Daily self assessment for brain fog?

That's a great question, @buzzbuzz. I went on an internet hunt and this is what I found.

The Montreal cognitive assessment is a validated tool used by health professionals to assess cognitive impairment. It appears that it is used by some professionals to assess for post Covid patients although it may not be validated yet.

- Screening for brain fog: Is the Montreal cognitive assessment an effective screening tool for neurocognitive complaints post-COVID-19? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9359801/

You can read more about this assessment tool and download an at-home versio here:
- Montreal Cognitive Assessment Test (MoCA) https://www.dementiacarecentral.com/montreal-cognitive-assessment-test/

I think you might also find logging symptoms in a daily journal to be helpful for talk with docs. Devise a simple yet consistent system that makes identifying patterns easy. Perhaps a grading system from 1 to 3, 1 = feeling good, close to normal and 3 = bad, can't think straight. Or however you define your brain fog. Then note possible triggers like time of day, quality of sleep, exersion or activities, etc.

Does that sound like it might work?

I keep a daily log of my symptoms and bring it with me to appointments. I can look back and see if I overdid myself a couple days ago and compare to symptoms today. I made an excel chart and filled in which symptoms I had and can look over the month and look for trends.(I am a bit OCD!) I look at worsening breathing, fast heart rate, Exhaustion/, Post exertional Malaise, Headache, sensitivity to light & sound, Muscle Pain, Sleep Disturbance, Chills, Balance, Sweating, Memory/Recall, Brain Fog/Concentration, Word Finding, Spelling, Nausea, Appetite Loss, ringing in the ears, days I've had to cancel plans because I was too exhausted, working beyond my 2-3 hour limits for each cognitive and physical activity per day
My best personal test is Sudoku. Every morning I do a puzzle from the same degree of difficulty (from Sudoku Deluxe app). If I cant solve it, I know I am not tracking well that day-abstract thoughts, patterns, number recognition. I know I shouldn't be doing critical thinking tasks that day like financial/legal decisions.

Hi Colleen, thanks but unfortunately the dementia assessment doesn't lend itself to a daily assessment for a number of reasons: questions refer to your experience over a period of time (we want an assessment that covers 24 hours or less, but ideally an hour), repeat testing lets you game the system/train to give the right answer, etc. I have run into many tests like this with the same challenges, and am looking for something that doctors would understand but would assess for example rapid brain function as a proxy for characteristics of brain fog (not being able to find the word) but are assessed quantitatively not qualitatively. It could be something as how fast does it take for you to solve a puzzle and the puzzle changes every day. In the quantified self movement days in the Bay Area 20 years ago one guy had used a very simple tracker that was how fast did you click on a dot that you saw, and because the computer was able to measure the response times so finely, he was able to see patterns of change in his response time (which he eventually tied to diet). Anything like that? Thanks!

Hi, I’m 11 months PASC / long covid. I have found Amantadine 100mg twice daily to have reduced fatigue and brain fog symptoms subjectively. This old anti-viral drug has been repurposed and used long term in Parkinson’s Dx, MS, and Traumatic brain Injury for these symptoms with success. I provided the research papers and my primary doc agreed to a one month trial. I’m 3 weeks in. Need to have kidney function monitored and report improvement to continue.

I also do Sudoku as a test of my brain function. I complete the daily puzzle slower, enter the wrong number into a cell (not the number I repeat in my brain), or count on my fingers.

I use to do Word Search, Jigsaw Puzzles, and other brain function games each morning prior to Covid. I would see how fast I could complete each game.

Post Covid, I have dropped down to 2 games, because I began having high anxiety just trying to do the games. I noticed my brain was not operating like it use to.

It is so interesting that I can feel ‘normal’ and then find out I can’t do a puzzle I don’t know when I am not thing straight. I get so aggravated and full of doubt throughout the rest of the day because I don’t know what I am missing.

I have to keep looking at the things I can still do, or think I can still do. Otherwise my depression and anxiety will overcome me.

I had to start writing down things I would like to get done. Then break them into smaller steps so I can tackle them slowly.

@buzzbuzz, I remember the quantified-self days. Dealing with post-COVID will likely see a resurgence of this behaviour as people find “hacks” or health solutions with doctors who are willing to partner with patients who carefully track their symptoms, triggers and improvements.

I had my neurologist set me up for a neuropsychological evaluation- testing memory, logic, processing, everything. I was very useful and took about seven hours. Tests listed on my chart include-

ASSESSMENT PROCEDURES ADMINISTERED BY TECHNICIAN: Performance Validity Tests (PVTs); Test of Premorbid Functioning (TOPF); Wechsler Abbreviated Scale of Intelligence-2nd Ed. (WASI-II); Lateral Dominance Exam; Grip Strength; Grooved Pegboard; Boston Naming Test-2nd Ed. (BNT); Auditory Naming Test; Visual Naming Test; Verbal Fluency Tests (Letter/Semantic); Rey Complex Figure Test (RCFT; copy trial); Rey Auditory Verbal Learning Test (RAVLT); California Verbal Learning Test-3rd Ed. (CVLT-3; Brief Form); Wechsler Memory Scale-4th Ed. (WMS-IV; select subtests); Brief Visuospatial Memory Test-Revised (BVMT-R); Wechsler Memory Scale-3rd Ed. (WMS-III; select subtests); Wechsler Adult Intelligence Scale-4th Ed. (WAIS-IV; select subtests); Stroop Color and Word Test; Trail Making Test; Wisconsin Card Sorting Test (WCST); Short Assessment of Health Literacy-English (SAHL-E); Numeracy Understanding in Medicine-Short Form (NUMI-SF); Instrumental Activities of Daily Living Questionnaire (IADL); Adverse Childhood Experiences Checklist (ACEs); Childhood Trauma Questionnaire (CTQ); Perceived Stress Scale (PSS); Beck Depression Inventory-2nd Ed. (BDI-II); Beck Anxiety Inventory (BAI); PTSD Checklist for DSM-5 (PCL-5); Epworth Sleepiness Scale (ESS); Pittsburgh Sleep Quality Index (PSQI); Patient Health Questionnaire-9 (PHQ-9); General Anxiety Disorder-7 (GAD-7); Brief Fatigue Inventory (BFI); Neurobehavioral Symptom Inventory (NSI); Health Anxiety Inventory (HAI; Short Form); Liverpool Adverse Events Profile (LAEP); Quality of Life in Epilepsy-89 item version (QOLIE-89);

Exactly. The 'to do' list is unachievable. I use a small post-it with enough space to write 2 tasks down and use that for direction for my day. Then, of course, I loose track of the post-it! I stick it to the back door to remember what to take with me as I leave the house, then on the car dash to know what errands I am doing, or flagging it off the edge of the laptop screen-kitchen cabinet. A bright color catches my attention. Otherwise, I set alarms on my phone as reminders of what to do today.