Friday, July 24, 2020

That cognitive assessment

It seems odd that trump is so fixated on the test he took...3 years ago!

As far as anyone can tell it's the "standard" test used to evaluate cognitive decline. It's administered to people with various cognitive disorders, people who experienced head injuries, and for early evaluations of dementia, Parkinson's, and Alzheimer's.

It is not "30 questions" but it typically scores 30 points. Doctors don't say you did great, or the best, it's just a tool for evaluation. And they don't give "extra" points (like giving a seal a fish) because that's not how it works.

The questions don't get harder, it's consistent in its design.

It's not administered at random or to everyone. It's only administered when there's some cause for concern. Perhaps trump took it as part of his medical evaluation when he ascended to the office; it does seem peculiar there hasn't been follow up that we know of.

And why do I know anything about this? Because my father was diagnosed with Alzheimer's a few years ago, and during the initial evaluation, he took several variations on the test. It's more or less the same, it's just that the words the ask you to remember and the pictures they ask you about do change.

But what gets missed along the way is that there are no context clues. When trump gave an interview where he listed off some words, and then repeated them, he was picking objects he saw.

The words they give you - like Apple, table, horse - have nothing in common and wouldn't be seen in medical facilities.

But they do also quiz you on things like the date, where you are, and so on.

In my dads case, he had enough awareness to use clues around him to answer most of those questions. And then it got harder.

As for the test itself, it was interesting to watch his mind slip away. He had good days where he could do more of the test, some days he got some answers, other days it was different answers.

I believe he had an awareness of what was happening to him, though he couldn't say anything about it. Early on, he said he felt great and tried hard to stay sharp. When he'd take the test he'd talk about how well he did. IMHO I think he was afraid of what was happening and trying to tell himself that he was okay. Like trump, he sometimes talked about this test. It was a means of coping.

I'd Be curious how trump does on a test today, 3 years later. Is he trying to convince himself that he's okay?

At some point, they stopped administering the test to my dad. He had Alzheimer's. Every test and MRI told us that. There was no reason to conduct it. All it could tell us was generally how fast it was progressing.

But my mom kept giving him the tests. And while it wasn't helpful it was interesting. He kept having good and bad days. And some questions he couldn't answer at all.

Surely trump is cognitive decline, we deserve to know how severe it is and whether it affects his ability to govern.

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