Can neuropsych test results be wrong?

Rozieglow

Here is some background and the reason he was tested:

My DH has been complaining for several years about memory problems. At first I brushed it off, but in the past 2 yrs I see it for myself. Other things that concern me are

1. his difficulties in dealing with his phone and computer. He was always way ahead of me with technology, and my go-to guy when I needed help. Now, he calls me to help him out.
2. He has a hard time processing what he hears, for example when we're watching TV, I often have to put it on hold to expain what is going on. He says they talk too fast. Subtitles don't help.
3. Driving - he often tells me he feels too foggy to drive. This from a former, self-proclaimed control freak - he always felt more comfortable behind the wheel.
4. Very wide mood swings and some personality changes.

The list goes on, but you get the idea. DH wanted to be tested because there is a lot of Alzheimer's in his family and he is acutely aware of his difficulties.

The geriatrician gave him the shorter test and said he has MCI. The MRI was "unremarkable."

The neuropsych said he is fine, and in fact is in the 90th percentile for his age group (he is 72). DH and I are both skeptical. We live in a 55+ community and are quite sociable. DH has such a hard time with word finding that he is embarrassed to talk to people anymore. I regularly interact with people our age and older and I absolutely don't seem him as being 90% cognitively better than our peers.

Can a smart person have impairment and still ace this exam? Has anyone here had a similar experience with the neuropsych testing?

jfkoc

Which tests did the neuro do???

Quilting brings calm

Did the neuropsychologist do the full 2.5 hours of testing or just another version of the 10 minute test? The tests are like the standardized testing we did in high school. If your spouse is highly intelligent, he may have been able to impress the doctor with his reading ability and knowledge retention etc, which would have skewed the test scores.
I would go with your gut. If he unable to function well at work, then ask your PCP to request disability ( if there is work disability to be had). If he’s only enough to retire, then do that.

Dusty217

If they did the full 2.5 hours it's harder to fool, however all the other symptoms mentioned jump out to me. Can you get your doctor to order a blood test called P217 Tau. It shows amyloids in the blood and is about 94% accurate for Alzheimer's. It took about a week for my DH's to come back. It would only rule in or out for Alzheimer's but worth asking.

Rozieglow

https://alzconnected.org/discussion/comment/267380#Comment_267380

She interviewed both of us together for 1 hr, then did a 2 1/2 hr evaluation alone with DH which was a combination of 16 tests.

Rozieglow

https://alzconnected.org/discussion/comment/267390#Comment_267390

Thank you, yes he's highly intelligent. I believe he's good at "show timing" because when at home with just me, it's like a different person. This is very different from past behavior. He retired in 2019, so at least that's not an issue.

Rozieglow

https://alzconnected.org/discussion/comment/267393#Comment_267393

I don't believe we've had that test done. I'll check it out, thank you.

SDianeL

if you live near a teaching hospital affiliated with a university see if they have a memory center in Neurology and see if you can get an appointment there.

H1235

When mom had her testing they took into account her level of education. Did they inquire about his education? If he has a high intelligence I can see how that might affect the results of the test. Unfortunately there isn’t much that can be done even if there is a diagnosis. I can definitely understand wanting answers, but it may be necessary to just wait. Eventually the doctors will figure out what you have already.

Michele P

My husband has had multiple neuropsychological testing . Each session of testing was two and a half hours; however , the difficulty of the questions varied on each test from the different doctors. I would ask which tests he was given. Additionally, I would make sure that an MRI and PET scan of his brain is ordered along with the blood test for Alzheimer’s. What you are describing sounds like more than MCI.

tucson anne

Yes, the tests can not show Alzheimer's in the early stages for someone with "high cognitive reserve." That means intelligent and well-educated. They are normed to average people. My husband was in the ADRC study for years that did a battery of tests each year, testing both normal people and those identified with Alzheimers. He was in the normal cohort for 10 years. Later,he began complaining to the neurologist about his memory, and I saw issues, but the neurologist said he at most had MCI. Eventually he got a PET scan as part of the study, which showed Alzheimer's. He's had a classic progression of deterioration since 2017—now in about stage 6. The reason to find out, if you are interested, is the new drugs that slow down progression but they are only given in the early stage. So I totally agree with MicheleP's suggestions for the testing (Medicare won't pay for the pet scan but I believe they will for the blood test).

Michele P

https://alzconnected.org/discussion/comment/267451#Comment_267451

Yes, Medicare paid for the blood test.

Rozieglow

Thank you all for your helpful replies. It's just so weird when you KNOW there's a problem and the experts are telling you things are perfectly fine!

Michele P

https://alzconnected.org/discussion/comment/267511#Comment_267511

You know something is wrong. You see it 24/7. Don’t give up on getting the proper diagnosis. An early diagnosis is your best option for the treatments available and slowing up the progression.