MMSE score at initial diagnosis

Discussion in 'ARCHIVE FORUM: Support discussions' started by kayleigh999, Apr 24, 2007.

  1. kayleigh999

    kayleigh999 Registered User

    Apr 6, 2007
    53
    Birmingham,England
    Hi All

    Forgive me if this has been mentioned many times as i am fairly new to all this with my dear Mom only getting a diagnosis 4 days ago of VaD and patchy AD.

    My Mom tok the MMSE test 4 weeks apart and scored same 4 days ago as she did a month ago. From what i can gather on reading up her score (14) seems to indicate moderate dementia. I am wondering if this is a low score for initial diagnosis. While i realise it is only a small part of the diagnosis process she seems to have deterioated very rapidly from when i first thought of the possibility that she could have dementia which was around christmas last.

    Of late the psychotic symtoms have increased alarmingly too. I suppose i am worried we are on a big deteriation and the stable days are fast disappearing.

    Would it be intrusive to ask anyone else what their relatives scored? I am new to all this and trying to take it all in and whilst sometimes too much info is not a good thing i do keep reading things that could have been totally written about my Mom so i think denial is a luxury i no longer have .

    Thanks for "listening" and i wish a good day to any other carers,

    K xxxx
     
  2. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    68,656
    Kent
    Hi Kayleigh,

    My husband does not have VaD but does have Alz. For what it`s worth, and I`m beginning to be unsure of the wisdom of reading too much into the MMSE scores, my husband scored 23 in 2005 and 20 in 2007.
     
  3. Margarita

    Margarita Registered User

    Feb 17, 2006
    10,824
    london
    No the feeling , but sometime I Drife in out of denial , as I like the feeling of denial , keep me grounded , that's just me

    My mother scoring was 12, 2 years ago , last July it was 10 , but then my mother has been on medication for late stage AZ for the last 5 year's , so her progression must be slower then someone that is not on mediation for AZ .

    Then as I always read on TP every one is different , with the progression with or without medication for AZ
     
  4. blackburn

    blackburn Registered User

    Feb 20, 2007
    17
    North East
    When my mother took this test in hospital she scored 15 and I was told at that time that it was inconclusive - it was the brain scan that confirmed VaD.

    I can only speak from my experience of this but it may give you a little hope. :) When my mother took this test she was very confused and it was very, very obvious that something was "wrong". Since then she has settled remarkably well and has had several weeks where she is mentally stable. I am making the most of this because no-one knows how long it may last.

    Take care.

    Isabel
     
  5. Helena

    Helena Registered User

    May 24, 2006
    715
    With Vascular Dementia the progression and deterioration can be very rapid it depends how thick and fast the infarcts in the brain are happening

    My Mother went downhill very rapidly in her last 5 weeks
    before she fell and got pneumonia she probably would have scored 28 on a good day ...........about 14 after they treated the pneumonia but zero 4 weeks later when they tried to assess her for EMI home

    Age , fragility of the brain , infections all take their toll
     
  6. BeckyJan

    BeckyJan Registered User

    Nov 28, 2005
    18,972
    Derbyshire
    Hello: to answer your question I would think 14 is low for an initial test. That would probably indicate VasD as you would more aware of a low downward decline if it were just AD. I think the MMSE tests have to be taken with a pinch of salt; in our case my husband started at 27 - down to 24 in January this year and (on my own testing) he was 21 yesterday. This would sound as if he has no problems!!! - but it is the 'orientation' part that he is poor with. He has no problem with counting backwards, spelling backwards etc. Our CPN and Consultant both say they take more account of what we 'the carers' report than the actual test. Obviously when the decline is severe then the testing will show this up.
    For your info at the bottom of the MMSE sheet it quotes that
    24 - 30 is regarded as having no cognitive impairment
    18 - 23 mild cognitive impairment
    17 or less severe cognitive impairment
    Again I think this has to be taken lightly as each case is so different - just a UTI or something similar can cause a decline, maybe sometimes only temporarily.
    Try not to worry too much about the MMSE. Dementia is a dreadful thing to cope but we are all here to listen and understand.
    Best wishes Beckyjan
     
  7. blue sea

    blue sea Registered User

    Aug 24, 2005
    270
    England
    Hi Kayleigh
    Dad scored 12 on the first test, though by then he was already showing major symptoms, confusing night and day etc. By the second test, 3 months later he scored only 3, which was a fair reflection of the incredibly fast deterioration. As you know, he had vasc dementia, and this is marked by sudden declines, but the consultant did say this was very extreme. By this time he needed 24/7 care. However, looking back, he had had mild symptoms going back 4 or 5 years and had lived quite happily with mum with no major problems at all, apart from forgetting words and becoming less sociable. The steep decline was linked to frequent TIAs and was definitely accelerated by mum's death. It really is very unpredictable with vasc. dem. You may well find that the medication reduces the worse symptoms and your mum plateaus for quite a while - could be months. Best thing is to prepare for the worst but hope for the best. I think you can only take the test score as a rough guide - people's results will vary from day to day or even within a day, but it does give you a fair picture of which 'grade' they are in.
    Blue sea
     
  8. Margarita

    Margarita Registered User

    Feb 17, 2006
    10,824
    london
    #8 Margarita, Apr 24, 2007
    Last edited: Apr 24, 2007
    That what has been happening with my mother

    reducing the worse systems ( never thought of it like that ) as mum was being double in incontinent , before medication .

    That why then as I read that you said before Blue sea , some people go into a really deep denial , ( that was me ) because the medication stop all those systems , so I thought she was going to , not so much as get better , but stay like that on that plateaus 5 years ago not go down . so now she does seem to go on plateaus and slowing droping,

    but still go to the toilet herself :) , yes like someone said above , am just going to enjoy my time with my mother while she still with me and not geel guilty when we both need time apart from each other
     
  9. DickG

    DickG Registered User

    Feb 26, 2006
    558
    Stow-on-the-Wold
    Mary started in 2000 with a score of 25 and last October her score was 9. Whilst her last score seems to be very low she is happy and still retains the ability to help me around the house provided that she feels confident that I will help her and not get exasperated. As you can see, over the past 7 years we have experienced constantly falling scores and the scores have not always reflected Mary's condition; she is probably calmer and more at peace now. I am not complacent for this may just be one more transient phase.

    Dick
     
  10. Sunlight

    Sunlight Registered User

    Feb 12, 2007
    55
    My mother's score on diagnosis was 22. She hasn't had the test repeated but I think she is deteriorating slowly but surely.
     
  11. sue38

    sue38 Registered User

    Mar 6, 2007
    10,856
    Wigan, Lancs
    My Dad scored 14 at initial assessment in December and the same again in March. No one else was present when the Consultant carried out these tests. He had another assessment yesterday by occupational therapist when my Mum was present but we weren't told his score.

    My Dad has few problems with day to day activities. He dresses himself, has a shower and a shave, gets his own breakfast, drives his car, plays golf and goes out socially both with and without my Mum, takes the dog for a walk etc.

    When the occupational therapist asked him what day it was he replied 'the first day of the week' but couldn't say Monday until she asked 'is it Sunday, Monday, Tuesday..?' He confirmed it was Monday. Then she asked what month it was. Again he couldn't say until she said 'January, February, March, April..'. He confirmed it was April.

    His main problem is remembering specific words. That's not to say he's not forgetful about other things. The electricity board were due to come today to update the meter. My mum was on a course and he rang me and asked me where the meter was. 'Under the stairs?' I suggested, (not sure myself). 'Of course it is, bye!' :)

    I'm not sure how reliable the tests are when comparing different cases. I try not to pay too much attention...but if on the next test he scores 16 ... we will be doing laps of honour round the room. :D

    Sue
     
  12. Becca2910

    Becca2910 Registered User

    Apr 24, 2007
    3
    Hi

    My Dad was diagnosed with AD 8 years ago and there is no consistancy with his results they go up & down depending on his mood.

    My dad's consultant has confirmed that there is no scientific way to monitor this illness so really its down to the carer's own observations and experiences. You will know when your mother is deteriorating.

    Becca :)
     
  13. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    68,656
    Kent
    Hi Sue, your post shows how puzzling the MMSE scores are.

    My husband has no problem namimg the days of the week, as he hasn`t yet lost any language. But he has to refer to the paper, to find out what day it is, and if it happens to be yesterday`s paper, then that`s what day it is. Same with the months.

    He no longer drives and has lost all his social skills.

    He hasn`t a clue where the meters are.

    He does dress himself but needs help bathing, as his balance is so poor.

    He scores 20
     
  14. twink

    twink Registered User

    Oct 28, 2005
    265
    Cambridgeshire UK
    Steve was diagnosed in August 2004 and had a memory test a few months later and scored 28. A few months after that he scored 21 and then 6 months ago he scored six. He doesn't have a clue what day it is, can't wash or dress himself and doesn't know he is in a home. He can't hold a conversation either. He can talk but it doesn't make any sense. He's 56.

    Sue
     
  15. connie

    connie Registered User

    Mar 7, 2004
    9,519
    Frinton-on-Sea
    Last year Lionel's consultant said he had not seen him so well, and scoring as good, for four years.

    Today he cannot even take the test.

    Bah, humbug. My Lionel is still himself. The outside world is changing. So, he does not fit in. So be it. What really does this alter?
     
  16. kayleigh999

    kayleigh999 Registered User

    Apr 6, 2007
    53
    Birmingham,England
    Thanks

    Hi All

    Once again i want to thank everybody who replied to my post. I really do appreciate it. I think i am comparing notes and trying to see where Mom fits in but from the replies i think everyone is different really. I suppose i (as a newbie!) am trying to make sense of this devastating illness as maybe a way of coping.

    I was told on my own 2 years ago by the consultant after her stroke that he could see dementia on the scan. I think i "forgot" it on purpose as a coping mechanism and thought not Mom,this only happens to other people. It sadly has become very apparent that he was right and i also think he was reffering to longer-term damage as previous to the major stroke she had many what i now think were TIA's.

    I did not know much about dementia before all this and i wrongly thought (i hope this does not offend anyone) that sufferers just slipped in to a world of endearing memory loss ,mixing up peoples names and a bit of confusion. What a wake up call i have had. Its the most horrendous illness and i feel like someone has ripped out my heart with no luxury of answers,timescales or any chance of a recovery.

    I will just have to try and enjoy what time i have left with Mom and stop panicking that i am forgetting her as she was.I will remember that after i guess and yesterday she kissed my cheek and said "love ya".She is still in there somewhere. (cant type now for tears)

    Thanks again and my heartfelt wishes to everyone affected by this and may i wish you all the best possible day.

    K xxxxx
     
  17. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    68,656
    Kent
    Dear Kayleigh, It`s a hard lesson, but you are learning fast.

    Make the most of your mum. As long as she still knows you and loves you, you have a lot of living left.

    Take care
     
  18. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    Kaykeigh, I think you have just made a very important point there.

    I think that is how most people see dementia, and that is why it appears to be so low on politicians' agendas.

    We see people like Ronald Reagan and Margaret Thatcher on TV, all scrubbed up and tidy, just looking a bit vague. We don't see all the unpleasant bits that go on behind the scenes.

    And they have teams of helpers making sure that thay appear at their best -- we have it all to do ourselves.

    Perhaps we should press for a dementia reality programme!:eek:
     
  19. Nell

    Nell Registered User

    Aug 9, 2005
    1,170
    Australia


    I think this is why so many AD sufferers are in such denial about their own diagnoses. This is what they think of when they think of Alzheimers / dementia, and they KNOW they are not like that!! Sadly, the diminishing of reasoning ability prevents many (most?) from recognising that it is a gradual decline into that state.

    As we never stop saying on TP, how cruel is this disease - for those who have it and for their loved ones. Nell
     
  20. kayleigh999

    kayleigh999 Registered User

    Apr 6, 2007
    53
    Birmingham,England
    Hi Everyone

    I would like to thank you all once again for your time in replying. I seem like im always posting but it is all new to me and i get some helpful kind replies that I will carry on if that Ok :)

    It does seem,looking at the replies there is much variation in the results and I do think it means different to everyone. As one poster said age and health with have an impact and my Mom being 82 and having suffered a stroke will be different to the younger sufferers i guess.

    My problem is I am a very methodical person and I like organisation and everything in black and white. I am going to have to get over that and change my thoughts because as I am finding out no 2 days are the same. I came on her with my very first post because my Dad was losing his temper with Mom and pushing and shoving her. Whilst that is still so out of order i have now seen the other side where Mom is going at him with a broom,a phone and just with her fists. Its so,so sad. My parents have been married almost 60 years and in retrospect I cant ever really remember seeing them argue even much. Mom is now in early days of anti-psychotic medicine so I am hoping things improve.

    I have S.S going in to access her for daycare to give her (and Dad) a break.

    I hope I have not waffled on,I do talk a lot:) and its good to unwind on these boards. Sometimes the pain and sadness and uncertaintly overwhelms me and it does help I am not alone. I never knew anything about dementia really until now,was told after Moms stroke it could be seen on scan but i "forgot" i think. Myabe as a coping mechinism. It is quite clear these last 3 or so months it is taking an effect and quite severly.

    Thank you again and my very best wishes to everyone reading.

    K xx
     

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