S1E19. My Screening Test

In the third episode ‘My Life Is Now An Experiment’ (https://tinyurl.com/3j6vaf7x), I described myself and this blog as an ongoing experiment, recording data that could later be evaluated to determine if my experiences represented normal aging or the path to dementia.

It’s not a ‘real’ experiment, of course, and that made me think that it might be valuable for me to apply to participate in a real clinical trial…and so I did.

My Facebook feed is overrun with invitations to participate in a variety of studies and so I responded to one. I received a telephone call a few days later which was described as a ‘pre-screening interview.’

I was told about the experiment and asked if I was willing to take medication, undergo periodic testing including MRIs and blood samples, and travel to a testing site periodically for ongoing assessments. I was more than happy to do so. 

The person on the phone asked what kinds of problems I was having and I related some of the information I’ve posted in this blog. She wanted to know if there was a caregiver available who could accompany me and so I had her talk with Sally.

I was informed that someone would contact me to arrange an in-person appointment for an actual screening.

I was delighted!

Last Friday, I drove an hour to the nearest testing site (this is a nationwide study) for my assessment. The office was located on the first floor of an unassuming building. I presented myself to the receptionist and was asked to complete a standard form detailing my medical history. As I did so, I smiled inwardly because the form required me to write the date on each of 8 pages. I chuckled because I knew that one of the standard assessment tests that is frequently used to screen for cognitive impairment asks you to give the current year, month, and date…and here I was practicing the answers to 3 of the questions!

The physician performing the assessment ushered me into his office a few minutes after I turned in my completed forms. He went to great lengths to make me feel comfortable, explaining that this interview would be very informal and not like a normal visit to the doctor. He explained that his practice contracts with drug companies to recruit participants in research projects.

He then asked me if I was having problems with my memory and I told him about my recent experiences. He then explored what kinds of accommodations I was using.

We talked a little about my career as a psychologist and my volunteer political work over the last decade.

At this point, my gut feeling was that I was not sufficiently impaired to be selected for the study, i.e., I had flunked the interview! But he asked if I’d like to go ahead and have him administer the screening test, and I, of course, said ‘Please do.’

As I had guessed, the instrument he used was the Mini-Mental Status Exam (MMSE). I had administered it often in my work, but if you had asked me, I would only have been able to name a few of the items from memory…like the ones asking about today’s date. However, I did recognize each question as he asked it.

(I’d like to pause here for a moment to ask a favor of you. Even though it’s easy to google the MMSE and download all the questions, I’m going to ask you not to do that. If you should ever find yourself being evaluated, you want the testing to be as accurate as possible. Knowing the questions and, far worse, practicing the answers would contaminate the results and contribute to an inaccurate diagnosis. And that is why I am encouraging you to use some constraint here.)

I wanted to do my best (even though that might result in my not meeting the impairment criteria for the study) and so I decided to take my time and double-check my responses before answering.

There are a couple of questions that ask you to perform tasks in your head using working memory. I was a little surprised at the amount of effort it took, even though I got the right answers.

There was one task that I was on the verge of messing up, but I caught myself in time and corrected my mistake.

There was another question I answered correctly, but realized afterwards that I hadn’t considered a critical element of the solution when formulating my response. 

Final result: I only made 1 mistake. If I had made 3 mistakes, I would have met the criteria for further testing.

The doctor told me I did not qualify for this study and we chatted a few minutes longer. He offered advice for maintaining cognitive health, including learning new things, eating lots of colorful vegetables and berries, exercising and staying socially engaged.

He thanked me for offering to participate and I thanked him for the work he was doing.

I drove home with mixed emotions. I was disappointed that I hadn’t gotten into the study, but relieved that the errors I was making didn’t yet meet criteria for an impairment.

So far, so good.

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