On June 11 we
traveled to Harborview in Seattle for my annual cognitive
testing—almost four hours worth. I was anxious because I had slept
very poorly the night before, and I had foolishly scheduled the
testing for the afternoon. I’m a morning person, and when I’ve
missed sleep it might not hit me until the afternoon. But, we went
ahead with the tests, and I was surprised at how well I felt about
how I’d done.
Not being a patient
person, I wanted to know the results immediately. But they needed to
be analyzed and assessed before the doctors could share them with me.
So I needed to wait; we would need to return more than a week later
to hear the results.
Before the test
began, I had a discussion with the new neuropsychologist who will be
following my case. We discussed the status of the SNIFF (insulin)
study, and the fact that I had been getting quarterly psychometric
testing from them. I wondered about how “the
practice effect” might influence my results. She said that was
a consideration, and she had made some changes to the test suite to
differentiate these tests from what I had taken before.
Yesterday (June 23)
we made the trip back over the mountains to meet with my neurologist
and review the results. They were even better than I had
anticipated.
It was true that the
neuropsychologist had shaken up the test suite, and so I can’t make
the sort of year-over-year, test-by-test comparisons that I’ve made
before. Nevertheless, there were 42 individual assessments, and I
could easily get an overall sense for how things were compared to
2015 through 2017. In 23 tests I scored high average, superior, or
very superior. As I write this, I’m still in Seattle, and I don’t
have my old tests available. But I don’t recall ever having
received a “very superior” before. There was only one low
average, and none of the below average scores that I had sometimes
scored in the past.
In her summary
assessment, the neuropsychologist identified five areas in which I
had improved (single-trial learning and delayed recall from a word
list, both semantic and phonemic verbal fluency, basic attention, and
visual tracking/psychomotor speed), adding that some of them may have
been inflated due to the practice effect. But from a broad cognitive
standpoint, she wrote, “Mr. Brown is doing very well across all
domains.”
My neurologist was
quite enthusiastic about the results, and agreed that the
improvements were likely a consequence of the lifestyle changes I’ve
made. She mentioned that at least one other professional in her
office had gotten a copy of Beating the Dementia Monster.
During the visit, we
reviewed images from my most recent MRI (February) and compared it to
the MRIs of 2012, 2015, and 2017. Some of these were done using the
research machine for the SNIFF study. What we specifically looked
for was a way of understanding the assessments of hippocampus volume.
(The 2015 radiologist report had me in the 36 percentile of people
my age, but the SNIFF study reports had me at less than the 1
percentile.) She didn’t try to assign numeric values from the
images, but it was evident that there was little or no deterioration
from the time I made the lifestyle changes I describe in Beating
the Dementia Monster (December
2015). Nevertheless, there were notable changes (atrophy)
between the 2012 images and the 2018 images.
So how do these
results affect my future course? The neurologist said that we should
not do cognitive testing next year. I will have a closeout suite for
the SNIFF study in August, but I should take a break from cognitive
testing after that until the summer of 2020. She said I should
return next summer for an annual visit to see how things are going.
We’ll be alert for anything unusual or unexpected, especially when
the SNIFF study ends, and I’m taken off the insulin.
I won’t lie. Some
mornings it’s really hard to get on that treadmill and keep it
going for 45 minutes. But it’s really worth it.
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