Cognitive testing results before and after 5 months of the MEND Therapy

[TheBrain]

Friends, thanks for all the kudos!

Terrific news, Allyson!!! I appreciate that you explained the issues you had with your first test. (I think I experienced something similar ) Regardless, it's clear that you've made some REAL improvement. More importantly, I'm curious to know if that has spilled over into your everyday life? To me, that's a more tangible indicator of your cognitive progress.

You know, I've also experienced significant cognitive and overall health improvements by following the approach outlined in the MEND protocol. I think it offers anyone experiencing (or at high risk of) cognitive decline a concise blueprint of prevention strategies to follow. Thanks for sharing your good news. I look forward to seeing continued progress!

Julie, I'm delighted to hear that you are also experiencing improvements, both cognitively and with your overall health. I am SO impressed with the MEND protocol. Dr. Bredesen is my hero.

The biggest improvement I've noticed in my everyday life is with word recall—which is interesting because the CNS VS assessment didn't really capture that. (Thanks, Richard, for confirming my suspicion that the first pass of the Verbal Memory Test was invalid because I must have been hitting the wrong key, and my input wasn't being captured.)

I'm a word person (writer and editor), so perhaps I'm more sensitive to changes in my professionals talents. I can say that now, my word recall is as good as it's ever been. Another problem I've been experiencing is losing my train of thought as I'm speaking. That's much better now, though it's not completely gone. If I go off on a tangent or if someone interrupts me, I have trouble finding my way back to my original train of thought. If I give myself a bit a time (up to 5 or 10 seconds), it will usually come back to me (which didn't used to be the case).

Also, I'm less likely to forget where I've put something or when something happened.

Frankly, I'm surprised my visual memory improved at all. I can't close my eyes and visualize anything clearly, so I would never expect myself to be good at remembering geometric objects and how they are positioned relative to each other. However, I'm confidant I could recall familiar images such as a table, hat, or helicopter; I wasn't tested that way.

[TheBrain]

If I may comment on the verbal memory test, since this is an area of expertise for me, it would be typical on the first presentation of most 15-word verbal memory tests for people in their 50's and 60's to get something like 6-8 words (depends on which of the many such word lists was used). To recall no words after the first list presentation in the absence of obvious dementia, altered consciousness, major distractions during the word list presentation (among a few other conditions), would be rare. It is definitely not something you see in isolated mild cognitive impairment. Your suspicion of hitting the wrong key sounds spot on. I think 14 out of 15 on the last trial is more telling, definitely a respectable score. Keep in mind that any learning score that measures improvement over subsequent trials and the total recall across trials will be messed up by the use of the wrong response key and are best ignored.

Richard, I appreciate your helpful comments on the verbal memory test. Previously, I found myself wondering if hitting the wrong key served as evidence of my cognitive impairment!

Would you mind sharing what you think your levels of anxiety and any depressive problems were at the time of the two testing sessions (in general, not just during the word list learning)? Did the MEND assessment protocol make attempts to quantify those issues? Did you get feedback from a study coordinator or the doctor about your cognitive assessments?

I would say that my levels of anxiety and depressive symptoms, in general, were about the same. However, I did not acknowledge the depressive symptoms initially. My sense is that the MEND assessment did not attempt to quantify these issues. Near the beginning of this process, I completed some forms. I checked off a box that I have anxiety, but I didn't check off a box that I have depression. That's about it. In hindsight, I should have checked off both boxes.

On my own initiative, I started seeing a mindfulness-based therapist because I knew I was struggling. Her first inclination was to diagnose me with some kind of depression-related adjustment disorder (in my case, from adjusting to my ApoE4 genetics and all that comes with it). But I was concerned that my insurance company would ask what I was having trouble adjusting to. She ended up giving me a diagnosis of PTDS (due to childhood trauma, with repercussions that continue to this day).

My Muses Labs coach told me she was stunned by the results of the first assessment. She thought I would have done much better, given how well I communicate and keep my tracking sheets for her. When she sent me the results of my second assessment, she wrote: "Wow Alysson! Fabulous Results!!!"

When I told my functional medicine practitioner about how I suspected I hit the wrong key for the first part of the verbal memory test for the first assessment, she ended up dismissing the entire assessment—which I think is unfortunate. I see her this coming week and will bring her a copy of my results from the second assessment. I want her to see them side by side.

During my last appointment with her, she told me she sees no cognitive issues with me. She said that of all the patients she has seen (1400+), I'm one of her top five, cognitively. She doesn't think I'll ever get Alzheimer's. She thinks I'm doing way more than I need to do for my brain health. Frankly, I don't know what to think of all that, except to suspect that many of her patients are very ill and that maybe she doesn't fully understand the risks of being homozygous for ApoE4.

[TheBrain]

RichardS wrote:
Again, looking good. I hope this puts your mind at ease.

Thanks, Richard. This definitely puts my mind at ease. But... I got some very sad news today. First, let me say that I have never communicated with my aunts, uncles, and cousins very often. My dad was in the military so we moved around, and I never lived near my extended family past the age of 5.

But I've been wanting to talk to my aunt Rose Mary about my ApoE4 genetics, in case she might be interested for her own sake and/or her children's sake. So I tried reaching her yesterday. Her email address was no longer valid. Her phone was disconnected. So I searched online and found a phone number for her son, my cousin Chris.

I spoke with Chris today and learned that my aunt has advanced Alzheimer's. She declined very quickly over a 1–2 year period and has been in a small group home for dementia patients for about two years. Chris says she seems to recognize him and his brother, but she can’t remember their names. She is 85 years old now. At least she made it past her 70s before becoming ill.

I spoke with my aunt a few times while I lived in Colorado; each time, she was mentally sharp. Since learning about my ApoE4 status, I've been believing she had been spared. Except for her mother (my grandmother) who died of vascular dementia, heart disease has been the nasty affliction present in both sides of my family. Up until today, I thought no one in my family had ever suffered from Alzheimer's disease.

I feel so bad for losing touch with my aunt Rose Mary. I could have had many more conversations with her while she was well. I could have gotten on a plane and visited with her and my cousins.

I guess the silver lining here is that I am determined to develop relationships with my cousins and my one uncle who is still alive. It's not too late.

[Tincup]

Alysson, congratulations on your results!

[TheBrain]

Thanks, George. I'm up for my middle-of-the-night snack and know I shouldn't be using my iPad, but at least I'm wearing my blue-light blocking sunglasses.

Yesterday, I was flattened by the news of my aunt Rose Mary, but many tears later, I'm coming around and returning to the delightful news of my cognitive improvements, I want to celebrate!

[SusanJ]

Sorry to hear about your Aunt Rose Mary. Hugs girlfriend. May you find peace in your day.

[Julie G]

That's terrific news that you're actually seeing cognitive improvements as you go through your every day routine, Alysson! That's further confirmation of your improvements So sorry to hear about your Aunt. That hurts XO.

[circular]

(((alysson1))) What a topsy turvy week for you!

Fabulous progress with your cognition as you know. Lots of kudos. Yes, it sure appears all your hard work is beginning to pay off and it's time to take some pages from Stavia's balance beam <(beam)

I'm one of her top five, cognitively. She doesn't think I'll ever get Alzheimer's.

I had copied this text before reading about your aunt, which turns out to be ironic. I wanted to mention that once I heard or read that people with good cognitive reserve will often acquire LOAD later than they otherwise might have (that part of course being uncertain), but they will decline faster. By the time they show symptoms they've gone through their reserve for the most part, so there's not much left and that's why they decline fast. Others may have something to add to this yea or nay. I think your functional med doctor may just not have as much experience in this area. It's my understanding that many highly intelligent people get AD, not moreso, just that it's not evidence that one's on track to avoid it.

Have you considered going to visit your aunt? My mother-in-law and great friend died last summer. She had memory issues during the last 1-2 years and had not recognized her daughter-in-law a few times. My husband needed to go see her because it had been about four years because of how crazy our life was. I couldn't go at the time. We wondered if she would recognize him. As it turned out his sister was going to visit the same time (!), so all the kids spent a day with her in the facility. She remembered them all and it was her last good day. She died a month later. You just never know. Maybe seeing you will spark something in her, whether it's recognition of who you are or not. You could take her some music she liked from her past and give her some joy, and even if she didn't remember you, you'd have that to remember. This page talks about how to use music in the later stages. If nothing else, maybe it will be useful to your cousins http://www.alzfdn.org/EducationandCare/ ... erapy.html

[RichardS]

Circ wrote:

I wanted to mention that once I heard or read that people with good cognitive reserve will often acquire LOAD later than they otherwise might have (that part of course being uncertain), but they will decline faster. By the time they show symptoms they've gone through their reserve for the most part, so there's not much left and that's why they decline fast.

Yep, this was initially called the "Brain Reserve Capacity" theory of dementia which I first heard about in the early 90's during my training. It is now a commonly held belief among experts in the field. It was also my father's fate.

[Stavia]

My mum's psychogeriatrician said the same thing. She was extremely smart. I first wondered about an extremely subtle cognitive change around 87 but nobody else agreed with me. She could still have a deep complex conversation but there were a couple of out of character actions. She passed away a few months ago at 89 from renal failure but by then had deteriorated over 2 years to a point where she couldn't remember where she lived, had forgotten most people except immediate family, wasn't sure how dates worked. The last 6 months decline was rapid. I feel that her death from renal failure was a blessing, as awful as it all was.
The psychogerries specialist said that extremely smart people lose a lot of cognitive functionality before its noticeable thus are further along the track at that stage.
Sigh.
I guess if I make it to 87 I'll be happy.