Even though Alzheimer’s disease is so common, it can go unrecognized or misdiagnosed in its early stages. An early diagnosis is important as both patient and family worry a great deal and aware of the fact that there are medications that can slow down its progression, they are keen to start on them as soon as possible. I have been told that a definitive diagnostic test cannot be done until after the death of a patient with Alzheimer’s disease, as only then can the brain be examined for microscopic changes. Frankly, after my husband’s death, I was unable to bring myself about to donate his brain to science, even though I’d given it a great deal of thought beforehand.
When our geriatric neurologist realized that my husband had a memory problem – and it took quite a while as he was so good at covering up – she sent us for a series of questions and tests known as MMSE.
Oriention to time: The tester asked my husband what the date was.
Registration: She told him that she was going to say three words and expected him to repeat them. The words she chose, at random, i think, were grape, chair and dollar.
Naming: She pointed to objects in the room and asked him to name them one by one.
Reading: She asked him to read a sentence and act it out, like: ‘Give me that book please,’ ‘Please sit on the other chair,’ etc.
A few months later, they re-tested him at my request, even though it was obvious that they were loath to do so, as his condition had deteriorated. They’d been unable to guage a change in him due to his ability to concentrate and cover up. This time, they asked him to draw the face of a clock showing all 12 digits in the correct places and the hands of the clock to show the time, which was then 9:15. Then she mentioned five words, chatted to him about general topics, and then asked him to repeat the words. He was unable to repeat more than one so he asked her to repeat the whole process as he told her he could do better than that. She agreed but the results were the same.
Only when the neurologist saw the results, I felt it was the first time that she started to take note of what I had been saying. Until then, I had been given very little time to say anything during our sessions.