Obsessed with MMSE

[drummer-john]

Brenda is obsessed with the MMSE and spends a large part of every day "practising" her answers, even though it will probably be months before she's tested again in the Memory Clinic. Unfortunately, it just brings home how far she's deteriorated, which leads to more worry and more "practising".

Has anybody else seen this? I've tried to get her interested in other activities, with not much success.
John

 

[Lynne]

Hi Drummer-John

My Mum (also called Brenda as it happens) gets obsessive about things too, although so far not the MMSE test itself. She's only had 2 - scored the same in both so hopefully the Aricept is doing its stuff - but for about 3 days after each one I kept finding little slips of paper with attempts to spell 'World' backwards!

You've prob. already tried this, but how about using the tack that doing crosswords might help her keep her brain ticking over (if she can still read of course, otherwise it's a stupid suggestion) Mum still does the local daily paper one, although now it takes most of the day instead of just an hour in the evening. Still, it's something we can do together, and she can laugh at me when I suggest stupid answers (not 'cos I'm trying to, just 'cos I'm stupid!)

Best wishes

 

[BeckyJan]

Hello: no David does not have a thing about the tests, in fact he just does not remember them. In fact his score is relatively high - 23 - but its a pity they don't test his ability to perform everyday tasks. He can spell almost anything backwards, can count backwards etc etc. I noticed your post mentioned 'other activities'. We went to an 'Exloring Dementia' course yesterday and it was advice on activities that I was interested in.

I have come away with the idea of starting a memory and treasure box, and also maybe with David 'attempting' his life story. Here he will just have to remember snippets and I will build up with help from his ex colleagues. He can then hopefully draft and redraft what I have done. This sounds like his sort of thing but whether it will work or not time will tell. He reads a lot - usually the same book several times. He does not like tv much and certainly does not follow the detective/mystery type programmes which he used to like. He has never done crosswords and does not even read the newspaper or follow the news now.
Two years ago when he was more 'with it' he did sort out masses of our so called stamp collection. That really did absorb him.

Concentration on activities is so hard for them. I tried getting David onto a computer but he did not like that. We tried jigsaws and I ended up doing them.

I am not sure whether these comments will help you but I do hope you can find something to interest Brenda - it is a hard task! Best wishes Beckyjan

 

[tedsmum]

Hi John

Yes my Dad knew exactly what he was going to be tested on everytime and would ask me just before the test what day of the week it was and the date etc.Lynne it was so strange to see what you had written as my Dad used to practice spelling world backwards as well and on one occasion even said to the consultant after they asked him to spell world " Shall I spell that backwards as well"
He's deteriorated so much since then and I am having a last attempt to get an EPA with a solicitor on Thursday. If you haven't got that yet please try as it would have saved so much time and grief if I had realised how quickly things were going to go downhill.
Just a thought on the test why don't they just vary the questions a bit and change the word to be spelt!!

 

[jenniferpa]

That stupid, stupid test. It's the "gold standard" but I swear, they've never checked with those of us in close contact with dementia sufferers as to how accurate it is. My Mother is one of those for whom the test is always new, but whose brain damage (due to stroke) is in a very specific area, and it defnitely isn't the one that tells you how to count (or spell) backwards. I took her GP to task about this one day - his explanation is that at a certain stage, the sufferer will lose track when counting backwards. My point was that while it might work to show gradual decline, it's bl**dy useless for assessing current deficits.

Jennifer

 

[Grannie G]

Testing

My husband tested himself continuously. Not with official medical tests, but with dates of family birthdays, all the addresses of previous homes we had, names of people he worked with, name places where family members lived and everything else he thought of.

I felt it was his only way to keep hold of what he knew.

Grannie G

 

[Nebiroth]

Yep Dad did the same between two visits from the two different psychiatrists we saw. Sadly he just practised the bits that test short-term memory which just exposed how he couldn't remember three words/objects after a couple of minutes.

His score actually rose several points after starting Aricept.

 

[bubs]

can you give some information on aricept

Hello, i look after my mum who is 80. she has had vascula dementia for 6 years . she has lived with me and my family for the last 2 years. Keep hearing about medication called Aricept can you please give me some information on this drug .mum has never been given anything apart from mild sleeping pill .which does not work,on a bad day she can stay awake for 18 hours without a nap. Does this Aricept help the dementia. Thankyou Bubs

 

[jenniferpa]

Unfortunately, there are currently no drugs prescribed in the UK to help vascular dementia - drugs like Aricept are only used for alzheimers. Apart from trying to ensure that the conditions that led to the TIA's that caused the Vascular Dementia (e.g high blood pressure, blood thinners) there not a lot of treatment available.

Jennifer

 

[Amy]

Hiya Bubs,
Just wanted to welcome you to TP. Like your mum, mine has vascular dementia; she has in the past been on medication for high blood pressure, and takes aspirin daily; that's the lot though.
Love Helen

 

[alfjess]

Hi
Yes, my Mum rehearsed as well when she thought she was going to be asked questions. She would question me on day, date, family etc. but couldn't remember when it was time to answer.
Unfortunately, now she just wouldn't understand whom she was talking to, she thinks, everyone has worked for her in the past, even the actors on television.
It does make things easier for me now, because she thinks everyone is her friend
Alfjess

 

[Nebiroth]

As I understand it, Aricept is not prescribed to people with vascular because, unlike Alzheimers, the underlying cause of vascular can be treated and further damage prevented. The damage is caused I believe by progressive strokes. So medications are given to lower blood pressure and thin the blood, preventing further strokes. so hopefuly the patient won't get worse, even though the damage already done cannot be repaired.

Whereas Alzheimers is progressive, and Aricept can in some cases slow the onset of symptoms. It does not address the underlying cause of the disease and does not halt the progression of it. The Memory Nurse told us that Aricept is only licensed for Alzheimers - nothing else.

That's how I understood it anyway.

If you think your Mum is getting worse, then maybe she should be reassessed. It's possible to have something called mixed dementia, which means you have Alzheimers and vascular - which is what my Dad has got. He's on aspirin for the one and Aricept for the other.

 

[drummer-john]

Thanks to everyone for their replies. At least I now know I'm not the only one with permutations of "WORLD" and "DLROW" on bits of paper all over the house! The sad thing is, I think Brenda was a bit dyslexic anyway, so probably couldn't have spelt "world" even without the AD.
Best wishes
John

 

[Lynne]

Just a thought on the test, why don't they just vary the questions a bit and change the word to be spelt?!!

I think the MMSE questions, spelling "World" etc. are kept the same, since it would be significant if the patient could recall it from the previous time. Not much chance of that though, sadly.

 

[Margarita]

My mum need to go for a reassessment for that test .I just ask my mum some quotation of the The Mini Mental State Examination (MMSE) - a guide for people with dementia and their carers .

All she would do was count from 10 backwards to 5 then stop my mum on Ebixa , oh mum just remember who is the prime minister so that it .

So my mum must have a low score .when she go for her reassessment could they take away her Ebixa

PS Sad really my mum use to get me to right all the answers down for her in case the doctor came around in emergency respite now at home with me she does not even mind me asking her where before she use to get very angry

 

[KenC]

Mmse

I have just done this test again this week and seemed to get the same results as last time or similar.
My wife knows these questions off by heart and she asks me the questions over and over again before we see the consultant, or the memory nurse.
Why can't they change them so that we do not know what is coming. I am sure that if I was asked other things the problem would be more obvious.

Regards

Ken

 

[Splat88]

Mmse

My MIL who is on Aricept, and who also had an increase in her score when she was first put on it, has been pretty stable since then ( 3 to 4 years now)

She was quite cute with the date, noticing that it's written on the wall next to her!!! Otherwise she doesn't know the year, date, day of the week, etc. She can't remember the objects after a few minutes. Has no problem with spelling WORLD backwards, or doing the instruction and drawing part. She often writes a sarcastic sentence, usually "why are you asking me these stupid question?"

As I understand the state with Aricept, it slows the progress but obviously can't reverse it. And there will come a time when the MMSE score is low enough for the drug to be stopped as it isn't helping, I think a score of 12 was mentioned once?

 

[Nebiroth]

Yes, as I understand it, Aricept slows the onset of the symptoms - it does not slow the actual progession of the disease itself, but can help to prevent some of these symptoms.

From what I gather: loss of nerve cells in the brain causes a deficit of a chemical called acetylcholine - a chemical thought help messages be carried from cell to cell in the brain. Aricept prevents the natural process which causes this chemical to be broken down, the effect being to increase the amount present.

But as more and more cells are lost, the levels fall again. I assume they can't just keep giving you higher doses of Aricept because you'd overdose on it.

From what I was told, patients do reach a level at which Aricept no longer offers any benefit - at that point they do a "drug holiday" (stop it for a month) to see if you get worse without it. If there's no effect, no point in taking it.

I was also told that some people do not benefit from it anyway. Plus, Aricept does not usually help with short-term memory, but is likely to help with confusion and time sense. This is obvious in my Dad who before treatment would mix up morning and evening, which he has not done since.

I am not a doctor but that's how I understand it to work.

AD varies so much from person to person. Our Memory Nurse has one patient whose score has not changed for six years!

I think the short-term remembering of the three things is one of the first tests people fail. Short term memory is usually the first to fail, most people report to doctors with "memory problems"

That was the case with us, now we look back over the last few years. We went to the GP when the confusion set in.

 

[connie]

Just feel I have to interject here: Lionel saw his consultant about 12 days ago

"Haven't seen Lionel so well for four years, his score has just gone up." wonderful except we have had the paramedics out 6 times in the last 10 dAYS, THEY ARE WELL AWARE OF HIS SPATIAL AWARENESS PROBLEMS, and so the merry go round continues.

I am exhausted.......up every night 2/3 times, but "his score has gone up".
Excuse me, I am going to bed.

 

[Norman]

I understand that consultants take an all round view of the patient.
A patient may be lucid bright as a button and still score low.
Much is to the consultants discretion.
I also understand if the medication is discontinued there may well be a decline and there is no going back.
Norman