Improved Cognition?

JessiJ

Has anyone experienced a LO having improved cognition?  In August 2021 my mom totaled her car while wondering at 1am.  She was like a shell and hardly there when I was with her.  I moved her from NY to my home in SC.  In February she scored 19/30 on the mini mental state exam (MMSE) and was diagnosed with moderate Alzheimers.  I have been researching a lot on prevention and have tried to incorporate practices into our life.  As a result of living with me, her sleep has improved, increased exercise (walking and zumba), and better diet - less sugar.  In the last couple weeks I have seen a step up in her cognition.  She now has a concept of time and is aware that she has been here for a year, is more aware of things going on.  At the neurologist last week she scored a 24/30 on the MMSE.  Now she is insistent on going back to NY and living alone, which is really not possible.  She is starting to get more angry.

Has anyone experienced this increase in cognition?  How much did you trust it to allow more independence or take steps to back track and unwind some of the changes made?  Did the increased cognition last long?

May flowers

We also saw an cognitive increase in my FIL after we moved him in with us - similar to you and your mom, his diet was better (we limited carbs), he walked outside daily, and slept through the night (thanks to melatonin). So, I definitely think a healthy diet and exercise helped him. That, and taking away so many responsibilities  that were stressing him, like bills, housekeeping, meals, etc. 

But, he still did decline over the course of a year, part of that time was in MC and I know his diet wasn’t as good, but he really enjoyed being around his peers. Several stressful events and meds at MC led to a sharp decline to the point he was no longer able to speak at all.

IMO, It is possible that we slowed it somewhat, but dementia marches on.

After a fall in January and surgery, he is now stage 7c and back home with us, on hospice. He is more communicative than he was even before his fall (the MC) maybe because he is on less medication, but physically he is on the verge of not being able to stand at all or feed himself. I don’t think his being here instead of MC would have made a huge difference because he was starting to get lost and fall outside here, so I think where we are now is close to where we would be anyway.

At this stage, we have forgone the diets and let him enjoy what time he has left, including food he likes. He can really only taste sweets so we incorporate them in a way he still gets a lot of protein, like ensures, chocolate peanut bars, breakfast bars, mio juice in his water, etc.

JJAz

When an impaired person has a strong support system around them, they appear to improve cognitively.  Their scores can improve on a good day.  But lacking a support system, things will deteriorate again.  This is a 100% progressive and ultimately fatal disease.  No survivors.

jfkoc

The MMSE measures cognitive impairment. That's it. It does not diagnose cause.

Olly_Bake

Yes a noticeable change. We can have conversations and watch tv and listen to music and he is on point. It is scary frankly because I wouldn't want it to change back to the old. I do not know the why of the change but he now is being treated daily with multiple vitamins to keep away the severe anemia. And the hospital removed every med that was said to help with dementia and the associated issues like agitation, sleep, etc.

Ed1937

I think it is futile to expect any cognitive improvements to last very long when a person has dementia. But here is an interesting video regarding cognitive improvement. Exercise plus THIS 1 THING improves thinking 

Stuck in the middle

Think of a two-bulb light fixture with one bulb that flickers.  Sometimes it is bright, sometimes less so, but that bulb will burn out pretty soon.  So will the better one, and you won't know when until it happens.

Similarly, you would think my wife is OK, with me running interference for her all day.  She can carry on a conversation, so long as you don't ask her what day it is, what month it is, or ask her to read an analog clock.  Sometimes she can turn down her bed and sack out without help, but move one thing and she needs help.

hezazebra

The event in August may have caused a brain injury that is separate from a progressive dementia.  

My father had a couple of strokes and improved significantly after the initial damage, recovering both function on his left side and some improved use of language.  He did not have dementia.

My husband had an anoxic brain injury from which he mostly recovered.  Over the years, his brain has shrunk more than due to normal aging.  The doctors say vascular dementia, but I don't think they really know.  He is still quite functional, but not what he was after recovery from the initial injury.  I have seen him take significant drops in cognition after psychological traumas.  He can lose his sense of self.  I have seen him recover from those episodes and be functional enough to do his laundry and make minor repairs around the house.

I think people with progressive dementias can also suffer from other types of brain injuries and that they can somewhat recover from the injuries.  I would expect you could see a temporary increase in cognition.  There is no way to predict how long it could last.

harshedbuzz

It's not uncommon to see a temporary bump in function with better diet, structure/routine, social engagement and scaffolding/support.

My aunt improved quite a bit when she moved into memory care initially. Before that she's been very isolated and living on junk food. She was in a wonderful MCF with fitness classes, crafts, outings and activities which she joined and enjoyed. She had VD and plateaued for several years at this level.

My dad also improved but his situation was a rather unusual one. He had mixed dementia and one of those was caused by a deficiency in Vitamin B1, in his case caused by alcohol abuse. Once his levels were restored through IV infusions for 5 days and an abstinent lifestyle enforced by a SNF/rehab he became much clearer and also a lot more angry. Alas, abstinence was not something he desired and family refused to be abused by assuming the role of alcohol-police in the context of his co-occurring Alzheimer's so he did begin to worsen over time but it would have once the Alzheimer's progressed.

MMSE is a snapshot in time. FWIW, my dad was quite bright and well educated and brought a lot of cognitive reserve to the testing. I was there when he geri-psych administered the last MoCA (a similar test) dad took about 6-9 months before he died. He scored 25; he could do serial subtraction faster than my mom. He bragged about how well he did all the way down to the lobby where he proceeded to get into a random car being driven by a stranger dropping her car of at the valet stand. Living with her gives you a better sense of how she is doing than a quick and dirty screening in a doctor's office.

HB

ZackFootInMouth

Testing reminds me of playing dice games.

The basic rule is: 4,5,6 you win; 1,2,3 you lose. The closer to 6, the more you win. The closer to 1, the more you lose.

A single test is like a single roll of the dice; there's always a chance you can roll a losing number... And that's not specifying how badly the roll is going to be, or if the die is giving you less than 50-50 odds.

Maybe I'm being obsessive or paranoid (I'm almost guaranteed to suffer this fate as well), but I'm for tracking someone 24/7 in case of a sudden "really bad roll".