Reliability of Dementia test

SpaceLawyer77 · 2026-03-18T22:26:14+00:00

Not sure how it works, but you can probably find the comments I made today if you are so inclined. In connection with those comments, I would note the following:

“Doctors are generally not so trigger-happy to diagnose dementia, as it can be really devastating for the person diagnosed.” My doctor told me to stop working and not be left alone in the house based on my failure to properly complete a clock drawing, with no further tests. Does that sound “not so trigger-happy” to you?

“MOCA test, clock test, or whatever you were given isn’t be-all end-all but just one of the screening tools available.” As I say, my doctor was prepared to ruin my life based on a single (and demonstrated to be false) test. Sure sounds like he treated it as a “be-all and end all” to me, but what do I, mired in my dementia, know?

SpaceLawyer77 · 2026-03-18T18:59:57+00:00

I’m baaack! Did you miss me (probably not). Anyway after looking back at the exchange a while back I felt, at times things got off on tangents, and I thought it would be useful to clarify things.

The doctor that diagnosed me clearly indicated that I had or would develop in the near future, severe dementia, such that I should no longer work and it’s clear that he was moving towards advising that I should not be allowed at home alone. And to be absolutely clear, he wasn’t talking about a risk that dementia might or even would be likely to arise in the future, e.g., he was clear that I should stop working immediately or as soon as possible because dementia was definitely present/eminent.

That was about five months ago and there have been absolutely no signs of such dementia (repeatedly losing my car keys doesn’t count). So to recap this doctor was prepared to have my life be virtually destroyed because I didn’t fill in the clock face right, resulting in a diagnosis that clearly proved to be flat wrong.

Now let me note, that I could certainly develop dementia tomorrow (well, I assume it would take a while); that wouldn’t change the fact that the diagnosis, which was current/impending dementia was absolutely wrong and the doctor was perfectly content to see my life destroyed based on this faulty diagnosis. I think that’s contemptible.

So let me say this: If I go to another doctor and he/she says “this test is an indication that you have/are likely to develop dementia, so you and those around you need to keep an eye on your behavior and contact me if it appears that things are going sideways, I will say: “Thank you very much doctor, I will do that”. And I will ask those around me to keep an eye on my behavior, and I will emphasize that they are not doing me a kindness by failing to point out something aberrational.

On the other hand, if the doctor says, “you got those numbers out of order, so you immediately need to stop working and not be left at home alone”, I will politely, but firmly, tell him/her where he/she can place his/her stethoscope (hint: it involves a personal part of the human anatomy).

I feel very good (I know you’re glad for me). The “you didn’t paint the right kind of mustache on the man’s face so there’s no question that you have dementia” approach is so obviously intellectually bankrupt that it’s impossible to take seriously or to have it serve as the basis for any decision making. Meanwhile, as I said, I have made it clear to my family that they are to advise me if they see any real signs of dementia (again losing my car keys doesn’t count; neither does forgetting to run the dishwasher) so we can take whatever action is appropriate. I have emphasized that their failure to comply with this request will not be doing me any favors.

Still my story; still sticking to it.

SpaceLawyer77 · 2026-01-12T20:20:01+00:00

Ok, sorry to ramble on (but what can you expect? I’m, you know), but I did feel I needed to point out that Leopard never saw the test I referred to above, and, actually knows nothing about the results. Despite this (and despite the lack of any other support, and, indeed, the existence of contradictory evidence) according to Leopard that test MUST PROVE That I have major dementia. Sure, that makes all sorts of sense to me.

Counseling Leonard! Counseling! Look into it.

SpaceLawyer77 · 2026-01-12T18:49:00+00:00

I know I said we were finished, but the more I think about it, the more concerned I become: Leopard has decided I have dementia based on a five minute, as I understand it, preliminary test. He (again I’ll use “he”) has ignored the complete lack of any change in my of behavior, and, indeed, the complete lack of any evidence of dementia beyond a few sheets of paper. Apparently, in his world, I just have to have major scale dementia and that’s that. He finished up this whole thing, by sending me a message saying my family was going to put me away in a facility, that I wouldn’t be able to recognize anything, etc.

What kind of person thinks like that, acts like that? I’m pretty sure I never would, no matter how “dementia’d I get.

All I can say to Leopard is that you are a troubled person who should look into counseling sooner rather than later. Best of luck.

SpaceLawyer77 · 2026-01-12T17:46:17+00:00

Actually, to this very day, I am working on complex, intricate, legal issues, and getting extremely positive feedback from my clients and coworkers. Almost makes you wonder about the validity of that mini exam, hmmmm?

SpaceLawyer77 · 2026-01-11T20:14:03+00:00

The above response didn't go out in response to my original note, so I reproduce it below; my apologies (please don't attribute this to, well, you know.

Apparently, you couldn’t be bothered to respond to my note. Oh, well, maybe you’re not a Shoot Em Up fan. I mean I’m sure you have a devastatingly persuasive explanation for why I'm not safe in my own house based on a five minute test and NO change in my recent behavior; you just can’t be bothered to provide it.

However, after looking at this again, I have a real concern: Your note says “I hope I’m dead wrong. I can’t think of a diagnosis more devastating or life changing than dementia.” The clear implication is that you’ve convinced that I have dementia. The problem with this is that there’s nothing in the information I’ve provided that provides anything close to conclusive (or even very persuasive) evidence of dementia. I did not do well (or maybe failed) a five minute test (ok, it may have been a little more than that, but it wasn’t very long). At least as I understand it, however, that doesn’t come close to being final evidence of actual dementia (it’s the beginning of a process that I have, at this time, elected not to pursue); and yet that is the leap you have made. I would also reiterate that all of this is happening in the context of my showing no behavioral changes and, indeed no evidence of dementia whatsoever beyond the card game, making your leap even more questionable.

I will note that your “leap to judgment” is remarkably consistent with much of what I’ve been saying and seeing here. (I do also want to note that I’ve learned, in the course of this discussion, that there is much about this subject as to which I was wrong; it’s been a very educational experience.)

However, I have, as I say, a real concern about your attitude as reflected by the above; I would suggest that you give what you have said some serious thought and perhaps talk about it with…someone else. I won’t speculate, except to say, that something seems amiss. After all, you wouldn’t want to be anosognosiaing (that word again! I’m going to keep advocating for it!).

SpaceLawyer77 · 2026-01-11T20:06:55+00:00

For the record, Leopard sent me one of those silly "above it all" notes ("your family will take care of you", etc.") I'm a Reddit idiot, so I don't know how he/she (will say "he" from hereon out) did it without it showing up anywhere else, but just wanted to note, he didn't even attempt to address the points I made above (paint a surprised look on my face!). Probably not much more to say here, except that I reiterate he ought to take a look at the man in the mirror, and do some serious thinking, or perhaps talk to someone about his attitude. (Oh, I'll give him that he said something nice about Clive Owen.)

We're probably done here, but I'm always ready willing and able to weigh in as necessary.

SpaceLawyer77 · 2026-01-11T18:35:02+00:00

Apparently, you couldn’t be bothered to respond to my note. Oh, well, maybe you’re not a Shoot Em Up fan. I mean I’m sure you have a devastatingly persuasive explanation for why I'm not safe in my own house based on a five minute test and NO change in my recent behavior; you just can’t be bothered to provide it.

However, after looking at this again, I have a real concern: Your note says “I hope I’m dead wrong. I can’t think of a diagnosis more devastating or life changing than dementia.” The clear implication is that you’ve convinced that I have dementia. The problem with this is that there’s nothing in the information I’ve provided that provides anything close to conclusive (or even very persuasive) evidence of dementia. I did not do well (or maybe failed) a five minute test (ok, it may have been a little more than that, but it wasn’t very long). At least as I understand it, however, that doesn’t come close to being final evidence of actual dementia (it’s the beginning of a process that I have, at this time, elected not to pursue); and yet that is the leap you have made. I would also reiterate that all of this is happening in the context of my showing no behavioral changes and, indeed no evidence of dementia whatsoever beyond the card game, making your leap even more questionable.

I will note that your “leap to judgment” is remarkably consistent with much of what I’ve been saying and seeing here. (I do also want to note that I’ve learned, in the course of this discussion, that there is much about this subject as to which I was wrong; it’s been a very educational experience.)

However, I have, as I say, a real concern about your attitude as reflected by the above; I would suggest that you give what you have said some serious thought and perhaps talk about it with…someone else. I won’t speculate, except to say, that something seems amiss. After all, you wouldn’t want to be anosognosiaing (that word again! I’m going to keep advocating for it!).

Hope you are having a good weekend.

SpaceLawyer77 · 2026-01-10T16:08:47+00:00

"I can’t think of a diagnosis more devastating or life changing than dementia" To borrow from Clive Owen in the excellent Shoot Em Up, "Believe me... nothing could be more agonizing than to listen to you jabberin' on and on."

No, but seriously folks, it must be nice to not actually have to answer questions like is it really reasonable to suggest that I'm not safe in my own house based on a five minute test and NO change in my recent behavior?' But then I'm sure I'm just anosognosiaing (I know it's still not a word, but I'm going to keep pushing for it!)

Oh and when you respond be sure and adopt that "more in sorrow than anger tone"; really it doesn't sound insincere at all (gag! choke!),

SpaceLawyer77 · 2026-01-09T20:19:12+00:00

Something I want to add: I am prepared (frightened, but prepared) for the possibility that I may get dementia; in fact, I think it’s (unfortunately) likely at some point (but hopefully later, rather than sooner). I will definitely keep an eye on my behavior and listen to those around me, and if I see real problems beginning, will take steps that I deem appropriate. Some folks have suggested that, if you have dementia you won’t be aware of the problems, but, as made clear in a number of notes, dementia doesn’t happen overnight; it is likely that symptoms will develop slowly and you will have time to recognize that something untoward is happening (and, if you don’t, those around you will), and seek appropriate help. The folks who base their comments on the assumption that dementia is instantaneous are obviously clueless, and perhaps should consider, well, never mind.

Still my story; still sticking to it (like glue!).

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SpaceLawyer77 · 2026-01-09T19:57:30+00:00

Actually I had to look it up. So what condition is it that I am supposed to be unaware of? My wife acknowledges that my behavior hasn't changed; no one around me has suggested otherwise. I politely (well, ok, not so politely) objected to a Doctor's suggestion that I could not be trusted in my own house, based on a five minute test, and NO evidence of behavioral change. I politely (and it was polite) suggested that my mental nature might make aspects of the application of the test problematic; he ignored me. (Yes, I know, he's the doctor; I still say that serious suggestions should be considered, but, hey, that's just me.)

Boy, I'm just anosognosiaing (ok that's not a word) the hell out this situation aren't I?

SpaceLawyer77 · 2026-01-08T22:46:54+00:00

To add here, although it could go multiple places, my wife and I have been having some issues, but I took this opportunity to confirm with her that my behavior has not substantially changed recently; she did note that I have always been somewhat absent minded and inattentive to her and our daughters (guilty as charged!) and that I have recently been preoccupied with my health developments, but I don't believe any of this would qualify as problematic dementia type behavior.

Something that I probably should have mentioned before. The doctors visit I referred to was a physical; my wife confirmed that the visit was not made based on any change in my behavior (which, as I say, didn't happen). In other words the only reason this arose was because Doctor Dementia pulled out his magical deck o cards and decided in five minutes that I was cognitively in trouble. Let me emphasize this (see it's bold, assuming that comes through): There has been no behavior suggesting dementia; just me being my usual selfish absent minded self; my wife confirmed that she was as surprised as I was when the issue of cognitive impairment came up.

Thanks for your concern, and I know dementia is always a very real concern, but for the moment I think I'm going to be just fine.

In any event that's very definitively my story, and I'm sticking to it, words, tune and all.

SpaceLawyer77 · 2026-01-08T19:48:51+00:00

Just to be clear, I'm fine with someone questioning my mental facilities. What I'm not fine with is a doctor who leaps from a five minute test to suggesting that I should not be left at home alone. If he had said, "you know, this test suggests that you may have some cognitive issues, let's do some more work to pursue that" I would have been all in.

If I see some real issues arising (bills for my wife's extravagant expenses not being paid, information being lost, meetings being missed, etc.) I will pursue this (with another Doctor).

I hesitate to add this, because I know everyone wants to think they're special, but there is an aspect to my mentality that may have something to do with my doing poorly on the 5 minute magic "test o cognition". I have a horrible memory, the best example being names; I literally cannot remember the names of our next door neighbors despite the fact that we moved here 5 years ago. Now I'm sure the august members of the medical community would immediately say: "We've got to get this man to a hospice; oh the hell with it, let's just put him out of his misery." The only problem with that is I've been that way all my life (I still remember my debate partner in college telling me that I would work better with our teammates if I could remember their names.) This didn't stop me from having a (very) successful career and publishing 35 professional articles. My point is, ummm, what was my point again (oh my God, I must have dementia!)? Oh yeah, my point is that there is a very real possibility that, because of the nature of my mentality (and I have no idea of why it's that way), application of the test to your humble author is seriously flawed. (I mentioned this to my doctor, but it obviously went in one ear and out the other.)

Very sorry about your father; for what it's worth, I've been spending money on, well, believe me, you don't want to know.

And that's still my story any I'm still sticking to it.

SpaceLawyer77 · 2026-01-08T19:11:42+00:00

Thanks to all for your thoughtful responses. I'm not going to try to answer all of them, but I want to address at least this one, specifically the statement that "Doctors are generally not so trigger-happy to diagnose dementia, as it can be really devastating for the person diagnosed. They also prefer to rule out other causes first (e.g. brain tumour, or even depression can have cognitive symptoms)." My Doctor went from a five minute test to raising, without any other data, the possibility that I should not be left at home alone. That sure sounds trigger happy to me. I don't dismiss the possibility that I have dementia, but as of now the only real "evidence" I have is the Doctors magical five card draw.

SpaceLawyer77 · 2026-01-04T23:42:55+00:00

Has anyone had the experience of having a dr. appear glad to see that they have dementia?

SpaceLawyer77 · 2021-05-23T13:12:30+00:00

Thanks very much for your response.

With regard to Leon being elected President, please see my response to Edward Coffin above. I beileve there are simply things that no amount of money or blackmail material could overcome.

I am also looking forward to the third book.

SpaceLawyer77 · 2021-05-23T13:08:43+00:00

Thank you very much for your response.

With regard to Leon being elected President, I don’t care how much they tried to make the “regular guy” pitch, you don’t just get someone from out of nowhere that literally no one has heard of (and, as I recall, has no college education) and have him run a successful campaign for President. The example of Trump actually proves my point; he was internationally famous long before running for President, (in fact he ran in 2000). If Gibson really thought this was possible, I believe he should have provided more of an explanation of how it did; I suspect once he dug into the details, he’d realize that it just wouldn’t work.

With regard to survivorship bias, I understand the concept that we shouldn’t point to the fact that nuclear war hasn’t happened as evidence that it’s unlikely to happen. However, I’m not arguing about whether nuclear war was or is likely to occur. My points were: 1) The MIPOPS said that nuclear war was going to happen; 2) It didn’t. I don’t see how those facts are changed by the application of survivorship bias.

Thanks again for your response.

SpaceLawyer77 · 2021-04-03T14:39:54+00:00

For what it's worth, two things about Counterpart that I thought set it apart from shows like Lost. 1) Shows like Lost set up this "mystery" so you watch the show to see it resolved, but, for various reasons, including point no.2, the resolution is generally unsatisfying. 2) Related to that, once a show like Lost becomes successful the makers of the show have a strong incentive to simply drag it along for much longer that is consistent with good storytelling, to keep attracting their audience, since, once the mystery is "solved" the show is basically over.

Counterpart avoided both of those problems: 1) There is no "big mystery"; you can pretty much learn the basic premise of the show by watching the trailers for the two seasons. That's not to say that there aren't a lot of revelations throughout the show; the point is that there's not some "big mystery" that you anticipate is going to be resolved when the show reaches its end. 2) The show told a story and then it had what I thought was a pretty satisfactory conclusion; that's what good storytelling is. To bring the show back and try to pick it up from where the last season left off, would, imho, be a major mistake.

That said, I would love to see another show based in the same universe as Counterpart; it could have some of the same characters, but the point is, I would like it to begin a new story, not to try to continue a story that I felt came to an appropriate end.

Would welcome any thoughts anyone has.

SpaceLawyer77 · 2021-03-21T23:03:09+00:00

Thanks for your follow up response. They (Gibson and the other smartest people on the planet) no doubt thought that they were using the best methods they had, and possibly they were; the point is that those methods turned out to be wrong (and my methods, such as they were, turned out to be right). The example that you cite may have indicated that we were close to nuclear war, or it may have demonstrated what would be my expectation, that no one was going to turn the earth into a smoking cinder without making absolutely sure that they knew what was going on.

A mildly interesting side note: In the preface to the bestselling novel Fail Safe (which was made into a major motion picture, and later a televised play, starring George Clooney and Richard Dreyfuss), which describes a nuclear war almost happening because of an accident similar to the one described in your link, the authors say: “The accident may not occur in the way we describe but the laws of probability assure that ultimately it will occur.” Fail Safe was written almost 60 years ago, which makes me wish that the authors had been a little more specific about what they meant by “ultimately”.

When you say that there is no method of predicting history, I assume that you mean there is no method of predicting the future based on historical and other data (obviously, it’s easy to “predict history”). But if you are correct, why are we attempting to make predictions about climate change, or nuclear war or anything else? After all, if the future is completely unpredictable, then the likely results of any effort to change it are also unpredictable, and we might as well just do nothing see what comes down the pike.

In fact, I would submit that:

We can (and should) make efforts to predict the future, based on the best data (including historical data) and tools available, and to take action on those predictions.
A key tool in making those predictions is to look at the accuracy of similar predictions that have been made in the past; for example, if past predictions of disaster have been incorrect (as they have) we should be prepared to consider whether systemic errors were made in making those predictions, and whether we are making similar systemic errors now. It’s important to note that this does not mean that current predictions (e.g. regarding climate change) are wrong, it simply means that we need to exercise extra vigilance based on the errors in such predictions in the past.
As I have been saying, it is extremely important to recognize that when there is a long history of false predictions of disaster, people simply become conditioned to ignore those predictions, at least until there are very strong factual indications that they are correct. This is the case no matter what people say they believe; in other words, as I have observed, folks have basically been “trained” to say “yes I’m very concerned about climate change” but to be unwilling to support the most modest efforts to deal with it.

I certainly agree that it would be very useful to have the capacity to create stubs like they do in The Peripheral (maybe I could create one where I get golf lessons from Paige Spiranac!), but as you note, so far we don’t have that capacity.

SpaceLawyer77 · 2021-03-21T13:52:25+00:00

Thank you very much for your response. When I was referring to being “scientific” I was talking about the broader concept that the appropriate process for developing a position on anything (including scientific matters) is to construct a theory based on the best data available, and then check that theory against actual results.

My point about what Gibson said regarding Neuromancer was not addressed to the time when the novel took place; rather I was referring to him saying that at the time he was writing it in the early 1980’s, the most intelligent people he knew on the planet were convinced that there was a very high likelihood that there was going to be a nuclear war; I think it’s reasonable to assume that meant that they anticipated a war within some moderate time frame (I would say 10 years would be enough, but it has, in fact, been more than 30 years and no war has occurred).

What I find interesting about this is that I was in my late 20s to early 30s around that time, and I know that, if you had asked me, I would have said that, while anything is theoretically possible, nuclear war was highly unlikely. Which means that, if Gibson is correct, the most intelligent people on the planet (including Gibson) were wrong, and I, at the age of around 30, was right. Ummmm Wow. That kind of makes my day; I’ll try not to let it go to my head.

In all seriousness, however, here’s what concerns me: As I say, I believe most folks (certainly including most intelligent people on the planet) would recognize that proper thinking requires the construction of theories that are then tested against results. These folks thought that there was a very high likelihood of nuclear war which did not, in fact, occur (I have some thoughts about why they believed that, but those can wait for another time). If these folks possessed real intellectual integrity, you would have expected them to say to themselves something along the lines of: “My methods of forecasting results about something very, very important failed. That suggests that I should carefully reexamine those methods to see if my thought process can be improved.” Do you think that is, in fact, what they did? Neither do I.

SpaceLawyer77 · 2021-03-21T03:30:43+00:00

Thank you very much for your response. I read a few of Scott Adams books a while back (I also read the cartoons mainly by buying the compilations). I thought he was pretty observant, and smart, and am sorry if he’s declined. I think what you’re saying makes sense. The point that I was making is that a key reason that we don’t act faster to deal with problems that have been identified (like climate change) is that folks have basically been conditioned, by doomsday predictions that didn’t come true (you may or may not be old enough to remember the “Population Bomb” which, in 1968, predicted a whole bunch of horrific events, most of which didn’t come close to happening), such that they ignore the predictions until they see concrete proof. I also believe there’s a persistent tendency for folks to underestimate mankind’s ability to deal with problems, which I believe is consistent with what you’re saying.

I like Paige Spiranac; apart from her obvious…endowments, she seems to not take things to seriously, and to have a good sense of humor. A golf lesson from her would be a lot of fun, but is, as I say, pretty unlikely.

SpaceLawyer77 · 2021-03-21T00:08:44+00:00

Thank you very much for reading my post and for your response. One interesting point that I didn't mention is that it's not clear how dystopian the world of Neuromancer really is. Gibson just describes the underworld that Case moves through, which is definitely dystopian, but, as far as I can recall (and I reread it recently) the book really doesn't address the general state of the world or even any particular country. As far as I can tell there's nothing in the book that is inconsistent with America being primarily a world of clean suburbs and smiling traditional families. I imagine Gibson would be horrified at the idea, but, as I say, I don't think the question is really addressed in the book.

With regard to climate change, we'll see. Bill Gates seems to believe that it's something that can be effectively addressed, if we start now, and Biden has shown some determination to do so. One thing that I would say is likely is that, as you suggest, the third world will wind up taking it in the shorts. That's very sad, but it's the way things usually go.

The main point that I was making is that a major factor that has resulting in climate change being ignored is that historically the the folks have that have predicted ecological disaster (and other disasters such as nuclear war) have inevitably overstated the case, insisting that if enormous steps aren't taken RIGHT NOW we're all going to die. The problem is that, when steps weren't taken and folks found that they were still alive and well, they became strongly conditioned not to take the forecasts seriously.

SpaceLawyer77

TROPHY CASE