Ask Nancy

Ask Nancy: Understanding a parent’s dementia test results

 

Special to the Miami Herald

Q: My mother is showing signs of forgetfulness and confusion. She constantly repeats questions and is often very confused. It’s easy for my sisters and me to see that her short-term memory is declining and we’re worried that she lives alone without any assistance.

When we took her to her physician, a Mini Mental State Examination (MMSE) test was performed and we were very surprised to learn that she scored a 28/30 — indicating no impairment. Now my mother insists that she doesn’t need any help. How is this possible? Do doctors really rely on this test?

Wendy D.

Richmond, Va.

A:You’re not the first one to be surprised about the results of a loved one’s MMSE, and perhaps you should delve more deeply into your concerns. I contacted Dr. Bonnie Levin, the director of the Division of Neuropsychology at the University of Miami.

“The MMSE is most useful as a screening measure, and not as a stand-alone test for dementia,’’ she said. “A complete work-up for dementia should include a comprehensive medical and family history, a medical evaluation, appropriate laboratory tests and careful mental status work-up.’’

She elaborated: “Like most screening tests, the MMSE has strengths and weaknesses. It's been shown to be relatively unable or insensitive to detect mild cognitive problems, when the earliest stage of dementia is beginning and interventions are the most effective. Also, the MMSE is biased toward picking up problems that involve memory and orientation, and less likely to pick up problems involving reasoning, judgment, planning, or organizing one’s thoughts.”

Keeping all this in mind, perhaps you and your sisters could talk to your mother about your concerns and suggest a more complete evaluation. Should you do this, I'd suggest that one of you accompany her to corroborate information that she provides in the event that she may lack insight into her own potential cognitive difficulties.

Nancy Stein, Ph.D., is the founder of SeniorityMatters.com, a local caregiver advisory and referral service for South Florida seniors and their families. You can contact her at nancy@

senioritymatters.com.

Read more Lifestyle stories from the Miami Herald

  •  
A few months ago, the Desert Inn had a for-lease sign in front and looked abandoned. The restaurant has reopened under new management, and there are ambitious plans for the rest of the property.

    Yeehaw Junction

    Desert Inn to get a Wild West revival?

    Some men look at an old restaurant and ask: “Why?”

  • Southern Cross Stargazer for Aug. 31-Sept. 6

    At dusk Mercury is visible rising above the western horizon. About 8:30 p.m. a celestial triangle forms in Libra in the southwest. The moon floats beside westbound silver Saturn, above eastbound ruddy Mars. Huge Scorpius crawls toward the southwest. Antares, a red supergiant, is the heart beating in Scorpius. The stellar Teaspoon shimmers above the left handle of the Teapot.

  •  
Tallahassee is a rooted place with a sense of history, more genteel and dignified than any of the state’s other urban centers, and infinitely more Southern.

    Quick trips: Florida

    Visit Tallahassee for fine and funky food (and football)

    Boiled p-nuts. Sometimes “boiled” is spelled wrong, too. There are stands that dot the back roads of the rural Florida Panhandle, fronted by hand-lettered signs that tout the glories of the green peanut. The outskirts of Tallahassee are P-nut Central, the stands’ proprietors hunkered over burners at the back of rattletrap trucks in the hot sun. So you stop.

Miami Herald

Join the
Discussion

The Miami Herald is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere on the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

The Miami Herald uses Facebook's commenting system. You need to log in with a Facebook account in order to comment. If you have questions about commenting with your Facebook account, click here.

Have a news tip? You can send it anonymously. Click here to send us your tip - or - consider joining the Public Insight Network and become a source for The Miami Herald and el Nuevo Herald.

Hide Comments

This affects comments on all stories.

Cancel OK

  • Marketplace

Today's Circulars

  • Quick Job Search

Enter Keyword(s) Enter City Select a State Select a Category