I've talked a lot about my dad's health over the past few weeks, which has triggered hundreds of e-mails from my readers. So today, I want to share some details of my own health journey...
Recently, I came across these two articles: The 5-Day Brain Health Challenge from the New York Times and 8 things to do this year to lower dementia risk and protect your brain from the Washington Post. They reminded me of my concerns about dementia and how I addressed them last fall.
You see, I have a history of dementia on both sides of my family. My grandmother on one side and my uncle on the other side deteriorated to the point where they couldn't even recognize their own children. It was heartbreaking and terrifying to see.
Dementia is the main health issue I'm concerned about long term, so I try to eat well, exercise a lot, and get eight hours of sleep every night.
I'll admit to being a little paranoid about it... Every day I can't remember something, and it makes me worry.
Last month, I couldn't remember Mike Pence's name! But I knew it started with an "M" and could remember everything about him and picture him in my mind. After a half hour of thinking and becoming increasingly frustrated, I gave up and had to google it.
My memory was the catalyst for reaching out to my primary care physician at Mount Sinai. He referred me to the department of neuropsychology, where I went in for a two-and-a-half-hour appointment in November.
Testing
The first half hour was an interview about why I was there, my family's and my medical history, etc. Then I sat with a PhD clinical neuropsychology fellow named Leah, who put me through two dozen tests over the next two hours.
Here are the formal names of the tests I was able to remember:
- Animal Naming Test
- Boston Naming Test ("BNT")
- Clock Drawing Test
- Controlled Oral Word Association Test (COWAT – FAS)
- California Verbal Learning Test-III (CVLT-3)
- Mini Mental State Examination ("MMSE")
- Rey Complex Figure Test ("RCFT")
- Trail Making Test (Parts A & B)
- Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV)
- Wechsler Memory Scale, Fourth Edition (WMS-IV), select subtests
- Wisconsin Card Sorting Test ("WCST")
She started by asking me simple things like the date and day of the week. Then she asked me to draw a clock and show the hands for 11:10. She also gave me three words at the beginning of the session (dog, flag, and tree) and asked me to recite them an hour later.
After this, the harder tests started – some verbal, some on paper, and some using an iPad.
She listed three numbers and asked me to repeat them back. Then she listed four, then five, etc. I failed at around eight numbers.
Then I had to repeat a series of numbers backwards, starting with three numbers again and adding more each time (she'd say 7-2-5-9-2, and I'd reply 2-9-5-2-7).
Then again, but I had to put the numbers in ascending order (she'd say 7-2-5-9-2, and I'd reply 2-2-5-7-9).
She asked lots of math questions, such as: "John picked 188 ears of corn in four hours. How many ears did he pick per hour on average?"
I had to assemble various shapes using eight cubes that were solid white, solid red, or half-red, half-white on each side, like this:
She showed me a complex shape and had me draw it on a blank piece of paper. Next, I had to draw the shape from memory. Then, she showed me various shapes and had me say whether these shapes were part of the primary image.
She showed various images in which there was a pattern, and I had to pick the correct missing part of the pattern, like this:
The iPad showed four cards that had three characteristics: a color, a number, and a shape. I had to match a fifth card with one of the four, and I did this over and over again as the cards changed. It's called the Wisconsin Card Sorting Test – here's a sample image:
She showed me an image like the example below, with two symbols on the left. I had to pick which, if any, of the five symbols on the right matched. The correct answer in this example is the fifth symbol:
There were a few exercises where she recited 15 words split into three categories (vegetables, vehicles, and furniture), and I had to recall as many as I could.
She read me two short stories, and I had to recite them back to her with as many details as I could remember.
In 60 seconds, I had to name as many words as possible that started with a particular letter. (This sounds easy, but I had a mental block and only got 41, putting me in the 27th percentile!)
She read me two dozen words of increasing difficulty, which I had to define.
She showed me a piece of paper with two dozen words on it, and I had to pronounce all of them (the last few seemed impossible).
She showed me pictures of various items (broom, bed, scissors, bench) and I had to name them. (Again, they got harder – frustratingly, I needed hints for trellis and protractor.)
Leah was very nice, and I felt I was doing well on most of the tests, so I was having fun. Plus, I've always loved brain teasers.
Results
About two weeks later, Leah called and gave me a verbal evaluation and the opportunity to ask questions. I was also sent a 12-page formal report.
The good news is that I scored very high across the board: I was in the 95th percentile or above for most tests and the 99th percentile for several.
Overall, my Full Scale Intelligence Quotient ("FSIQ") was 148, and my General Ability Index ("GAI") was 153 – both in the 99.9th percentile.
No signs of dementia, which is a relief – and a nice ego boost!
So, was it a waste of time?
Leah said no because it's valuable to have a baseline for my next evaluation. Knowing my baseline, they would be better able to detect a decline.
I don't need to come back for at least five years, unless I have worrisome symptoms. But when I'm next evaluated, even if I had rapidly advancing dementia, I might still test at, say, the 75th percentile, which means they'd normally give me a clean bill of health.
If you want to be tested for dementia at Mount Sinai's neuropsychology department, they accept Medicare, Blue Cross, Cigna, and Aetna – just get a referral from your primary care doctor.
Otherwise, the self-pay cost is $4,200, which Leah tells me is lower than what most private practices charge.
You can contact them at adultneuropsychology@mssm.edu.
Best regards,
Whitney
P.S. I welcome your feedback – send me an e-mail by clicking here.
P.P.S. Thanks no doubt to the best wishes and prayers of hundreds of my readers, my dad is home doing much better and getting stronger every day. It's his 84th birthday today – happy birthday to the greatest dad ever!
