Follow
Share

We met with her new Memory Care Physician. He evaluated her and gave her the MMSE. I don’t understand how she can score that high yet needs caregivers for EVERYTHING. Has anyone else experienced this?

Scoring a 24 on the MMSE indicates mild cognitive impairment/Alzheimer's Disease.

MMSE score, for example, denotes the severity of cognitive impairment as follows: mild Alzheimer's disease: MMSE 21–26, moderate Alzheimer's disease: MMSE 10–20, moderately severe Alzheimer's disease: MMSE 10–14, severe Alzheimer's disease: MMSE less than 10.

Some of your mother's behavior of needing help with everything could be learned helplessness. Maybe she enjoys the attention and help? When my mother took the MoCA test the first time, she scored an 18 out of 30 which also indicates mild cognitive impairment (the tests are scored differently). Meanwhile, she was introducing me, her daughter, as her MOTHER to people I'd known for years. She was also incontinent at that time. So, dementia presents itself differently. The old saying goes, if you've met one person with dementia, you've met one person with dementia. And no truer words were ever spoken.

Mom had good days and bad days, yet she could always Showtime like an Academy Award winning actress. She moved into Memory Care Assisted Living at one point, and caregivers were asking WHY she was there! She could make small talk beautifully, but ask her a REAL question and she was lost.

A good book to read is Understanding the Dementia Experience by Jennifer Ghent-Fuller available on Amazon. Or The 36 Hour Day, more of a reference book. I recommend both.

Wishing you the best of luck with a difficult situation.
Helpful Answer (13)
Reply to lealonnie1
Report
KPWCSC Aug 2, 2024
@ Lealonnie 1: "MMSE score, for example, denotes the severity of cognitive impairment as follows: mild Alzheimer's disease: MMSE 21–26, moderate Alzheimer's disease: MMSE 10–20, moderately severe Alzheimer's disease: MMSE 10–14, severe Alzheimer's disease: MMSE less than 10."

None of the simple dementia screening tests can denote Alzheimer's disease. Substitute the word dementia for Alzheimer's and your post is very spot on. There are a wide variety of dementia types that can only be verified by a full neuro-psych evaluation. Several years ago, a neuro-psychologist verified my husband had moderate dementia related to his Parkinson's. We were also told he did not show tendencies like Alzheimer's or Lewy Bodies at that time.... but it did not rule out either from ever becoming his issue. Recently, it has progressed to where I am being told Lewy Bodies are probably forming in his brain. However, his dementia is still not diagnosed as Lewy Body Disease. Our neurologist told me that over time, PD often has Lewy Body symptoms tagging on to it and Lewy Body Disease often has PD symptoms tagging on to it but they are still separate diseases.
(1)
Report
Those tests are NOT reliable in my humble opinion
Helpful Answer (7)
Reply to jules925
Report

It's not THAT high a score. Just a passing score.

Dementia is like cancer, there are so many variables...not One Size Fits All.
A possible case of "learned helplessness?"
Helpful Answer (6)
Reply to Dawn88
Report

Hi Gigigrl,
My mother also tested very high on her initial cognitive exam when I knew something was seriously wrong. Mom had been primary caregiver for her Mother, Father, and my Dad. She knew all the standard answers for the NC cognitive test by heart. I had to inform her doctor of this before it was agreed to change the standard test questions slightly and retest her. Six months after showing significant decline, we finally had a diagnosis of dementia.
Perhaps this is the same situation for your mother. Don't be afraid to ask for a slightly altered test so she can't pop off memorized answers. I hope this helps!
Michelle Freeze
Helpful Answer (5)
Reply to michellefreeze
Report

One thing to be aware of with these tests and the scores, is they are for an "average" person and for those within their age cohort. In other words, a younger person in theory is expected to score higher than someone 15 years older, so the what is mild cognitive v various stages of dementia depends. Also, "the average" part means that someone with advanced degrees, PhD, JD, MD etc. would be expected to shore higher than someone with a high school degree.

All to say, generic numbers for this or that test really depend on the above noted parameters. Talking with the LOs' neurologists or neuropsychologist who likely performed the test is best to have an accurate understanding of what the test numbers mean for your LO. One size (one test score number) does not fit all.

And folks w/dementia can rally; do better one day relative to the next. If they have had the test several times, they may do better as they might be more comfortable with the test.

Finally, mini status (MMSE) and the MoCA tests are fine in terms of a screening, but a full neuro-psych testing battery is IMHO better. More here: https://practicalneurology.com/articles/2016-july-aug/a-primer-in-neuropsychological-assessment-for-dementia
Helpful Answer (3)
Reply to Sohenc
Report

My mom passed the cognitive tests for a year before we got her in on a bad Lewy Body Dementia day! Cognition changed hour to hour..
Helpful Answer (3)
Reply to Sadinroanokeva
Report

I would say it means start learning what you can. I wish I had taken my husband's diagnosis more serious when we were first told he had Parkinson's related mild cognitive decline then later PD related mild dementia. So many things during his progression might not have frustrated me as much if I had opened my eyes a bit wider to better understand why he was acting the way he was. I am just now able to accept and call it dementia when with family/friends... which I am sure they probably called it that among themselves from the beginning.

@Lealonnie1 "A good book to read is Understanding the Dementia Experience by Jennifer Ghent-Fuller available on Amazon. Or The 36 Hour Day, more of a reference book. I recommend both."

I have not read the first one yet, but I have "The 36 Hour Day" and agree it is a great resource to use as I have new questions. I also recently got and highly recommend "Dementia Care Companion - The Complete Handbook of Practical Care from Early to Late Stage" written by Mehdi Samadani. I have not read either completely but enough to tell me I need to keep reading as well as having both handy for reference as my husband's dementia progresses.

Information definitely empowers and can help reduce the frustration. Even if it is only a small bit at times, I have found it helpful as a stress reducer.
Helpful Answer (1)
Reply to KPWCSC
Report

Prayers sent.
Helpful Answer (1)
Reply to Llamalover47
Report

Teepa Snow is an expert on dementia and how to care for those with dementia. She is on YouTube.
Helpful Answer (0)
Reply to DonnaF777
Report

Ask a Question
Subscribe to
Our Newsletter