welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Thursday, January 18, 2018

alzheimers news-trumps memory test

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ill be the first to admit
i dont like donald trump
lets be fair to him regards his memory test

alzheimers starts in the brain 15-30 years before
any symptoms start
before any memory tests are abnormal

there are subtle things that can happen before the
memory tests become abnormal

sometimes the first thing is spatial things
missing things in your peripheral vision
which can show up when driving
sometimes subtle memory things happen
im speaking from personal experience here
things you notice that others do not

eventually when the time comes
the memory tests become abnormal

first let me say
if you are going to need memory testing anytime
dont be reading whats in those memory tests
it affects how accurate they are

now i have personally been administered the same memory
test he had done more than 15 times over the last 8 years
i have personally administered that particular test to
family members and friends several times
i am quite familiar with the moca memory test

when you go to a doctors office
he might administer one of three tests

one is the minicog test
it involves being told three words to remember
you are given a time and asked to draw that time
on a clock

if you dont pass that one
you have memory issues
you need more evaluation

its a quick and simple test
its not sensitive though in picking folks up early
with memory loss

the next is the mmse
multimental state exam
its scored up to 30
get 30 and you might be ok
for those like me when i was first tested
it missed me
i got a normal score on the mmse

the third test is the moca
thats the one that trump took
the best score you can get is 30
a normal score is 27-30

when i was first tested in 2010
my score was 25
which was abnormal
its in the mild cognitive impairment range

the moca test is a more sensitive test to pick
up those early changes
like what you see with early alzheimers or mild cognitive impairment

its not a 10 minute test
its a 20-30 minute test

so with a normal result
a 30 score
as of right now
trump probably doesnt have any symptoms of dementia
or short term memory loss
the first thing that usually shows up in alzheimers disease

my scores earlier this year on one of the moca test
was 30
a perfect score

so why did mine get better
medication ie aricept (donepezil)
correcting things like cholesterol blood pressure weight exercise
stress sleep staying mentally engaged
all helped to make my scores improved

so i have a perfect score on my last moca test
does that mean i dont have alzheimers disease
the diagnosis is made on more than just the moca test

they use
family history
past medical history
risk factors
spinal fluid for tau and amyloid
a pet scan for amyloid the amyvid pet scan
genetic tests
serial memory tests
the gold standard
the neuropsychological exam
eg mine is abnormal even though my last moca was normal

the neuropsychological exam is more accurate
if there are memory issues it will show up
yes you can have a normal moca and have
an abnormal neuropsychological exam
it take 2-3 hours to do this exam

the moca test is a screening test
it doesnt rule out alzheimers disease

there is a state
prealzheimers or prodromal alzheimers disease
the memory tests are all normal
the scans and spinal fluid levels are abnormal
in this stage
you just dont have symptoms yet

either does not have alzheimers disease at all
he is in that prealzheimers state or prodromal state
a time that can last 10-20 years

as a medical doctor
as a family doctor
as someone who has had this test multiple times
as someone who has administered this test multiple times
as someone who reads 10+ articles on alzheimers disease each day
as someone who has lectured on alzheimers disease multiple times
as someone who has been and is now in two of the most
important alzheimers studies ever done
i feel like
i can speak with some authority about alzheimers disease

if i was trumps medical doctor
if i had administered the moca test to him
i would tell him
right now there is no evidence that you have memory loss or dementia

i would tell him to correct those other health issues
the what i called heart attack levels of the ldl cholesterol
he is just a point or so away from being labeled morbid obese
get more sleep
get more physical activity
greatly improve his diet
let your calcium score on that heart ct be a warning
if a heart attack or a stroke dont get you
demential or alzheimers might in the future

the posting of the moca test for all to read
i think does a disservice to those who may need a moca test
in their workup for memory loss
practicing or reading the tests affects its accuracy
i am not allowed in my studies to have other memory testing
since it causes what they call testing effect

this doesnt mean trump doesnt have mental problems
or psychological issues
this moca test this screening test
doesnt check
for anxiety
for depression
for bipolar disorder
for psychosis
for paranoia
for narcissism

those are tested usually by a psychologist or psychiatrist

no he dont appear to have active dementia or alzheimers
manifesting itself right now

lets all move on from this

mudslide update
maybe next week the 101 will be open
no new recoveries no change in the death toll
we saw what seemed to be miles of trucks loaded with mud
and stuff on the freeway waiting to go to a dump place
way north of santa barbara
they are expecting to dump over 20,000 dump truck loads of
stuff in those dump sites

thatcher update
he is awake
tape free
looks like iv free except for the pic line
oxygen free
soon to be moved from icu
you go thatcher

here is his gofundme account
#thatcher strong

the organicgreen doctor

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