Rapid Decline

hiya

My DH dropped 3 points on the 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 a solid stage 5 with a foot in stage 6 on Tam Cummings. Has anybody 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 the doctor to see what further info I can find out. Thanks for any insight.

Jeanne C.

My husband dropped 10 points in a 6 month period earlier this year. We haven't bothered to check since because he has progressed too far. I'm sure others will chime in, but I think the progress varies with big drops and long plateaus. My husband's progression since diagnosis in January of 2023 has been rapid and fairly consistent. I'm told younger onset can be like that (he's 65).

harshedbuzz

@hiya

Absent a reason like non-cooperation, lost hearing aid or illness, it's likely progression.

Sometimes caregivers can pinpoint a recent event that resulted in an uptick in disease progression— an illness or hospitalization, moving, change in primary caregiver for some reason. Sometimes not.

The type of the dementia matters, vascular dementia tends to progress a little more rapidly than Alzheimer's in general. VD also tend to follow a notable decline/plateau pattern of progression whereas Alzheimer's tends to follow a steadier decline.

Dad and my aunt had dementia at the same time. Dad had mixed (ALZ and WKS), his progression was like a ski run— a gentle decline followed by a steeper one in which decline accelerated. Auntie's (VD) was more like coming down a path with an occasional step or two on the way down. Atypically, she lived with VD about 15 years. I suspect dad journey with ALZ was about 15 years. He was diagnosed late— I'd say stage 4/5 with cognitive reserves for days and oddly preserved speech. He died 20 months after diagnosis which made his decline feel very rapid.

HB

Crkddy

My wife was diagnosed with EO Alzheimer's at age 55. The first three plus years after diagnosis were marked by rapid decline. Then she seemed to level off for a couple of years, and another rapid decline last year. Now she seems to have plateaued again. Every case is unique, but yes, rapid decline does occur but it doesn't mean it will be a steady progression.

Quilting brings calm

I read somewhere that the average MMSE decline is 2-4 points per year. So 3 points in 6 months would seem to be faster than average. However, I think the better frame of reference would be on his his everyday behavior and symptoms. My mom’s MMSE was staying the same or improving according to her NP. Meanwhile she was declining in my opinion and that of the staff at the AL. She continues to do so.

Maru

Feeling pretty ignorant….what are these points that the above conversations are about. DH was tested by neurologist who gave him all kinds of tests, including the NUCOG test.

hiya

https://alzconnected.org/discussion/comment/222646#Comment_222646

MMSE, Mini Mental State Exam is a test of questions that gives a very basic view of one’s thought process to orientation, thinking etc. the test is out of 30. it is used often by doctors to see if a patient needs to be referred for further evaluation. When DH score dropped to 26, he was referred to a memory care clinic. If you google MMSE you can see the questions online.

sherryandwilliam

Thanks I found that test. Will try him taking it

Cate2024

I wasn't familiar with MMSC but I'm in Canada so maybe they use a different scale. I've only heard of the 7 Stages of decline. We had a slow progression from diagnosis in April 2022 but in August 2024, my DH thought his wife of 23 years had left and been replaced with me, a care giver. We then went through a high fever with Covid which seems to have exacerbated the situation. Cetalopram seems have helped with the extreme night agitation and we have a CT scan later this week to see whether he might have had a mini stroke the night he had the rapid decline. it's such a rough road….