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I've scoured the internet and searched this forum site but I can't find an explanation for borderline dementia.


My dad was screened by his geriatrician on Friday and the doctor said he scored borderline dementia. I was not there, my sister was and she is a nurse practitioner so I asked what that meant. Her answer was not very helpful. All she said was the protocol for assessing dementia is a long process and there are preliminary steps to go through before Neuropsychological testing. OK I get that...but I still want to know what borderline dementia means on a screening test. Does anyone here know?

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It means not yet, but soon. Dementia progresses with age.
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Not knowing the exact answer, I would say that you father scored poorly on a screening exam. Not poorly enough for the doctor to say yes this is dementia. These mini mental exams ( you can Google that term) are questions like who is the president, count backwards from 100 by 7s, where are we, etc. This screening measures awareness of the world around, some short term memory. You really want to wait for the full workup , because that will tell you where his reasoning skills lie.
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I think a more common diagnostic term is MCI -- Mild Cognitive Impairment. That may or may not precede dementia.

I would guess that in this case the situation is something like this: on a certain test a score below 15 is considered "dementia" and your Dad scored 16. Something just on the edge of a dementia score. That the geriatrician would use the word "dementia" at all tells me the doctor is fairly certain dementia is present but there is not enough test evidence yet to send Dad on for further tests. (Just my guess.)

What may be even more important is the observations of people who live with Dad or see him very regularly. Does his behavior seem different to you? Is his judgement a little "off"? How is his memory? Is he having any trouble with balance, or finding the right word?
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Thank you for your helpful answers. My own observations make me think it's more than borderline. They have not mentioned Alzheimer yet so it could have other causes. The signs were sudden after his sepsis and worse after his surgery for the aortal aneurysm.

There are also signs of depression so the doctor put him on a low dose of Zoloft. I am hoping that will help his spirits to lift. He has been through a lot in the last year and his life has drastically changed.
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Where I am from... this is like saying someone is borderline diabetic ... if that makes sense? The results of the testing indicate the person is on the cusp... close... predictive.
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Just wondering. How much is real dementia and not caused by drugs or hearing loss.
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The baseline testing as described above doesn't tell much and can be affected by a number of factors including time of day the test is conducted (is dad sharpest in morning,afternoon, etc. -- which affect performance on the questions); nervous during test, etc.

Much more telling are family and friends observations from spending extended time periods with LO over the course of a day/evening and in different situations, at bank, driving, restaurant, social settings.

A full neuro workup is the only true way to get a quantifiable score. Secondly, it really helps if you can document all your observations factually of behaviors, things they say and do, etc. that are of concern. Be sure to document anything positive as well -- such as dad cooks his meals, can dress himself, routinely showers, does laundry, runs dishwasher on his own, never has been lost while driving, etc.

Regardless, the diagnosis from dr should be wake up call for family to begin having discussion with dad to start getting all wills, AD, DPOAs, in order. Have frank discussion about care wants/needs for future -- where does he want to live, how will family and dad's finances make that possible as he ages whether or not dementia gets worse (which it likely will over time). Try to work with dad to put safeguards in place -- on-line banking; direct deposits, someone on the bank accounts to monitor and be able to assist when dad isn't able.
Start visiting senior living options, residential care -- just so dad is familiar with it, costs, etc. He may not like it, but good for all involved to really look at whats available locally or near a child whether or not you ever need it. Don't wait until it is too late and you are in a critical situation 3-5 yrs down the road.
Keep documenting your observations and those of other family members -- keep a diary. You may need in the future as you have continuing discussions with doctors, social workers, caregivers, etc. over time and medications that may be prescribed.
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"Borderline dementia" is like borderline pregnant. It makes no sense. You either are or you aren't. It is possible that there is not sufficient evidence to make that call yet, but if it exists it will soon make itself known.
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