human behavior

A demented view of politics

Posted in American Culture & Politics, Health & Medicine by humanb on February 3, 2010

Today I shadowed a doctor at the Geriatric Cognitive Disorders Clinic. Most of the patients we see have early dementia, but have yet to receive a diagnosis. Others attend clinic post-diagnosis for follow-up.

Every patient undergoes a Mini-Mental Status Examination (pdf), but the results of this test can be equivocal in the very early stages of memory loss. For example, on my “off” days, I couldn’t tell you the date or the day of the week, and would therefore get a lower score.

In point of fact, I usually have to look at my watch to confirm the date when I’m asking an 80 year-old to tell me. If you’re a 80-year-old who is long retired and doesn’t need to keep track of the date anymore, it can be tricky. So when a patient doesn’t seem oriented to time, doctors will typically ask a more general question to assess time orientation:

Who is the president of the United States?

Our first patient could answer this correctly, and proceeded to answer correctly the names of the three presidents who preceded him.

Our last patient was a lovely 82-year-old woman whose cognitive impairment may have been the result of dementia, temporary delirium, stroke or some other pathology. If her cognitive impairment is improving (which it is), it is more likely the result of delirium or stroke, though she probably also has some underlying dementia. When asked on a previous doctor’s visit…

Who is the president of the United States?

She answered: Osama Bin Laden.

But today she regretfully replied, “I can’t remember.”

I’d call that improvement.

I wish her well.

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  1. Anonymous said, on February 3, 2010 at 12:06 pm

    The name Osama Bin Laden must be more meaningful to her because of 911 and that devastation. Simple confusion.

    • humanb said, on February 3, 2010 at 12:22 pm

      Sure. We all recognized that the names were similar. The confusion is still a sign of a problem. The challenge is to determine the nature and cause of the problem.

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