My husband had an appointment at Cleveland Clinic yesterday

We saw a neurologist, but not the neuropsychologist. Have they done an MRI? Ruled out anything unusual looking on MRI? A mini psych eval? Do they or the PC believe it’s vascular or Alz? I ask because meds really helped my dad. The behavior is really the most challenging part, imo. The repeating, obsessing, fixations, etc, can really be exasperating. Try to get support so you can take breaks and recharge your energy.

I woke up in the middle of the night once last year to find my husband in the kitchen staring off into space. After some probing he finally admitted that he was convinced I was going to leave him when I left for an upcoming hiking trip with my sister. I sat up with him all night until he was finally calm. He went back to bed, I went to work. When I got home, I asked him if he wanted to know where we had decided to go on our hike (trying to include him so he would feel less anxious). He said “who’s going with you on this hike?” I was shocked considering the conversation we’d been up all night having. So I asked if he was serious and he said “yeah. I’m not a mind reader”. He had forgotten everything about the hike, our conversation etc. He’s had a few minor instances like this but that one was the worst. For the most part, he’s stable with some daily confusion. But that scared me 😕. He has an annual MRI so we can see if there is any progression. Has your husband had an MRI?

My husband had an MRI in 2016 that showed mild bran atrophy “normal aging”. That was done when he seemed to be forgetful and a little off at times. His next MRI in 2022 showed ischemic changes in the small vessels of the brain- not in those words- he was diagnosed with MCI early 2023 after Mini Mental or MOCA. He has never sat through the 3 hour neuropsych evaluation but we have 2 neuropsychologists who meet with him and me regularly. We know he lacks executive functioning, spatial recognition, and the concept of dates and times are gone. He functions well enough with 24/7 guidance.
I had thought of going to Mayo or Cleveland clinic but what will that serve?
We are doing our best. I think it’s mixed dementia- vascular and possibly toxic due to years as a dentist treating with mercury fillings.
Regardless it’s getting worse but I am learning to let go more and enjoy what moments we have …

I might discuss medications that help slow symptoms in case it is Alz. It brings significant improvement with some people. These meds are generally approved for Alz, but some think they help with Vascular too.

With all those tests, I’d wonder why the diagnosis isn’t more specific. My cousin’s PC diagnosed her based on office visit , medical history and MMSE eval. It takes about 15 minutes. She referred her to a neurologist who confirmed after office visit and MRI. Multiple mini strokes were apparent.

I wish you all the best with this. It’s quite an ordeal.

I am curious about meds given for early Alzheimer's. Comments?

Thanks. He has had a Brain MRI. Ultrasound for the Carotid arteries. Sleep study.
We started all of this last November with a neurologist.
The appointment with the neuropsychologist was final test before the neurologist gathered all of the test results.
Unfortunately, my husband's anxiety level has accelerated with these appointments.

I believe He needs to be on anxiety meds, His primary care doctor doesn't want to prescribe them.
He told me to reach out to the Neurologist. Round and round we go.
It is exhausting

I'm lucky to have support from my sisters. I'm one of five girls. My dear husband and myself of 47 years were not able to have children. I have an awesome tribe to keep me grounded.

This sounds outrageous to me. Why are they not treating him for his symptoms? Wow….I’ve been active with the online dementia care community for years. I’ve never known of anyone who had dementia to not be on meds for anxiety. The reason is due to them being quite anxious about their condition and the changes they are experiencing. Most primary doctors treat patients who have dementia as do neurologist diagnose them.

Also, meds for Alz are particularly helpful for early and moderate stage dementia according to my dad’s doctor.

I might inquire if they have experience with diagnosing and treating conditions that cause dementia and if not locate a second opinion. Best wishes with getting some answers.

Thanks for your response!! I am Momma bear after this last appointment
I was relying on the medical community. It's in my court now. One thing about me. Not afraid to ask questions. My husband's care is my #1 priority