MCI Diagnosis

brupt30 · January 17

My DH has been diagnosed with MCI after a fairly brief evaluation from a neurologist (with review of his MRI and bloowork). It appears that this is an umbrella term that could mean any number of things, so I'm confused about his actual diagnosis. I'm contemplating getting a more detailed neuropsych evaluation but hear that it's quite grueling and I'm afraid that my DH will refuse to go and/or refuse further treatment if too overwhelmed. Does anyone have thoughts about what MCI diagnosis means, and experience with psych evaluation?

I am concerned that he is actually further along than what we were presented, given his declining cognitive ability at home, combined with his exceptional coping skills when we are in front of doctors & nurses,

midge333 · January 17

Neuropsych testing is the primary means of diagnosis. It takes about 4 hours of testing.

RetiredTeacher · January 17

https://alzconnected.org/discussion/71804/mci-diagnosis

I understand how you feel hearing your DH's MCI diagnosis. My husband was diagnosed 6 years ago. At that time wasn't sure what it meant but have come to understand it is an often used term for people with cognitive impairment that is early on the continuum. It wasn't until several years later I've come to understand that is the label they put in it early. Many people who were previously diagnosed with MCI go on to develop dementia of one type or another. I think the medical field needs to get more evidence/data of declining cognition to be able to reliably make a dementia diagnosis. Hang on, it's a long, slow, bumpy road we are all on. The people with MCI are very good about appearing and interacting with professionals who may not realize the subtle changes we witness on a daily basis. I'm glad you found this site. It is a wonderful support group that has lots of knowledge, experience and understanding for you. Take care of yourself along the way.

harshedbuzz · January 17

@brupt30

I don't know if this applies to your specific situation, but it is fairly common for neurologists to initially diagnose a patient on their first visit as MCI and then wait until the 6 or 12-month follow up to diagnose dementia.

That said, if your DH showtimes, the doctor may not be getting a clear picture. This is especially true if your DH is a lousy reporter, and you haven't been given a chance to discretely share what you're seeing at home. Dad's neurologist met with mom and me while dad did the quick assessments which allowed us to fill the doctor in without dad feeling like we threw him under the bus. At his geripsych and PCP appointments, I sat behind dad in sightline of the doctor so I could non-verbally signal whether dad's answers were true or not. I also used the patient portal to communicate with his doctors.

I would have liked neuropsych testing for dad, but his neurologist didn't feel it would bring anything to the party as his PET scans offered a lot of information. An amyloid PET scan or lumbar puncture can confirm Alzheimer's and would be needed if you're interested in the newer infusion medications.

HB

DWTired · January 17

In my case my DH was also Diagnosed with MCI, his Neuro Dr was a friend. He seen him due to a TIA and small stroke. He has never said anything other than MCI with no explanation. I guess not to worry him with a Dementia DX. I had to look at MRI and MRA, CT's reports etc…..and investigate myself to determine he has Vascular DM. In my case it was better, as he was a retired Perimedic, and I know he knows something is going on but he has said in the past he doesn't want to know. I made an appt and went by myself and paid out of pocket to get answers without my DH there. I do have medical POA so am able to do that, although the front desk at first said I could not. My DH now dose not even want to go back to the Dr because he stopped him from driving…

It helped me to know what kind of Dementia he has so you can research figure out where you are in the journey. My DH is in stage 5.

SDianeL · January 18

I would keep a list of his behaviors and send them to all of his doctors at least monthly. Do not show your DH the list! He will deny it. Send privately to his doctors. Get your name on his chart at all his doctors. HIPPA forms need to be signed. Go to an attorney and get affairs in order. You will need Power of Attorneys. With a diagnosis he can apply for SSDI if they are not already on SS. Taking the 4 hour test won’t help in my opinion. It didn’t my DH. It only caused anxiety. After the test, the Neuro Psychologist called and said he should no longer be driving. That was a shock. Here’s a link that explains the MCI diagnosis https://www.alz.org/alzheimers-dementia/what-is-dementia/related_conditions/mild-cognitive-impairment#:~:text=Individuals%20living%20with%20MCI%20who,MCI%20due%20to%20Alzheimer's%20disease.

SDianeL · January 18

https://www.alz.org/alzheimers-dementia/what-is-dementia/related_conditions/mild-cognitive-impairment

Quilting brings calm · January 18

My mom never had the extensive neuropsych testing. She was diagnosed with MCI by a nurse practitioner at a memory clinic. The problem with an MCI diagnosis is that doctors are reluctant to give a dementia ( moderate cognitive impairment) so they hedge with MCI even though the caregiver knows better. Diagnosis was done by a 10 minute verbal test, watching her walk and a CT scan. The NP never changed her diagnosis even though Mom declined. I eventually cancelled her appointment when nothing ever really happened there.

My step-dad did do the 2.5 hour neuropsych testing. Some testing was skipped because Dad only had a third grade reading level. I figured he would balk or get exasperated but the doctor was really good with him ( I was in the room). Dad actually enjoyed himself. We got the results a few weeks later - he never processed his diagnosis of stage 4 dementia (MCI is stage 3). He then showed his stubborn streak by refusing to go to the memory clinic

brupt30 · January 18

https://alzconnected.org/discussion/comment/234196#Comment_234196

Thanks - that's the first time that I've heard the term "showtime" and it accurately depicts how he behaves…I need to be much more assertive with his doctors so that they are aware of his symptoms. His previous primary care provider did not take any of this seriously.

White Crane · January 18

brupt30, my DH's doctor didn't take me seriously either but I knew something was wrong. Be assertive as you said. You are his advocate.

Phoenix1966 · January 19

My grandmother was excellent at showtiming, so what I did was intentionally bring her to her doctor’s appointment several hours too early. I blamed them for the change in her appointment time and took her shopping at the commissary while we waited. By the time of her actual appointment, she’d burned out her reserves showtiming while shopping. Within 10 minutes with the nurse and then doctor, she couldn’t pull herself together.

MCI Diagnosis

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