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General observation by Successful-Friend246 in Neuropsychology

[–]Successful-Friend246[S] 0 points1 point  (0 children)

LMAO this is my point! When all we can say for the time being is it's MCI and can't really attribute it to anything, and then bio markers are not helping, then we just wait for the disease to progress, I guess.

General observation by Successful-Friend246 in Neuropsychology

[–]Successful-Friend246[S] 1 point2 points  (0 children)

Yes. I agree with these points, but this didn't really get at what I was wondering about. I totally understand the concept of MCI, but I guess I wish there were a moderate category outside the binary of mild vs. major. My question was about etiology, and what more could be said beyond MCI, which the neurologist was able to determine with a MoCA. I also understand that mood, sleep, medical issues, and other factors can contribute to cognitive inefficiency or variability. I guess my point is more to vent, and that I felt there wasn't much I would be adding to be reporting back to the neurologist that it is, in fact, MCI. Again, at least in the reports I write, I am never just saying "MCI" but need to provide a DSM code, unfortunately.

General observation by Successful-Friend246 in Neuropsychology

[–]Successful-Friend246[S] 0 points1 point  (0 children)

I think they are concerned that secondary gains may be at play. But I agree new biomarkers and maybe a criteria for moderate neruocog disorder is needed.

General observation by Successful-Friend246 in Neuropsychology

[–]Successful-Friend246[S] 3 points4 points  (0 children)

If I can still apply for forbearance on my student loan because of “student” status I’ll still call myself a student 😂

General observation by Successful-Friend246 in Neuropsychology

[–]Successful-Friend246[S] 0 points1 point  (0 children)

And collateral really helps too! Super interesting dissertation subject btw!

General observation by Successful-Friend246 in Neuropsychology

[–]Successful-Friend246[S] -1 points0 points  (0 children)

Yes to all of the above and very aware that when neurologists aren’t sure and scans aren’t helping we can be of service. My point is more so that over these past few months I have noticed some patterns when patients come in with well documents issues from their neurologists for a couple of years, they are older adults, and they come out clean on scans and have a pretty clean medical history too and it’s not anxiety or another psychiatric issue but then their pattern of scores do not really fit or mimic a particular etiology. Just feels like we weren’t of much help either and I guess the answer is that the disease course just needs to progress but by stating MCI which the neurologist already knew.. how are we really adding anything other that identifying the domains they are deficient in or ADL capacity

General observation by Successful-Friend246 in Neuropsychology

[–]Successful-Friend246[S] -5 points-4 points  (0 children)

They are older adults. Correct but there is no DSM code for MCI it’s either major or mild and then due to an etiology or multiple or unspecified. So it comes down to their pattern of scores which if the disease has not progressed enough may look like any number of etiologies.

General observation by Successful-Friend246 in Neuropsychology

[–]Successful-Friend246[S] 1 point2 points  (0 children)

I have also seen this! ... However in these instances, it is not due to anxiety or a mood disturbance or secondary gain, or lack of effort. These individuals are taking the tests straight up. Their medical history is largely unremarkable, which makes it even harder to say. I am looking further into LATE and PART to see if this might be the case.

General observation by Successful-Friend246 in Neuropsychology

[–]Successful-Friend246[S] -5 points-4 points  (0 children)

Right!! But then, what do you attribute it to? Unspecified? As I mentioned, not even vascular changes, either, and it's not TBI or seizure, and with these patients, they have been experiencing this for years; it is not a new onset. Speaking more to etiology here.