@pamwill1960 Wow, that must have been an unhappy moment for you. If the neurologist dismissed him after a cursory look, I would head back to his primary provider, and with his permission, bring a list of the incidents and observations that are concerning each of you. And keep lovingly reminding him that being macho and not admitting what is happening is not helping him stay healthy for the two of you.

There can be explanations other than dementia for both falls and memory issues - some as simple as very high or low blood sugar, dehydration, hearing loss, an untreated infection (especially UTI's which can be asymptomatic in men) or pneumonia, and other ailments that are more serious but still manageable.

In my husband's case, the problems were not wearing his hearing aids, overmedication (conflicts between meds he takes for several conditions), bad reactions to one med, and a UTI. Once all was in balance, he is much better. And I am now cued in to subtle changes that mean he needs food or water and so is he. And I am much more insistent when I think he needs medical care.

Is there a geriatric practice near you? They are much more holistic in their care, I think. My husband's geriatrician schedules 45 minutes per visit. He is given the standard test(s), usually the Montreal cognitive assessment test (MOCA) and some neurological tests (reflexes, etc). The geriatrician then chats with him ( after chatting with me separately for about 10 minutes. ) This is every 6 months! He also sees a neurologist, but only once a year. I hope you can find a geriatrician easily. They will be the specialist you need.

My husband had been seeing the same neurologist for years for treatment of essential tremors when dementia symptoms began appearing. Eventually, we got an appointment with a neuropsychologist. I don't know if that helped, but at least we have a diagnosis of mild cognitive impairment. The neurologist put him on meds that are not helping in the least. The positive side is that I can see what our future is likely to be and I can try to be grateful for our present. I don't successsed in the grateful department very often.

It was confusing to me for years. My mom seemed perfectly cognitive for weeks or even months at a time, then she would have terrible memory issues, then would return back to normal.

Doctors would make informal comments about her memory but wouldn't document any cognitive deficit until very recently.

My husbands PCP is also a close friend. I think he was in denial until I told him I wanted my SO to see a neuropsychologist. His friend then referred us to a geriatrician who specializes in dementia. That is where we got the diagnosis of MCI in March 2023. We then saw two neuropsychologists for months after. Never saw a neurologist. No medications just a ton of supplements all prescribed by the neuropsychologist.
Along with continued exercise, a Mediterranean Diet that includes meat, socialization, and brain games. We do it all.
When I asked the geriatrician whether he needed to start Aricept or other meds he said- no. Continue whatever you are doing. He knows little about any of the supplements but felt good about what we are doing to keep things from progressing too fast.
Every individual with cognitive impairment has a different brain and body and needs a good doctor to SEE THEM. Some may need helpful meds, but for others meds may not be helpful.
Balanced exercise is the best medicine that all his docs agree on. My husband goes to the gym and walks. But all that may be prolonging life in his body. We need the brain to keep up.
This disease that causes confusion to the patient also is confusing to caregivers and doctors.
In the end all we can do is enjoy the moment.

Thank You for your advice and words of wisdom. He used to go to the gym on a regular basis but has stopped going. We were also taking walks on a nightly basis, but we stopped after I had reconstruction surgery to my nose after MOHS for SSC. The surgery has had complications so I am not myself lately, but hopefully will start again soon!
I am trying to find a neuropsychologist in Massachusetts without having to travel to Boston. Wish me luck!

@pamwill1960 My husband has Early Onset Alzheimer's diagnosed at age 59. We are now beginning the advanced or severe stage at age 63. There is wisdom out there. I am in a closed group specifically for female partners whose loved one has EOAD (aka YOAD aka as Alzheimer's Disease, Presenile Onset). Let me know if that is a specific fit for you and I will help you get connected. There is also Lorenzo's House. Please make sure you have your legal/financial ducks in a row before diagnosis.
Then he would need to have a full neuro-psych work up with psych testing, labs, a lumbar puncture, MRI and Petscan. Diagnosis can take a very long time because they rule out everything else first. Good luck in your journey.