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My 97 yo mum experienced a couple significant falls in April of this year. She was sent to rehab and diagnosed with moderate dementia (which surprised me - but if I think back, there may have been subtle signs). About a month later, she was reevaluated with the same score. She's been in rehab this whole time with daily PT and limited visitation from family due to Covid. I live on the other side of the country so depend on my family for whatever information they can gather and pass along to me as well as weekly calls to the facility with scant info. Yesterday, they reevaluated her and said her score jumped 3 points for the better. She is also improving quite a bit with her mobility. She was at first non weight bearing for the first couple months. Now she is walking 150 steps with help. So...I'm wondering if her overall well being is improving which can improve the cognitive state or...am I just hoping against hope?

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My dads dementia was always worse after a medical incident.

It is such a confusing disease because there is so much fluctuation in symptoms from day to day, hour to hour and definitely incident to incident.
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seaweede Aug 2021
It's tough! Especially when you're not prepared for it. I feel so bad for her and I want to "fix" it all for her when she'll say something off. Sigh... Thanks for the info!
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3 points out of 30? 3 points out of 15? 3 points out of 100?

Any test that measures cognitive skills has a "confidence interval". So, on a standard intelligence test (with an average score of 100 and a standard deviation of 15--which means that a difference of 15 points is significant) you can generally be 95% confident that the " true" score lies in a range of +/- 7 points.

You need to ask the person who is doing the testing if 3 points on this instrument is statistically significant or if it is within the band of error.

This is from a paper on that subject:

"Conclusion: An individual's score would have to change by greater than or equal to 3 points on the MMSE and 4 points on the MoCA for the rater to be confident that the change was not due to measurement error. This has important implications for epidemiologists and clinicians in dementia screening and diagnosis."
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seaweede Aug 2021
Thank you so much for this great info!
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In my opinion, if she was tested right after falls (and a hospitalization, I assume), that wouldn't really give an accurate result as to dementia. Medical crises always make older people go a little bonkers, and they don't necessarily bounce back quickly. I wouldn't do a dementia test for at least a couple of months after an event like that, because I think she would score badly at first then score higher later.
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seaweede Aug 2021
That's exactly when the first tested her and I as a bit shocked with the results since I had never seen her indicate that degree of decline as they were telling me. Thanks for the good "thinks"!
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To be 97 and to have moderate dementia is pretty darn good. I think that just about everyone who lives long enough will end up with it. I think it's reasonable that her score could improve. I imagine if they tested regularly, it would fluctuate. People have good moments, bad moments and seem great in one convo and out there in the next.

That's great that she improved. And on the PT and mobility side, that's also great. The more active she can be, the better.
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seaweede Aug 2021
She's English so I'm pretty sure it's all the tea she's drank her entire life! (LOL) She's doing pretty good for her age and I'm always so surprised when something "off" is thrown at me about her. She's really improving and that makes me so happy. :)
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Just my opinion. A person with Dementia that has been isolated, lets say by being in the hospital I think you would see some decline. Now take that person and put them in rehab where they have some interaction with other people, some therapy, eating and drinking regularly and getting meds on time I could see them getting better because the mind is getting some stimulation. But, they will always have Dementia. And there will always be some declining. With my Mom the decline was monthly. Others it may be longer between stages.
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Many factors contribute to her "scores". Nutritional status, hydration, infections, oxygenation... If some of these were a problem before rehab and were "fixed" in rehab, her scores will improve.
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seaweede Aug 2021
That may be exactly what's happening. She was living independently before and in no way the best "nutritionist" :)
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That's great that your mom's mobility has improved. Although there is no cure for dementia it's progression can be slowed down. My mom is 93 and also has dementia. Her mobility was much better before Covid but she does do chair exercises and now uses a walker. Encourage your mom to walk as much as she is able. Mental and social stimulation are important too. If she is in a nursing/ retirement home get her to socialize and interact with the other residents. My mom and I play Rummy 500 and she likes to do crosswords. Another thing your mom might enjoy is a radio that's programmed with her favorite music. There are senior friendly radios that don't have a lot of hard to use features. My mother can no longer remember the date or day of the week. Check out Walmart on line. They have a clock that shows the date, day of the week, the time and AM/PM on it. It is in large letters so it's easy to read. My mother loves it and it's saved my sanity - she no longer asks me over and over what day it is! Best of luck to you and your mom! I hope you found these suggestions helpful.
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Helenn Aug 2021
If your mom is ninety something and plays rummy and does crosswords
it’s a very very mild type dementia of the very seniors… mild slowly progressive not at all like the ones
people in their 70’s 80’s and younger ! I wouldn’t worry about someone with that advanced age and that style of dementia!!!
count your blessings !!!
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seaweede: Imho, for all intents and purposes, the tests given to your mother may vary for a variety of reasons, e.g. nutrition, prior lack of mobility, age, et al.
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Thank you so much and yes, I'm very proud of her! :)
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