Dementia Distress - A Watchface Worrywart

Every time I forget something I ask myself, “Is this the first sign of dementia? “

I’m not the only senior with that fear. At a recent concert, the performer claimed to have a photographic memory, “But I can’t get the film developed anymore.”  We all laughed, nodding in agreement, because we’ve felt that way at times.

I worry when I forget

We’ve all had times when we forget something. Experts say it’s natural for older people to experience some memory loss. Older brains are like overstuffed closets. Finding anything is a challenge. But you still worry.

Nowadays when you go for a physical exam, at many doctor’s offices the receptionist hands you the Mini-Mental State Exam (MMSE) with a few questions and an image to draw. The test supposedly spots dementia. I was talking about the test to hubby and my friends and they denied ever taking the test. Did I look like the poster child for forgetfulness, or were my friends just pulling my leg?

I’m skeptical about the test’s ability to detect dementia. One question has you draw the time on a clock. I worry that I’m doing it right. I always have test anxiety. What if my circle looks like an oval? Should I use a quarter to make a good circle? Is that cheating? What if my lines are squiggly?  When it asks me to draw in the hands for 11 o'clock, I just draw the hands.   I was reading that they expect you to fill in the numbers 1-12.  Did I flunk the clock test because I didn’t put in the numbers? 

Geeze - in comparison my clock drawing looks like Dali's Melting Clock

All my clocks are digital, so I have to dip back into my memory for what a clock face looks like.  Would I be cheating if I changed my watch face from digital to analog and copied it? My watch is square. If I draw a square clock will I flunk?

Another part of the test has you redraw a geometric pattern. I’m a bit suspicious that not being able to redraw a geometric pattern predicts dementia. In my mind, being able to draw a geometric shape has more to do with drawing and spatial skills, which some people never had in abundance. Hubby says, “I couldn’t draw a geometric shape when I was 20.”

I’m good at drawing and spatial relationships, still the test stresses me out. When I redraw the figure, did I get it the right size? Did I get the angles on the shape right? Does it matter how thick the lines are? What if I make a mistake on a line and want to redraw it?  What if my line is squiggley? Do they subtract points? Maybe I should take a straight edge to the doctor next time I go so I my lines will be neat, if I remember. 

I see a million things wrong with my drawing - and I'm not bad

Are they timing the test? Have all my worries made me go beyond the normal time to take the test?

Does worrying about the precision of my drawings make me an OCD candidate? I’m not worried about that. If you peeked into my apartment, with its chaotic closets, and unruly drawers, and saw my jagged, unfiled fingernails, you'd quickly declare, "Definitely not!"

After all my stress over the MMSE, the medical tech slips the blood pressure cuff over my arm. It’s sky high. Yikes!  Why do they take a blood pressure test after scaring you to death?

Another thing – you take the test and no one ever tells you your results. Can I assume no news is good news?  The doctors go through your blood panel results in detail, but never discuss your score, if there is one, on the MMSE (There is a score. See references).

And if they tell me the score, what does it mean? Assume I score an 80%, a B-. Does that mean my memory is diminishing? Can I study to make sure I get a better grade next time?

The results of your MMSE?

The person is supposed to rate you: Alert, Drowsy, Stupor, Coma.  Would they actually try to give the test to someone in a stupor or coma?  If so, I’d question the mental state of the test giver.

Experts say that exercise, eating a healthy diet, and drinking less alcohol help stave off dementia.  How much exercise is enough? If I skip exercise this week, how many brain cells will wither away? If I eat my favorite Italian Lemon Cake for dessert instead of a fruit cup, am I sentencing some neurons to doom?  (By the way, Dr. Google says alcohol in normal amounts does not kill brain cells).

All kidding aside, it’s scary facing the idea of dementia when you live in a senior community and see dementia around you.  While my memory still seems to be intact, every memory lapse causes me a mini-panic.

Do I worry too much? Hubby says yes, Does worry cause dementia? I hope not.

But chronic stress can. Since the test stresses me out, maybe I just stop going to the doctor or find a doctor who doesn’t give the test.  Is ignorance bliss?

Epilogue

While I joke about dementia, it can be a serious issue for seniors. I have several friends whose spouses have dementia and several friends who have died from dementia. Hubby’s and my mother had vascular dementia. Dementia comes in many forms. The three major forms are Alzheimer's (the most common), vascular dementia (caused by a stroke, mini-strokes, a loss of blood flow to the brain, or kidney disease), and Lewy Body disease (which Robin Williams died of, caused by a build-up of a protein called alpha-synuclein that forms clumps called Lewy bodies.

The Mini Mental State Examination (MMSE) - description and example of one of the versions.

A fun sideline - video of our cat watching a corn snake outside our neighbor's balcony screen: Casey watches a Corn Snake

References

Here are some of the books I read in trying to understand the experiences of someone with dementia and their caregivers.

1. Faith, Sally, I'm Losing My Memory; I'm NOT Losing My Mind: A Frank Perspective about Living with Early Dementia,  Stonebrook Pub., July 14, 2022.

2. Kozol, Jonathon, The Theft of Memory, Losing My Father One Day at a Time, Crown Publishers, 2012.