Rapid Decline?

hiya

My DH dropped 3 points on MMSE in 6 months. I was told this is rapid decline. His score is 18 but they said he has/had high cognitive reserves. I put him at solid stage 5 with a foot in stage 6 on Tam Cummings. Has anyone experienced this with their LO? Does it continue dropping at a rapid rate or can it be a one off? I’ve asked if I can talk privately with Dr to see what further info I can find out. Thanks for any insight.

Lucy C

It's true that anything can change at any time with this disease. I would definitely explore it further with the doctor. That said, the MMSE is a very general kind of exam. It's very short: some of the tasks might challenge even those of us who are "normal" on a bad or stressed day. (For instance, if I'm having a rough day, I might not do very well counting or spelling backwards either.)

So without further data or observation of decline on your part, or explanation on the doctor's part, I would be a little hesitant to label someone as having "rapid decline" because their MMSE score changed a few points. For instance, you might want to ask the doctor which tasks or questions showed a declining score. Was it on one task or three tasks? What is the significance of the tasks that got a lower score this time? Were they testing sequential memory? Retention? Etc.

Then, it would be good to know if there was anything else unusual that's changed lately. Was your husband especially tired that day? Was he ill for any reason? Has he had a recent change of medications or supplements? Any recent changes in appetite or diet? There are so many factors that can trigger a bad day, or overall decline, with this disease that it's sometimes really difficult to pinpoint what's the disease and what are outside factors that make it appear to be better or worse.

So yes, question the doctor, but don't dismiss your own observations either. I have observed a rapid decline in one case that was linked to previously undetected hypertension, but then seemed to get even worse after the patient was put on a blood pressure med. It turned out that a change of blood pressure drugs was in order: the patient did not fully recover from the decline, but with a new blood pressure med, did show marked improvement in terms of being less anxious, less tired, having a better appetite, etc.

Anonymousjpl123

My mom’s MMSE dropped about 6-8 points in two years and I freaked out. I think it is part of the disease. The test assesses their short term memory, language, etc. I do think it can be situational but often just part of progression. My mom sees doctors regularly for all things - diabetes, hypertension, hypothyroidism - and we try to manage it all. Check blood levels, vitamins, sugar, etc. But sadly the 3 point drop could just be the disease.

NizhoniGrrl

There are other more detailed tests you could ask for. That one is heavy on working memory (numbers, words) but not so much on applied skills/reasoning (ability to follow multi-stepped directions, impulsivity). I’d ask for a follow-up test with an occupational therapist to get a fuller picture.