Question on Mild Dementia diagnosis.
About five months ago my wife, who has significant hearing loss ah an episode of what I’ll call extreme tinnitus. She was hearing what she described as loud sirens (like this emergency broadcast test that pop up on TV). They were so loud it made her cry. I got her to our ENT who ordered an MRI which came back clear. Shortly after the mri results came she started seeing people, or ghosts as she first claimed, in the bedroom. She could describe them just as tho’ they were real people, but they disappeared when the light came on. She also saw a mother cat and several kittens in our back yard that just were not there, I went outside to look. About a week ago she saw something that involved me while I was laying in bed sleeping, right next to her. This also didn’t happen and when I turned on a flashlight, it disappeared. This scared me so I called our PCP, a nurse NP who sent a referral to a neurologist. The referral said Early Dementia, based solely on our phone conversation. We we to the neurologist yesterday. We told him what was going on and after some simple cognitive tests - three words, and one that involved an ink pen, ‘what is this, What color is it, what’s it use for? She of course knew, then he said “show me how you’d use it”. I myself did not really understand but he said with your hand (he wanted her to pretend to write with her hand) Partially be because she didn’t hear well, didn’t understand. Then it was “What month is this, what year, where are we now?” Which she knew , then “where are we?” After a short pause, she said “in your office”. Then he said “point at the door”, which she did. Based on this, he said she has Mild Dementia and prescribed Rexulti and said he wanted to see her back in 6 weeks. I had the CD for the MRI our ENT had ordered, and the report but he said he didn’t need to see this.
When we got home I did some online searches and everything I found said hallucinations alone, with no other cognitive symptoms, would not lead to a diagnosis of mild dementia. Others have suggested Lewy Bar or Charles Bennet but she’s not showing any symptoms of those either. I’d hat to accuse the neurologist but I almost wonder if because the referral said dementia, that’s what he looked for. A few years ago I watch our next door neighbor, about 10 years older than my wife, deteriorate rapidly from dementia. This scares me to death and I’m not sure I want my wife to start taking Rexulti.
