My Medicare Advantage plan sends an NP around to my home every year to check my general health. This year for first time (I am 81) it included a test of remembering three words while drawing a clock that said 2:15. I passed this okay, but I do carry one ApoE4 gene for late onset Alzheimer's--although neither of my parents lived long enough (62 and 80) for dementia to be obvious. Nor did my grandparents who all died in their early 80s of heart attacks or colon cancer. I am also taking some online tests each year through Brain Health Registry that I find extremely difficult but they don't tell me how I am doing. Is this clock thing really important, and how do you know if you are developing AD versus normal cognitive decline with age?
For my mom, her first happened unplanned.... she had torn a muscle cleaning windows; her regular internist - which did NOT do minis ever - sent her to see othopedic surgeon & his practice was within UTHealth Science Center system; ortho MD sent mom to be be evaluated by gerontology practice - also UTHSC- before he’d schedule surgery and this was more about her to be ok to be cognitive to do rehab, cause if she wasn’t competent & cognitive enough for 2-3 mos of post surgery rehab he wouldn’t do it. My mom was in really good health with no chronic diseases. Gerontology did full on work up and mom ended up getting into a study on nonagenarians. Mini mental every 4 mos, annually full ACE (Addenbrooke) & Battery 100. Everything pointed to her having Lewy Body Dementia. And on retrospect, she was pretty classic Lewy. The medications for Lewy are different than for Alzheimer’s, so knowing she was Lewy was important. She was on Exelon as aricept doesn’t work for Lewy. Also the most common prescribed psych meds are totally adverse for Lewy.
The testing tech told me that the more “Dali” like for the clock and the more extreme the clock melt, the gerontologist could use to actually determine where a patient was in their Alz phase over time by looking at past drawings. The ones with Lewy could clock draw pretty well till death.
Another thing about any of the Dementia “testing”, if your first language was not English or you grew up in a bilingual household, your test results could be somewhat inaccurate as they skew English only. My mom was fluently bilingual (an ESOL program volunteer in her 70’s) but as she aged reverted more to her first language or code switched in conversations.
If your really concerned about your dementia probability, I’d suggest you get an Addenbrooke / ACE done as it’s a pretty solid test & score is pretty spot on in my experience.
I'm all for responsible self-help, but is this beginning to cause you needless - even possibly counterproductive - anxiety?
Perhaps the best thing to do would be to appoint a health proxy and leave it in their hands and God's.
Personally, you seem ok to me. My husband who has Alzheimer's drew the clock face 2 years ago fine. This year all the numbers were on the right side of the clock.
It is important to know that just because several members of your family have developed dementia late in their lives, that does not mean you are more likely to get it, even with the APOE4 gene. It is only Early Onset Dementia (roughly before the age of 50) that there is a 50% chance of others in the family developing dementia, as explained in the film "Still Alice." Cheer up! You're still doing well.
We can't help beginning to feel very vulnerable and anxious, hm? - especially during phases when there just seems to be a sea of troubles facing us and our loved ones.
You've taken the right steps, and your daughter is a responsible, sensible and eminently qualified person. I'm sorry she's going through this with her father.
The rest of it really is just life, you know. I don't think there is an answer.
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