MoCA Test Score and Stages

janeymack

My husband scored a 2/30 on the MoCA test last August. I estimate he is late Stage 5. I can leave him alone for a couple of hours, at most. He is unable to cook, shop, pay bills, make a phone call, 50/50 on TV remote, short-term memory is about 30 seconds. Just wondering how your loved ones' scores matched up to stages.

CStrope

Interesting question.  I'm sure it's going to vary with everyone, but can I ask......how long since his last testing and what did he score then??

JJAz

Sometime during the "moderate" stage, patients lose enough skills and can no longer be tested.  The last time that Bob was able to be tested, he was 7/30.  The next time was 0/30 and they never tried testing again.  He lived until Stage 7c.

harshedbuzz

I would say that dad's MoCA did not necessarily reflect the physical aspects of the disease process. YMMV.

Dad was given a MoCA at an appointment with his geripsych while my mom and I were in the room. This was about 6-8 months before he died from aspiration pneumonia; he was already starting to lose weight and was mostly incontinent.

I don't recall his actually score- his clock was pretty incomprehensible, he struggled with word recall but his serial subtraction was spot on and better than my mother's. At the end, the geripsych said his test was about what would be expected of "a man his age with his level of education" (85/MA) which surprised me based on what I saw at home. Dad bragged about his results the entire way down to the lobby and then wandered off and got in some random women car while I turned in our valet ticket. 

By this point, my mother was rarely leaving him alone in the house for a 15 minute trip to pharmacy or even to putter in her garden. About 6 months prior to this MoCA, they were having a HVAC system installed on a day when my mom had an appointment. At that point she thought he was OK home alone for a couple hours during the day but she asked me to come over while the techs were there in case they had any questions. One of dad's perseverations centered on home remodeling; he was stuck on the notion of building a pair of guest bedrooms and additional bath in 6 x10' utility closet where the mechanicals were located and mom didn't want him trying to interfere with the install. 

At one point the techs were soldering something and set off the smoke detectors. Dad sat there for almost a minute before asking me what the noise was. I explained that the techs had triggered the smoke detectors. Dad processed that for almost a minute before getting up to find my mother to save her from the fire. At no point did he attempt to call 911. Both his cell and his landline phones were on the end table within arm's reach. Nor did he tell me to call. We never left him for more than 10-15 minutes while he slept at that point.

ScottyTom

My wife was evaluated a month ago.  She scored a six on the test.  The report said she is in "solid stage six".  She has been unable to do much of anything for herself, though it can vary day to day.  Until recently she could get herself a bowl of cereal, but now if she is hungry she will open a jar of peanut butter and use whatever is handy to eat from the jar.  The other day she forgot how to flush the toilet, but now she is not having that problem.  As I said, things vary from one day to the next.  The nearest thing she has to hallucinations is that she is obsessed with bugs.  She constantly thinks there are insects that bite her at night.  At times she will point to her bed sheets and insist she sees bugs.  In her case she can still visit and converse with friends and family.  Anyone who interacts with her briefly might think she was fine.

janeymack

CStrope - his previous score was 13, I think. I've been researching since I originally posted, and it sounds like beyond a certain point, the MoCA test is no longer useful, and is more of an evaluative tool in the beginning stages. This last time, H was making jokes about his abilities throughout the test, and although I've always sat there silent during his visit and testing, I finally said, "you can't charm your way out of this one". 

janeymack

Harshedbuzz - the smoke detector incident is extremely concerning. Who knows what my H would do? He can't make a phone call on his cell anymore, so would he leave the house or stay and wait for something/someone unknown to direct him? My days of leaving him alone at all might be at an end.

Crushed

harshedbuzz wrote:

At one point the techs were soldering something and set off the smoke detectors. Dad sat there for almost a minute before asking me what the noise was. I explained that the techs had triggered the smoke detectors. Dad processed that for almost a minute before getting up to find my mother to save her from the fire. At no point did he attempt to call 911. Both his cell and his landline phones were on the end table within arm's reach. Nor did he tell me to call. We never left him for more than 10-15 minutes while he slept at that point.

SAFETY WARNING

 I have have worked with fire safety experts all my career.  My father was a fellow of hte Society of Fire Protection Engineers.  The only proper response to a smoke detector is to GET OUT. No one should be looking for a phone.  I'm serious.  you might have one minute of breathable air. 

Humor mode

DW and I were in a hotel having a very friendly marital moment when the fire alarm went off.  She looked right at me and said Aren't we supposed to leave now ? 

 As we were grabbing our coats the alarm stopped the the loudspeaker gave the all clear.But I was proud of my girl. She reacted faster than I did.

I  always put my wallet in the coat and hung the coat by the door.  Very handy if you need to move through smoke or flames.  (put the coat over your head)

Rescue mom

One person died in a house fire near me recently because the spouse with Alzheimer’s (I think it was the husband with Alzheimer’s) just stood staring at the flames, leaving the caregiver to die from smoke inhalation. Firefighters said when they arrived—neighbors called because of smoke—the one with Alzheimer’s was just watching it burn. They had to fight and carry him out, seemed unaware of anything wrong. ..it was too late for her.

I know even when I’ve been at home and in another room, or otherwise occupied for a few minutes, my DH with Alzheimer’s—stage 6 but who you might think was OK just in passing—stood and watched a bursted pipe pour down an interior wall and flood our kitchen. Later a  pot of water I thought was turned off on the stovetop boiled over everywhere. Again, he just watched. No effort to move it, no yelling for me, no apparent awareness anything was wrong. 

Joe C.

I stopped the Dr. from testing following the diagnosis. The testing upset DW and I could not see any benefit of putting her through the testing. Instead I have relied on the attached functional assessment to track her stage.

 http://www.mciscreen.com/pdf/fast_overview.pdf

French

2 years ago, just before the diagnosis, my partner moca was 17/30. 

After the neuro did MMSE. I understood that Moca was better at the begining (diagnosis) of the disease because it detects better the small failures.

1/2019-  17/30 at MOCA, so about 22/30 at MMSE

7/2019 - MMSE was 20

1/2020 (one year ago) MMSE = 15.

Last summer no test has been done because it was a remote appointment and we will do one next week. He is clearly stage 5 and the new issues are apraxie. I had a look to the tests, they don't really try this kind of ability so I wonder why they are still carried out after stage 4 or 5. Perhaps it helps the doctor to quickly assess the progression.

For me it is something objective and it helps me to be sure I haven't dreamt (if possible !) the progression.

French

My partner seems to be like yours Janeymack, even if he can make a phone call but is not abble to use the TV remote.

Dressing begins to be complicated as well as shower. I must be there otherwise he would not be washed and the clothes would be inside out. He can't close the windows, no more able to sign, to set the table...

CStrope

@French.  It is so interesting for me to read your posts.  So much of what you say sounds just like myself.  I am always looking for signs that I'm actually living this horrible story, and not just dreaming it.  

I said before my DH diagnosis, he actually, on many days, could convince me that there was nothing wrong with him! I guess wishing that was the truth contributed to how far I could stick my head in the sand.

Now since he's had an official diagnosis, I often wonder if I'll appropriately know what I need to do for him as each stage comes along.

French

@Cstrope, 

I also put my head in the sand. I knew a few years ago (at least 4 before the diagnosis) that something was wrong. I felt that my partner wasn't turning so fast anymore. When we were working on things together he didn't understand what to do. Often I would take the tools out of his hands to do things myself.

 I managed to convince myself that he was just tired because of his work and the Complete refurbishment of our 120 years old house we have done together... not to mention the 5 children we were raising. At the same time, there were also all the tax and bank files that were no longer processed or with errors.  

When I thought he was slow, I said to myself « remember, you're the fast one and you have to be tolerant »'. Indeed, after my separation from the father of my children, the psychologist made me do tests that showed that I was gifted or precocious (that's what we're saying here). She explained to me that the failure of my first couple was due to that and that it was difficult to live with someone who is very fast. I always have anticipated everything, I can imagine that it can tire others. She said me that I had to make an effort not to always cut the grass under my companion's foot... 

Now I am sure that I was telling myself this but that I didn't believe it because at the beginning of our life together, I never found him slow and on the contrary I had finally found someone who was following me. 

It’s difficult to admit something you even can’t imagine. Before, I had no idea it was possible to have Alzheimer’s at 50. I discovered it after the first test searching on the net.

Michael Ellenbogen

There is no way to correlate the test to a stage.