Mild cognitive impairment: What questions to ask the neurologist?

Posted by sb4ca @sb4ca, Jul 8, 2023

I have been having increased problems with word retrieval, forgetting the subject in the middle of a discussion, not knowing how to spell words that I've always spelled in the past, missing important meetings etc. My neurologist had me take a cognition test and did an MRI. Both showed mild cognitive impairment. I really don't know how this advances or how rapidly. My meeting is tomorrow. Does anyone have suggestions on what I should ask?

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I have just been diagnosed with early stage Alzheimer Disease. I am feeling quite overwhelmed. Dr. says next steps would be infusions of Leqembi to help slow it down. My plan is to stay strong with God's help and make wise choices about diet, exercise and activities. My biggest worry is how hard this will be on my family. Let me know how you are handling all the challenges of living with Alzheimers. Thanks. MissPatty

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@misspatty

I have just been diagnosed with early stage Alzheimer Disease. I am feeling quite overwhelmed. Dr. says next steps would be infusions of Leqembi to help slow it down. My plan is to stay strong with God's help and make wise choices about diet, exercise and activities. My biggest worry is how hard this will be on my family. Let me know how you are handling all the challenges of living with Alzheimers. Thanks. MissPatty

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Gracious you surely are articulate for someone on the continuum.

I’m not sure everyone’s diagnostic path is similar but I’ve had head MRI which was age appropriate other than mild chronic small vessel ischemia in white matter.
I had a ton of bloodwork - none of which was remarkable. I did have the ATN Profile which said … Reduced Beta Amyloid 42/40 ratio, elevated p-Tau-181, has been associated with presence of Alzheimer's Disease pathology. and I had one copy of APOE 3/4
Gene.
I also had 2+ hours of neuropsychiatric testing. And Thursday I get the readout on that.
So we will see. Does that work up have similar Components to your diagnostic process?

How are you feeling about it?

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Thanks so much for your reply. I was referred to a neurologist by my Primary Doc because of a short amnesia event and moments of "lost" words or names that I know, but my mind just sort of paused. Also I have felt off - just not able to concentrate very well and distracted easily. The neuro clinic gave me a memory test that I did pretty well on. I had an MRI which showed nothing at all abnormal. They suggested I get the bloodwork P181 to see if I had the biomarkers associated with Alzheimer's. The bloodwork showed my numbers were High. They said I am in the early stages of Alzheimer's progression. Now I am having a PET scan this week to help confirm this diagnosis. Honestly, I have a million questions and concerns about starting the infusions. The list of adverse effects is long and scary. I'm being very consistent about exercise, very healthy diet, social life, and activities that exercise my brain. I have faith in God and know He and my family and friends will walk with me through this. But it's scary, isn't it? I hope you have a wonder support group that will be there for you. Please let me know how you are doing as you go to next steps. Blessings.

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@misspatty

Thanks so much for your reply. I was referred to a neurologist by my Primary Doc because of a short amnesia event and moments of "lost" words or names that I know, but my mind just sort of paused. Also I have felt off - just not able to concentrate very well and distracted easily. The neuro clinic gave me a memory test that I did pretty well on. I had an MRI which showed nothing at all abnormal. They suggested I get the bloodwork P181 to see if I had the biomarkers associated with Alzheimer's. The bloodwork showed my numbers were High. They said I am in the early stages of Alzheimer's progression. Now I am having a PET scan this week to help confirm this diagnosis. Honestly, I have a million questions and concerns about starting the infusions. The list of adverse effects is long and scary. I'm being very consistent about exercise, very healthy diet, social life, and activities that exercise my brain. I have faith in God and know He and my family and friends will walk with me through this. But it's scary, isn't it? I hope you have a wonder support group that will be there for you. Please let me know how you are doing as you go to next steps. Blessings.

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Same to you. My biggest observation is word retrieval. It’s pretty bad. And I noticed when they showed me a page with two shapes on it, and then asked me to draw them, I got the first but rarely remembered the second. So. It’s here.
I also have the high Tau181. I see neurologist on the 11th.

I’ve been planning for this likelihood for a long time. There is extensive family history so it’s no surprise. Time to start executing the early phase of the plan.

Let’s stay in touch.
Pam

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Pam, you are in my prayers. Please let's keep our conversations going. The night I was saying my prayers for my grandchildren and got stuck after the first 4 names.....that was hard to handle. Now I think about how soon I will need to stop some of my favorite activities. If you lived near me, we could take walks together and get some good fresh air. Now I worry about going for a long walk and forgetting how to get back home. It's a whole new way of thinking. And there will be a whole lot of letting go, too. It takes courage to face this future that you and I have coming. You are being very wise and courageous. Most of my friends are very supportive. Others are now very awkward around me. I guess they don't know what to say. God bless you. Patty

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@misspatty

Pam, you are in my prayers. Please let's keep our conversations going. The night I was saying my prayers for my grandchildren and got stuck after the first 4 names.....that was hard to handle. Now I think about how soon I will need to stop some of my favorite activities. If you lived near me, we could take walks together and get some good fresh air. Now I worry about going for a long walk and forgetting how to get back home. It's a whole new way of thinking. And there will be a whole lot of letting go, too. It takes courage to face this future that you and I have coming. You are being very wise and courageous. Most of my friends are very supportive. Others are now very awkward around me. I guess they don't know what to say. God bless you. Patty

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And you my friend. By the way I’m in the Greensboro NC area.
Pam

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When I see my neurologist on a couple of weeks, I’d like to understand whether there are milestones of sorts. Example: if you can’t find your keys, that’s frustrating. If you don’t know what the keys are for, that’s - in my mind - a milestone. What resources are available to my children to understand what’s helpful and what’s a waste of time.

I’m fortunate that I have a good friend who is a hospice nurse and she will help my children with that piece.

And what do I need to ask that I’m not.

As I said, I have a detailed plan

But we can chat another time about that.

Have a good evening.

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@misspatty

I have just been diagnosed with early stage Alzheimer Disease. I am feeling quite overwhelmed. Dr. says next steps would be infusions of Leqembi to help slow it down. My plan is to stay strong with God's help and make wise choices about diet, exercise and activities. My biggest worry is how hard this will be on my family. Let me know how you are handling all the challenges of living with Alzheimers. Thanks. MissPatty

Jump to this post

@misspatty ME TOO!
I was diagnosed last month with Alzheimer’s Dementia. I’m waiting for the approval from Medicare for the Leqembi.
My feelings are the same, exactly the same as yours with regard towards the family and relying on God.

I live alone and I cherish it because I can do whatever I want whenever I want. I dread having to move, but I know I have a lot of time left before anything like that needs to happen.

I notice lifelong personality traits are changing. It’s the “Executive Function”, the organization that is frustrating me.

Well, I will rely on God to get both myself and my family through this difficult time with grace.

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@pb50

When I see my neurologist on a couple of weeks, I’d like to understand whether there are milestones of sorts. Example: if you can’t find your keys, that’s frustrating. If you don’t know what the keys are for, that’s - in my mind - a milestone. What resources are available to my children to understand what’s helpful and what’s a waste of time.

I’m fortunate that I have a good friend who is a hospice nurse and she will help my children with that piece.

And what do I need to ask that I’m not.

As I said, I have a detailed plan

But we can chat another time about that.

Have a good evening.

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@pb50
Hello, I was just checking these “boards” and saw these posts.

Almost 3 years ago I made a comment to my PCP about something not being right in my thinking, mental acuity etc. He sent me to a Neurologist who did a few tests; MRI, EEG, Neuropsychiatric Test.
The diagnosis was Mild Cognitive Impairment.

If you read my other post from tonight, you will see that I now have progressed to Alzheimer’s Dementia.

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