Question about Cognitive Reserve

@akc783

My dad had considerable cognitive reserve coming into dementia as did the father (a PhD scientist) of a friend compared to my aunts who had it.

In dad's case, I would say that what @SDianeL posted was what I saw.

Dad's disease progression in retrospect, started by 2005 but he wasn't diagnosed until the end of 2016. At that point, the hospital attending put him at mild dementia and his memory center neurologist suggested MCI. Based on what I'd observed around his delusions, confusion and confabulations, I would have staged in at later mid-stage. The attending told him he had Alzheimer's and "could live 10- 15 years with it". He was dead within 18 months. It was as if dad's disease progression was slower in the very early stages but that the rate of losses accelerated as he got further along. I would say his stage 5 was about a yearlong and 6 was less than that.

Dad seemed to straddle 2-3 stages at times. In general, physical issues like balance and incontinence were present at a time when he could score in the MCI range on MMSE or MoCA. His logic, reasoning and problem solving were gone and yet he could carry on a conversation and subtract by serial 7s as quickly as I could. About 6 months before his death from aspiration pneumonia, he had a great visit which the geripsych trading punchlines in Yiddish (dad was a lapsed Roman Catholic, btw) and he scored a 24 on his MMSE. He bragged about being "off the charts" the entire way down to the lobby and then toddled off and got in some random woman's car while my back was turned to ask the valet to get the car.

HB