it...she knows something is wrong but then doesnt really want the dr to know, which i think she feels foolish about not being able to remember or answer correctly. Shes beem independent for 30 yrs since my dad passed.
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My mom seems to only want to eat the same thing every day....i buy her those things and also some different things i know she would like...but she never eats them, only her 'regular' stuff. I finally quit wasting money on different things.
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sherylbeth-before we realized our mom had dimentia, she had lost weight. she loves to eat, but apparently was forgetting she had not eaten. she would probably start to prepare a meal, get side tracked and go into another room to move something, on and on and assume she had eaten. we realized once at a restaurant-it took her so long to order(she would forget what was available and start reading the menu over and over) when her food came she said she did not want it, she had already eaten!
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I've never heard of that kind of test. They would ask my mother the kind of questions I would sometimes fail - but she was pretty good at it once she got off psychiatric medications: What day is it (who doesn't have to doublecheck this at times?) What date is it (who hasn't had to check that when writing a check?) What year is it (Don't ask me that in January) Who the president is (Sometimes I would like to forget that one) What month is it? What season is it? etc. I doubt I could name 15 animals, let alone 30.
I would be cautious with the memory drugs. A doctor took them as a test and said he had to quit them due to the nasty side effects. He now hesitates to prescribe them because his patients cannot articulate side effects. They also said that after 3 years those who took them were no better off than those who didn't. Wishing the best for you and your mom as you go through this difficult time.
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Some people, I believe, go into a new situation or go in knowing they have to be on or they'll be evaluated. My mom has been tested a number of times at the hospital and the doctor's -- she always does really well. Sadly it doesn't tell the whole story, like when she imagines we take photos of her and post them on the internet so everyone can laugh at her, or that we broke in to her apartment to steal toilet paper and dollar store figurines. I would love for a test to uncover that stuff!
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Oh, SherylBeth, I hear you.

When I first visited the AL and saw the memory care unit, I was appalled and thought how terrible it must be for the families to have a loved one in that condition. Six months later, I realized with a jolt--no, they have it much easier. It is clear that they have to take over. No one can argue about it.
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Also...her doctor put her on aricept (no diagnosis) but after 6 months, i saw no change and in fact her slow decline continued. So she is not taking anything anymore. My personal opinion is that there is no benefit to slowing the progression based on the state she is in now. It would simply keep her 'stuck' longer in the state she is in now, which is harder on her since she has some awareness that shes failing. I debate back and forth with myself whether insisting on lengthy testing is beneficial in order to get a diagnosis...or just let things progress as they will and deal with things as they arise, which will be necessary either way. I also think she would probably go downhill faster if she knew she had alzheimers. I feel certain she does after all the reading and research ive been doing on the disease. Her symptoms and progression match what ive read to the T. Ive been learning to try and not stress and worry about the future so much, and deal with the present. As long as i have a plan about what the next steps will be, i try to not to go beyond that as the sadness about whats to come is too difficult.
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