Would you take a test for possible dementia?

[ChezCheese:)]

This is an interesting article in the Guardian. Apparently they're coming up with a test to see if you might be at risk for dementia in the next 15 years. Would you want to know? Or would you rather live in blissful ignorance and not worry yourself into dementia? How would knowing change your approach to life?

Tell us: would you take a test for possible dementia?

A new computerised test claims it will accurately assess a patient’s risk of dementia. Would you take it?

www.theguardian.com

 

[rajron]

I would take the test. It will help me determine what I will do with my last years.
It is awful, the burden of dementia to loved ones. Preparation would help. I myself don’t want to burden those that are close to me.
My mom +96 years hasn’t known me or any of the family for the last five years. It is difficult to say the least.

 

[ChezCheese:)]

My grandfather had Alzheimers in his last 10 years, maybe earlier. My mother wished she had known that was what was going on, but people hide it for a long time, if they can. She was the last person he recognized -- the rest of us he didn't know who we were. So far, Mama is fine, I think. She is 90. Maybe it will skip a generation and land on me...

 

[rich c]

I know I'm at risk because of my mother. I thought I had researched the disease enough, but my world collapsed when even the muscles in her face changed. Add to that the medicine she was on, and she not only lost every memory she ever had in her life, she didn't even look like my Mother. I'll carry that haunting image to my deathbed.

 

[NovaDave]

I would certainly take the test. Forewarned is forearmed as they say. Having the luxury of planning, developing adaptive strategies and seeking remedial help as needed are factors in my decision.

 

[Comfortably Numb]

My current daily experiences are the only tests I need.
Things aren't looking good. CN

 

[Mike_V]

No, because I live in the present and think about the future.
Would you even get up in the morning if you knew what will happen tomorrow ?

 

[fooferdoggie]

well if you flunk it you can take it for the first time tomorrow. that sounds like me.

 

[indianajo]

I passed a dementia test given by Hartford Ins when I tried to get long term care insurance: 2003. The wife refused to talk to the nurse on the phone, so we don't have any. Price goes up age 60, which she turned in 2004.
By count of grandparents, I have 50% chance of dementia after age 88. Two out of four. One reason I work out aerobically so much. Exercise is reportedly negatively correlated with dementia (bbcnews.com). Grandmother declined noticeably when she gave up walking up the hollow (WV) 3 nights a week. Her walking friend died.
Wife only had one aunt with it.

 

[ActionJackson]

All a test may accomplish is to prematurely excite people who may think they’re getting something from you when you die. I like to keep them in suspense. However at my current burn rate they’ll be lucky to get rid of my liabilities before their own deaths.

 

[ChezCheese:)]

That amusing, but if you're completely gaga, you won't care. But if you knew there was a good possibility of becoming cognitively impaired, you could set up your systems and to make it as painless as possible. You don't have to tell your acquisitive heirs either.

That said, I don't know that I would want to know, for fear of the effect it would have - - would I make assumptions that ordinary forgetfulness was Alzheimers and freak out?

 

[tomjasz]

Demetia and aphasia are horrible task masters. A more recent second TIA has screwed the pooch. I need my computer files to fill in the memory gaps. An unpredictable and a frustrating experience. I'm going to stop working support this winter. Getting tested may find some medical help.

 

[Handlebars]

Demetia is the worst.

 

[Catalyzt]

If the assessment were accurate and completely private, I might consider it.

As things stand now, I would not-- and if someone tried to make me submit to such an assessment, I'd hire a lawyer. As a psychotherapist, I have very, very little faith in the reliability of psychological tests.

Unfortunately, neurological and psychological assessment is beset with institutionalized quackery. Some of this results from the inappropriate reliance on randomized clinical trials, which may be the gold standard for medical problems where the endpoint can be accurately measured, but are almost completely useless when you're using self-reporting inventories or answering any kind of a question on a test or assessment instrument.

If your subject is checking answers from a box, guess what? You've introduced a variable you can probably never adequately control for. Maybe you will, probably you won't but you'll never know for sure.

As a species, we just don't know how to assess whether our brains are working properly, which is understandable-- the problem is, we think that we do.

The other problem is, more and more I am hearing about people being diagnosed with Alzheimer's who could not possibly have it. Someone will tell me their mother or grandmother was diagnosed seven years ago, and three years later, they're 86 years old, still driving and taking care of themselves, and only get lost once or twice a year in unfamiliar places and have some occasional trouble with word-finding. That doesn't sound like Alzheimer's to me.

Anecdotally, the best things one can do to avoid dementia: Avoid or abstain from alcohol, don't take any drugs you don't need to take-- particularly SSRIs or antipsychotics-- or smoke anything whatsoever, get regular and serious exercise. If you start becoming really stressed by developmentally normative cognitive decline, just cut back your work load, dump self-blame anywhere you can throw it overboard.

Whatever is making you tremble with stress and rage? It's not worth it.

When my mother's cognitive decline from Parkinson's began to take hold, she ran around the house freaking out trying to find all her files and her keys as she tried to maintain a full case load-- and that's when the dementia got much, much worse. No empirical proof of this, but I've seen variations of this story again and again.

 

[tomjasz]

Yikes! This doesn't match my experiences at all. A definitive result is possible and in some cases there are treatments to alleviate the issues.
As always YMMV. And I respect your personal opinion. But find few facts, just anecdotes. However the anecdote you identify regarding mood altering substances is spot on. If I have a few cocktails I'm likely to experience a blackout. So, no booze here.

Accurate testing takes many hours in the Mayo system

 

[Catalyzt]

Yikes! This doesn't match my experiences at all. A definitive result is possible and in some cases there are treatments to alleviate the issues.
As always YMMV. And I respect your personal opinion. But find few facts, just anecdotes. However the anecdote you identify regarding mood altering substances is spot on. If I have a few cocktails I'm likely to experience a blackout. So, no booze here.

Accurate testing takes many hours in the Mayo system

Good points-- and I do believe that more specific assessment instruments for certain types of cognitive dysfunction can be be very useful after an event like a TIA! That type of test can be very, very important, and yes, there could well be effective treatment and substantial recovery. That would seem to be much more similar to testing for specific learning disabilities, where early intervention is very important. And great that you can avoid those cocktails! (Man, that was a journey with Mom, though a very different one due to the Parkinson's drugs, of course-- terrible interactions, not blackouts, more like word salad, and very, very scary-- thought she was making sense when she was not; the ideas were there, but not the expressive language capability.)

My hesitation has to do with testing for Alzheimer's in healthy people, and I think we've had poor luck with that. One example of a test frequently run on healthy folks is the MMPI-- it can yield some interesting information that might inform psychotherapy or career choice for some, but not all individuals. The problem is if you start trying to predict who is a psychopath or use it as a formal way to assess fitness for a particular job. Very real and broad-based controversies about that instrument.

I should not comment on the Mayo system until I know more about it, totally fair to call me out on that. I guess I'm identifying my own skepticism-- and bias-- more than anything else!

 

[AHicks]

That amusing, but if you're completely gaga, you won't care. But if you knew there was a good possibility of becoming cognitively impaired, you could set up your systems and to make it as painless as possible. You don't have to tell your acquisitive heirs either.

That said, I don't know that I would want to know, for fear of the effect it would have - - would I make assumptions that ordinary forgetfulness was Alzheimers and freak out?

My wife I think, is a little paranoid in this regard, as her mother had to live in an assisted care facility for quite a while prior to moving on. She's very concerned she's going to end up the same way and doing everything she she can to avoid it (staying fit, cross word puzzles, mentally active, etc).

In my mind there is more concern regarding the pain of cancer.....

My mom checked out in her mid 90's after having avoided both cancer and dementia (well mostly). At 70, I recognize we're all going to check out from something. Thankfully the wife and I are still in good health with nothing rearing it's angry head just yet.

So to answer the question, no, I don't think I would take the test. Too demoralizing.....

 

[mschwett]

it would depend on the level of certainty and accuracy. if it was accurate and said "you're absolutely going to get severe dementia by age xx" i would want to take it. then i'd make arrangements to go out in a blaze of glory before then.

on the other hand, if all it said was "your risk is elevated" or "you have a 50% chance by some age between 50 and 80" then no. not useful.

 

[Handlebars]

No, but I would take my lost Budgerigar.