Mild cognitive impairment: What questions to ask the neurologist?

The comments about neuropsychological evaluations remind me (and I need reminding!) that I've had 2. I've noted my fondness for the profession's use of "mild cognitive impairment," but my firt encounter with a neurological euphemism was when I got my first neuropsychological report, which said I was "borderline" in 2 or 3 things. My wife expressed her sympathy. I laughed and told her every scale has 2 borders and, until they tell me otherwise, I'm assuming they mean that I'm borderline superior!!! We had a good laugh--and laughter counts for a lot among us MCIs!

I suffered a mysterious neurological collapse 2 1/2 yrs ago. No one, even at the Mayo, can tell my what caused it. That's ok. I've practiced resilience--i.e., resourcefulness and optimism--coupled with a dash of resignation (when circumstances call for same). My cognition is a mixed bag. I can't sequence for the life of me, and I can't be distracted while concentrating, even while cooking a familiar recipe. Oddly, my reading comprehension is triple what it was before the collapse, but, try as I might, I can never answer many of the questions after the evaluator reads me a simple story.

My advice isn't much different from what's stated above. Eat right. Support your brain. Feed your neuroprocessors. Learn about agonists and antagonists re receptors and what foods may serve as either. Rest is impt, not just at night but during the day, and not just naps, but easing off the mental accelerator when you don't need to be conceptual processing. Exercise is very important, but it's a central nervous system (CNS) stressor too. I cycle 500 mi/month. After a hard workout, I might be mentally flat for an hr or two, but, over the long haul, the strenuous activity promotes cognition. Other CNS stressors are alcohol (I gave it up) and heat, about which I could write 20 pp, as I continue to cycle in N FL, which is very hot in the summer, but a little less frequently, a little slower, and a little less duration.

And what about brain exercise? I did heavy conceptual processing for 50 yrs, up to my retirement due to my neuro collapse. For at least a yr thereafter, I was incapable of any conceptual processing, but I resorted to sensory processing, just to keep the brain engaged. Jill Bolt Taylor describes this process in her book My Stroke of Insight. She was 37 when she had a stroke, and, despite her newly discovered passion for sensory processing, she had no choice but to rehab her conceptual processing (and did!). I was 70 and elected to "go native," staying with sensory processing. What's that? Cycling on the road and thru the woods, hugging my 4 Rhodesian Ridgebacks and watching them communicate by body language, cooking, heavy yardwork, and more.

While pursuing sensory processing, I read several books about neurology, in addition to Taylor's. Two covered the hemispheres of the brain, emphasizing the right hemisphere, which fit right in with my new emphasis on sensory processing. Julian Jaynes, The Origin of Consciousness and the Breakdown of the Bicameral Mind and Iain McGilchrist, The Master and the Emissary.

Lastly, tend to your parasympathetic nervous system, the rest-and-relax response. I did and doing so reinforced everything I've been doing to support my cognition.

It's been quite an adventure and I've enjoyed nearly every minute of it.

Yes, I just found one with University of California which is close to me and I have one doctor there also. I will ask tomorrow about this and also neuropsychologist which also sounds great.

@sb4ca this is good news that you found a memory clinic at a UC near you. Will you please return and let me know what your doctor says about this tomorrow?

I will thanks. I also acquired a viral ocular infection that is now causing motor dysfunction in my eye I believe So I need to ask him about that too. I may need another appointment to cover everything because each one is so important. In researching herpes eye infection or aseptic meningitis I found these can create white matter lesions as well. Have you ever heard of that? This time I’m having a recurrence but it’s way worse than before

sb4ca @sb4ca
I was part of a research study at Mayo about aging / cognitive / etc.. , because it was research and nothing abnormal was discovered, I was not given any definite results. I did have an brain MRI and showed some white matter.

I assume mine was all part of normal aging process. I saw a neurologist for a different problem, and she said it was nothing to be concerned about.

One thing, is you now have a base line, so if tested again in future, you will know if anything changes.

I walked away from cognitive test thinking I was losing it, lot of stress / anxiety / frustration about not being able to do what I thought I should be able to do. Then talked to other people who had similar test, both older and younger than me, and everyone had same frustrations, and to my knowledge, they had no serious cognitive disease.

As far as questions for provider, if it was me I would be asking about:
- Is this just aging or is something else going on?
- Any additional testing required?
- How do I prevent any additional cognitive decline?
- Suggestion for programs that help with coping skills?

I know for me, two coping skills I have are:
- Stop trying to multi-task, that is hard, when younger always juggled multiple things
- I write everything down into my computer, I do not rely on my memory. I am a retired computer project manager, so I am use to documenting everything, but now I do it as a backup to my memory. Lot of technology available, but I use an online app that can access via computer or smart phone. I keep lists, calendar, notes, to do's, etc. The most important thing is I can go back and search documents so if forget something, I have backup to check.

Laurie, age 67

When I go to the doctor with an ailment, I ask all the questions that I can think of. Then, my last question is: What questions should I have asked? This particular question is the best one I can ask, in terms of learning the most from the doctor. Also, before I go to my appointment I look up my condition in Mayo Clinic and learn all I can there. That often leads to questions I have. Lastly, if you google your condition it will lead you to commonly asked questions and their answers. I write all my questions down on paper and display the paper so that the doctor knows I have questions. By the way, Mayo Clinic has a program for people with MCI and their partners. Best of luck to you and please let us know how you are doing.

How can I join

Is this impacted at all by anxiety or by white coat syndrome?

Probably going to have to go through your neurologist with an MCI exam. I don’t know for sure (don’t remember the process) .

Hi Tallyguy,
This helps a bunch! MCI and a lifetimer sentence of ADD really makes this life challenging to say the least but I know these are the keys. I have gotten so much out of this post entry just wanted to say Thanks!! Will look for more in the future. First time reading this section of categories. It’s a good morning for sure.