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can you still pass the Montreal memory quiz, draw a clock
alz+
Posted: Saturday, January 20, 2018 12:22 PM
Joined: 9/12/2013
Posts: 3608


I know what day it is, the year and who is president. I can still draw a clock. 

Is the Montreal cognitive quiz able to point out your brain function?

http://www.mocatest.org/

I remember my dad being asked "who is president" in a crowded room with my mother whispering "Bush! Bush!" and he was given about 5 seconds to respond.

By the time I was given that mini exam by ALZ neurologist I could still draw a clock, name animals, do the puzzle parts etc. I think I missed one word in the memory of 5 word string and could not count backwards by 7s from 100 - but I could not do that at 40 years old.

I am asking because I don't think the test reveals our perceived losses in function which initially are inability to start/complete tasks, and other things.

what year is it?

who is president?

It was the fall off on my research related 4 hour repeated cognitive tests and my difficulty finding my way around the hospital that really showed where my issues were.

Curious how others feel about the mini tests.


alz+
Posted: Saturday, January 20, 2018 12:24 PM
Joined: 9/12/2013
Posts: 3608


Candidates first have to copy a cube, link up numbers to the appropriate letter of the alphabet. and draw a clock showing the time 11:10.

They are then given three animals to identify.

Five simple words are then read out and the candidate has to recite them immediately and then again after five minutes.

This test is then repeated with numbers, with a series of three numbers to be recited backwards.

To test “attention”, the examiner reads a long list of letters and the candidate has to tap with his or her hand whenever the letter “A” is read out.

Numeracy is examined by asking the candidate to subtract seven from 100 and repeat this operation five times (giving a series of 93, 86, 79, 72, 65).

To test language, the candidate is asked to repeat two phrases and then recite as many words beginning with a certain letter as possible in one minute. Eleven words are required to secure a point.

The two final questions are an abstraction test, where candidates have to decipher a link between two words, and “orientation”, where the candidate has to state the day of the week, as well as the month, date, year and what city they are in.

In the initial study that established the test, the average score was just over 27. Candidates with “mild cognitive impairment” scored just over 22 and people with Alzheimer’s disease around 16.


Mimi S.
Posted: Sunday, January 21, 2018 8:26 AM
Joined: 11/29/2011
Posts: 7027


The cube on that test is much easier than the figure on the other mini test. Shall we say my drawings were interesting.  What shocked me at first were that these had nothing to do withbeing able to remember.

Just remember that they test only a few aspects of our brain. Missing some parts may be indicative of a problem, but passing only means ee passed those particular aspects.


BadMoonRising
Posted: Monday, January 22, 2018 9:53 AM
Joined: 4/22/2017
Posts: 335


Mimi,

Try counting back from 100 by 7's. Sure, it tests "numeracy" but it also tests memory. You need to hold the prior number in your mind in order to continue the subtraction exercise. Another example is the naming of animals that start with a particular letter. Although I have never scored less than a 27/30 I do start to panic when my mind goes blank and I can't remember as many animals as I should. 

On the other hand, it takes me 3 1/2 seconds (just timed myself) to complete the test item where you count back by 7 because it is in my long term memory. (As are the first three words that you need to remember and the three animals that you need to identify on the MoCa.) My ability to remember crap like this is why my neuro did not give me the MiniMental or ask me to count back from 100 on the MoCa.


jfkoc
Posted: Monday, January 22, 2018 10:26 AM
Joined: 12/4/2011
Posts: 21244


Someone still has to convince me that they are relevant.
lisabramey
Posted: Monday, January 22, 2018 10:52 AM
Joined: 3/20/2015
Posts: 96


Dear Alz+,

II do not think I could passe it all. I do practice drawing the clock from time to time. My circles are becoming more messy, however. I guess it depends on the day the test is given. I have some good days and some days where the lights are on but nobody's home.

Lisa


Mimi S.
Posted: Monday, January 22, 2018 1:18 PM
Joined: 11/29/2011
Posts: 7027


jfkoc,

I think the tests are relevant. But, especially the medical profession has to understand that they must also use common sense, what they observe and what the patient and members of the family are soing. if in doubt, go further.

Some of the tests, like counting backward, are subject to practice bias. 


Mimi S.
Posted: Monday, January 22, 2018 1:21 PM
Joined: 11/29/2011
Posts: 7027


Dear JFKOC,

I do think the test has value as a screening tool.

However, the medical profession has to use common sense, what the patient and family are reporting and their own observations. If in doubt, go for the neuro-psych.


CF257
Posted: Saturday, February 3, 2018 11:30 AM
Joined: 2/2/2018
Posts: 24


I couldn't agree more.  To me, it would take an advanced stage of the disease to fail the clock drawing test - unless you were never good at drawing.  And, it depends where you start.  I started out being very, very good at manipulating shapes - I took the Naval officer's screening test (standardized, more mathematical than SAT or whatever) & told I got the highest score of any woman who ever took it at that location (Norfolk - BIG navy city).  I had asthma so I could not be accepted ... & maybe 2 months later, got a call, that they would waive the asthma problem and accept me anyway).   Long story short, I got just above average for my age & level of education on that - which was a way steeper decline than a normal person.  I had to draw a graph to explain to my PCP that my result was NOT normal.  (I can still draw a graph.  I used to be able to do advanced calculus and advanced differential equations).  The tests are laughable and very harmful, IMO.  They give not-so-well-educated physicians reason to "reassure" the patient and write off patient's perceived deficits as psychosomatic.  That delays help / support for - 5 years, in my own situation.   I had to turn over the results of my test in my mind for a long time, and get some insight from another old friend of mine who is a physician practicing 40 or so years, to figure out that my feelings that the test was wrong and my doctors stupid (my vocabulary is getting worse, but I'd probably use that word anyway).  I finally wrote a letter to the neuropsych doc two days ago, taking apart my exam and substituting my own starting point, which was not average for my age / educational level.  I have not gotten a response yet, but I'm sure his face was red and steam blowing out his ears.  These tests are very far from accurate.  One other thing - I forget new processes I have learned, simple ones (work-related), generally a day or more later.  It's like I have never seen them before.  But it takes longer than the 5 or 20 minute gap that you get in a neuropsych test.  Names, faces - I can forget those in a split second.  Name as many animals as you can - that is my lifetime interest and love - animals.  Tell me to name as many of something else as I can... I'd do worse.   Neuropsych assessment - even costs way too much of $ I don't have.  I'm pretty unhappy about it.
CF257
Posted: Saturday, February 3, 2018 11:36 AM
Joined: 2/2/2018
Posts: 24


Oh, one more important thing that is popping in and out of my brain .. while I can hold onto it -  the neuropsych doc threw out my very low scores.  He told me I must have been distracted by a truck horn or such thing.  I argued with him - that was not the case. I was in a central room of a big building and there were no distractions whatsoever.  He still tossed out the low scores, writing that despite them, a truer estimate of my intelligence / ability was slightly above average (based on items such as vocabulary, reading comprehension - those were items that should have been in 99th percentile based on lifetime history.  & I have been in education a long time - those prior test results were not all after high school & before applying for grad school.)   Neuropsych test interpreter throwing out low scores arbitrarily?  Happened to me.  Wonder who else it happened to?
jfkoc
Posted: Saturday, February 3, 2018 3:29 PM
Joined: 12/4/2011
Posts: 21244


OK but I could not count backwards by sevens not could I tell you the name of the building I am in or on some days what day of the week it is (they are very much the same). The season?  Here in OK they really mash back and forth. It could be 75 degrees in Feb (a lot like spring or early fall).

I will accept it as a screen tool but I am not getting 30


julielarson
Posted: Saturday, February 3, 2018 4:34 PM
Joined: 9/30/2015
Posts: 1155


CF257, that is terrible that the doctor did that.. I do not know what he is thinking? Maybe it hit too close to home for him that a person with your education and abilities could be having such troubles as you are having.. Thinking it could be him? I really feel lucky that the care I received through out my odyssey of thinking I had a dementia and actually having ADHD and memory loss due to a benzo medication I was on for a long period of time.. Their over all opinions were either that my medications or my mental conditions were largely to blame for my memory loss.. They were right on with those assessments but I was not buying it until another trip down the benzo path and my memory getting very bad very fast turned on a light blub for me.. Yes they were right about that and so I decided that maybe the first Neurologist was right that I have ADHD and I went to my therapist about it.. He confirmed it for me and here we are today.. I really hope you can find someone who will listen to you and take you seriously. Have you gone to a teaching hospital for diagnosis yet? That is where I would go because they are usually the most advanced in ability to diagnose  and treatment.. I wish you luck and I hope you keep on posting as there is much help here in these walls..
alz+
Posted: Sunday, February 4, 2018 3:39 AM
Joined: 9/12/2013
Posts: 3608


Julie! so good to read your post.

My husband went through a mental decline over 8 months, I watched it get worse, doctors did not seem to recognize anything. He had mood changes and the mistakes were escalating.

He went to new osteopath and had a B12 check, it was very low. I had no idea how common dementia/cognitive changes are from low B12. If he had gone much lower he could have died.

He has been taking sublingual B12 for 2 weeks and our lives are totally different. He is relaxed, he remembers my meds, we even did a clean up in our living room kitchen!

Really glad you are still visiting discussion and adding to it. Missed you as I am not here as often.   


Michael Ellenbogen
Posted: Sunday, February 4, 2018 7:54 AM
Joined: 11/30/2011
Posts: 4460


I have bad news in some of your thinking. I  use to use drafting as part of my job and I could always draw a 3 demential square. Even with my eyes closed. I no longer can and I slowly watched that happen over the course of two years as I was being tested regular as part of a trial. I knew a few folks in the early stage that can not draw a clock. It all has to do with what part of the brain has been impacted. I wish it was as simple on your stage but it is not. 


CF257
Posted: Sunday, February 4, 2018 11:33 AM
Joined: 2/2/2018
Posts: 24


Well, I'll grab the positive anyway - not the polyanna placations of my neuropsych assessor, but if drawing a clock is still easy for me, it makes me feel I have a bit of solid ground.  Other areas where that test showed strengths in are in a downward spiral.  I don't think I'm fine based on the clock.  I do apologize if I was cavalier in saying so.  Still learning, as much as possible.  I have quite a bit of adrenaline with this looming (AZ), and I think I am retaining more .   As a matter of fact, I know I am.  If it is something that I am very interested in, or something I have had a long standing interest and knowledge base in (like animals, veterinary medicine), I retain more of that.   Anyway, I know there are areas I am stronger in, and areas I am weaker in.  I have been a sketcher and drawer for a long time, and doodler in auditorium classes.  I hope that does not go away - when the things I really like and have done, or read about (both actually) are becoming lost to me, well, I consider that will be the end of the line for me.  I sure do appreciate all of the knowledge that is shared here.
CF257
Posted: Sunday, February 4, 2018 11:39 AM
Joined: 2/2/2018
Posts: 24


Hi Julielarson.  Thank you for commenting.  About the university / teaching institution,   that is where I have been for 24 years and where I was stagnating and drifting lost.  My psychiatrist there was the one who was not following me for memory problems, but bless his heart, listened to me and tried to come up with reasons.  He thought maybe B1 could cause my problems b/c deficiency can cause neuro problems,and it is unusual & I had not been tested.  So his idea got me to go out on my own, find an online lab where I could order it myself, I went and found my own hematologist, and that hematologist (community doctor, not teaching) sent me to the neurologist who is finally "on the job" so to speak.  He is also a community physician, not a faculty member at a teaching institution.  So, just being at a teaching institution does not guarantee you are getting cutting edge, comprehensive care.  Good docs can be right up the street from you.