Help With Understanding Cause & Steps For Cognitive Impairment

Hi Everyone.

Just joined this forum to see if I can get some additional insight to our mind bending situation.

My female spouse aged mid 50's has been experiencing severe anxiety, depression, memory issues, cognitive impairment now for 4-5 years. It seems to go up and down as stressors occur. Stress and anxiety started a bit earlier 8 years ago when she became caregiver for elderly parents 7-8 years. After her dad died just ahead of COVID, the rest of the issues seem to be more clear. From there, we had a series of stress events including the COVID itself, pressure with her job, anxiety attack that required emergency room, serious athletic injury to son, a second athletic injury to son, her job loss, my own job loss, different opinions from siblings for her mothers care, failed attempts to re-join the workforce at same level. There is also trauma earlier in life that I believe could be in play since it's very difficult to acknowledge or talk about. Menopause also occurred within last 5-6 years.

Most recently primary Dr referred to local neurology where she scored poorly on MoCA test, which sent her into major depression on top of what she's been dealing with. Because of that, they have hypothesis that it's early onset dementia. It was quick diagnosis with a clinic that we are not happy with. After I had put in effort to make sure they had medical records ahead of the neuro interview, initial testing, the neurologist hadn't reviewed medical history. I'm not convinced they know how the prior history and how it could be tied in to all the struggles. Due to neurologist being out now for 3 months, we were re-assigned NP, who seems to just be picking up notes from previous appointments.

After last neuro in Nov, we took findings to primary Dr who bumped up fluoxetine, suggested more exercise, better diet, eliminate alcohol, thinking some psuedodementia could be in play. She was doing okay to a bit better on this. Then recently we had follow up with new primary (old Dr retired) but previously seen, who was more concerned with MoCA score and wanted follow up with Neuro. That sent mood and anxiety into tail spin. All they did is test again (similar results), suggest memory med, and another follow up in 3 months. We've also since been to occupational therapy intake and have another action item to find CBT / talk therapy, which has been really difficult to pick out. I'll add that in-between an MRI has come back clear.

I'm in the process of picking up all of this and moving to dedicated center where we can have team of specialists handle. A request is in for Mayo and I also have reached out to Health Partners mental health center.

If you made it this far, thank you. I'm putting this out here to see if anyone may have experience with anything similar. This has been a mind bending journey so far. There have been many Dr visits over the last 4-5 years and it feels as if we just don't have a grasp or solid ground on what is going on.