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MineralMan

(146,288 posts)
Sun Jan 27, 2019, 11:34 AM Jan 2019

Note to Medicare Doctors: About that cognitive test...

Having recently had my annual Medicare Wellness Check, I have a recommendation to Primary Care Physicans:

Consider changing the three words you ask patients to remember and then repeat later. You've been using the same three words for several years now. Some of us can remember them from previous years. I realize that it's easier for you to remember them if you use the same ones every year, but "banana" "breakfast" "chair" is getting a little old, I think, perhaps.

The clock drawing thing? Try a different time than the one you always use. 11:10 is also too easy to remember after having drawn that clock several years in a row. Also, keep in mind that as new generations become geezers, some of them may not even know how to read an analog clock, much less draw one freehand in your office.

On the other hand, as the nice Physician's Assistant who administered those tests said, "Well, if you can remember the words from last year, then I guess you don't have any memory deficits...By the way, your blood pressure is very good, too."

See you next year, Doc!

27 replies = new reply since forum marked as read
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Note to Medicare Doctors: About that cognitive test... (Original Post) MineralMan Jan 2019 OP
Older DUers, I dare you to go in and before they can get out the three words... hlthe2b Jan 2019 #1
Good idea. I'll do that next year. MineralMan Jan 2019 #2
There was a clock above the wall behind the Dr's assistant Raven Jan 2019 #3
But was is at the right time? That's the problem, see. MineralMan Jan 2019 #5
Ah, no...I figured that out for myself but I was Raven Jan 2019 #9
OOOOH! What a good idea! MineralMan Jan 2019 #13
Remember that 4 is IIII not IV Ron Obvious Jan 2019 #26
Yeah, given that one of the symptoms they're looking for... Wounded Bear Jan 2019 #4
That's true, of course. MineralMan Jan 2019 #6
I wonder if Trump could pass that cognitive test....? Ohiogal Jan 2019 #7
Only if the three words were "collusion collusion collusion" MineralMan Jan 2019 #11
Or volstork Jan 2019 #14
LOL well i was thinking when they got to THAT part of the test bluestarone Jan 2019 #8
I'm sure they wouldn't. MineralMan Jan 2019 #10
Same here bluestarone Jan 2019 #12
Here's a good journal article about the clock drawing test: MineralMan Jan 2019 #15
Good read TY! bluestarone Jan 2019 #16
I'm retired and have the attitude that I don't have to remember anything that I don't want to in2herbs Jan 2019 #17
Well, refusing to do the tests is pretty silly. MineralMan Jan 2019 #18
When do docs start giving you the words/clock tests? I'm 68 and haven't had Nay Jan 2019 #19
I hated doing the clock. Doreen Jan 2019 #20
Also. Iggo Jan 2019 #21
I have a yearly visit to my neurologist. safeinOhio Jan 2019 #22
Counting back by 7s is a difficult thing MineralMan Jan 2019 #24
Mine had a 5 word memory test and none of your words we were in it. sinkingfeeling Jan 2019 #23
the counting back by 7s thing had me crying. IcyPeas Jan 2019 #25
The trick with the sevens it to mentally do the math for each number. MineralMan Jan 2019 #27

hlthe2b

(102,234 posts)
1. Older DUers, I dare you to go in and before they can get out the three words...
Sun Jan 27, 2019, 11:40 AM
Jan 2019

Give them "banana, breakfast, chair".... LOL

MineralMan

(146,288 posts)
2. Good idea. I'll do that next year.
Sun Jan 27, 2019, 11:43 AM
Jan 2019

My doctor's PA is a very nice 30-something woman. She has a good sense of humor, too. She's also 6'4" tall, which is a real surprise for people who meet her for the first time. She'll laugh if I do that, I'm sure.

Maybe I'll draw the clock at home on a post-it note, too and bring that in with me.

MineralMan

(146,288 posts)
5. But was is at the right time? That's the problem, see.
Sun Jan 27, 2019, 11:47 AM
Jan 2019

Actually, the clock drawing test is a very good one. It's not really how well you can draw the clock. People with various neurological issues draw it in predictable ways. It's not a bad diagnostic tool, really.

Raven

(13,889 posts)
9. Ah, no...I figured that out for myself but I was
Sun Jan 27, 2019, 12:08 PM
Jan 2019

really tempted to draw the clock with roman numerals. Maybe next time.

MineralMan

(146,288 posts)
13. OOOOH! What a good idea!
Sun Jan 27, 2019, 12:17 PM
Jan 2019

I will do that next time, just for a lark. I asked last year if I could draw a digital clock with seven-segment numbers. I can do that one, too.

Or ask, AM or PM? and then draw a 24-hour clock.

I do draw the hour hand at the appropriate position for the 10 minutes, though, although I doubt that gets noticed, either.

Last year, the PA asked me why I wrote in 12, 6, 3, and 9 before adding the rest of the numbers. I explained that it was easier to locate them accurately, due the their right angle positions on the clock face.

A guy has to do something to amuse himself in such situations.

 

Ron Obvious

(6,261 posts)
26. Remember that 4 is IIII not IV
Sun Jan 27, 2019, 04:43 PM
Jan 2019

That always catches a lot of people off guard who have seen clocks with Roman numerals all their lives, but have never noticed that before..

Wounded Bear

(58,648 posts)
4. Yeah, given that one of the symptoms they're looking for...
Sun Jan 27, 2019, 11:46 AM
Jan 2019

is "short term memory loss" it might not be advisable to repeat tests from a year or more ago.

MineralMan

(146,288 posts)
6. That's true, of course.
Sun Jan 27, 2019, 11:49 AM
Jan 2019

I'm just joking, really. They always give you the words before they do something else that is distracting, like drawing that little clock. It's a pretty good short term memory test, really.

I just think it's funny that they use the same three words. It's probably so they don't forget them between telling them to you and your repeating them back.

MineralMan

(146,288 posts)
11. Only if the three words were "collusion collusion collusion"
Sun Jan 27, 2019, 12:11 PM
Jan 2019

He can repeat those words at the drop of a MAGA hat.

bluestarone

(16,917 posts)
8. LOL well i was thinking when they got to THAT part of the test
Sun Jan 27, 2019, 12:03 PM
Jan 2019

I would ask IF they remembered my Birth date! Bet they don't.

MineralMan

(146,288 posts)
10. I'm sure they wouldn't.
Sun Jan 27, 2019, 12:10 PM
Jan 2019

On the other hand, I've been seeing the same doctor, once a year, for 15 years now. He does remember me, my healthcare issues, and we always have a pleasant conversation during the visit. So far, I'm healthy enough that he doesn't have to do much else.

His PA remembers me too, well enough to roll her eyes at my lame sense of humor.

bluestarone

(16,917 posts)
12. Same here
Sun Jan 27, 2019, 12:16 PM
Jan 2019

I fully trust my DR. 15 plus years as well. I have always thought what a stupid test, BUT maybe it does help some patients. I guess i should NOT be so negative about the test. They DO NOT use same 3 words here tho. Always different words.

in2herbs

(2,945 posts)
17. I'm retired and have the attitude that I don't have to remember anything that I don't want to
Sun Jan 27, 2019, 12:48 PM
Jan 2019

remember. The thing that irked me with the clock question is that the numbers on most of the clocks manufactured the past 30 or 40 years don't have hands, the time is reflected on the screen. Ask me questions about horses and I will talk facts all day long. Ask me to remember some silly words and I won't. It's not that I can't, it's that I won't. I agreed to do the test once and have refused to do it since. Retirement is liberating in this way.

MineralMan

(146,288 posts)
18. Well, refusing to do the tests is pretty silly.
Sun Jan 27, 2019, 12:53 PM
Jan 2019

The clock test can spot a number of neurological problems, not just dementia. The three-word memory test has been in use for a very long time. I first had to take it after being in a coma for two weeks from viral encephalitis in 1991. The doctor was very pleased that I passed it, since it indicated that I had escaped serious brain damage from the disease.

Refusing such tests can hide a developing problem that can be dealt with. They're funny to talk about, but they serve a useful purpose. It's best just to go ahead and do them. If there's a problem, it's better to know about it than not to know.

This thread is humorous, but the tests are serious. Let your doctor do his or her job. Really.

Nay

(12,051 posts)
19. When do docs start giving you the words/clock tests? I'm 68 and haven't had
Sun Jan 27, 2019, 01:00 PM
Jan 2019

to take them yet -- maybe my doc thinks I'm still too young? He's a proactive younger doc and has me do the other Medicare tests for arm and leg strength, etc.

And you have to remember only three words? Dang.

Doreen

(11,686 posts)
20. I hated doing the clock.
Sun Jan 27, 2019, 01:22 PM
Jan 2019

Yes, I am 51 but all of my life I have had a very hard time reading face clocks partly because of my dyslexia. I told my doctor that I have never done that well but I had to do it anyway. I did not do well at the three words I can not remember them all ( not the same ones as you got. ) I think I got at least one right. I fucking hate my learning disability.

safeinOhio

(32,674 posts)
22. I have a yearly visit to my neurologist.
Sun Jan 27, 2019, 02:50 PM
Jan 2019

A few years ago he started to check my memory and gave me the usual test. The one I really screwed up was to start at 100 and count backwards subtracting 7 each time. I was lost in a short time. So, the next year I practiced it and then he didn't give that one again.

I flunked my test the first year, so I worried for a whole year. The next year I scored one point higher so he said I didn't have Alzheimer's. Scored 3 points higher the next year so he said I don't have dementia. I have mild cognitive impairment.

MineralMan

(146,288 posts)
24. Counting back by 7s is a difficult thing
Sun Jan 27, 2019, 04:26 PM
Jan 2019

for most people, I think. I've never had to do that one. I've always thought it was too difficult a cognitive test and that it would often produce erroneous results. Some people just cannot do any arithmetic in their heads, and were never able to.

IcyPeas

(21,859 posts)
25. the counting back by 7s thing had me crying.
Sun Jan 27, 2019, 04:39 PM
Jan 2019

talk about math anxiety. I don't think I got past the first or second one. then the doctor said to "guess" or "approximate" so I guess at least if you get fairly close they can tell something.

Also spelling WORLD backwards.

Also naming the Presidents in order (starting with the current one down...).

MineralMan

(146,288 posts)
27. The trick with the sevens it to mentally do the math for each number.
Sun Jan 27, 2019, 09:07 PM
Jan 2019

"93 minus 7 is 86." 86 minus seven is 79. " And so on. Forget the idea of counting backward and just subtract seven from the last result. That's easy.

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