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Suggest Treatment For Difficulty In Learning New Things

Posted on Wed, 9 Sep 2015

Question: Is it possible to have mci at 22? I scored highly on the ravlt (95th percentile), corsi block test (75th percentile), reverse digit span (97th percentile) and the memtrax but did poorly on the moca (below 26) and the rey figure copy test (bottom 5 %). My memory in daily life (events, conversations) is not impaired at all but my memory for new vocabulary and new/foreign names is impaired for example I struggle to learn new words and try and repeat them over and over with failure to learn.

Answered by Dr. Neeraj Kumar (20 minutes later)

Brief Answer:
Unlikely to be Mild cognitive impairment

Detailed Answer:
Hello XXXXX,
I have gone through your question and understand your concerns.
Mild cognitive impairment at this age is highly unlikely.
The tests mentioned by you are screening and mostly validated for adult and elderly persons.
The design of these tests are not homogenous and vary.
If you have any problem in day to day activities of life then you should get tested for thyroid abnormality, vitamin B12 deficiency, uncommonly metabolic disorders like renal , liver or blood sugar derangements.
If all these tests are normal then nothing to worry about.
Some person have difficulty in learning a particular thing like faces, roads to a place, foreign names. Nothing serious about this.
If you are having any other neurological symptoms like headache, vomiting, fever, behavioural abnormalities, visual loss then you must visit a doctor preferably neurologist for detailed evaluation.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Neeraj Kumar (5 hours later)

Why can I do well in some tests and not others? For example my ravlt score, which is pure memory is high (95th percentile) while my moca score is low. But the only reason I scored low in the moca was because of the serial 7's and clock draw everything else I got right. Should I go for further testing or should I got to a cbt therapist for my hypochondria? Have you ever seen someone with my age with a diagnosis of mci?

Answered by Dr. Neeraj Kumar (5 hours later)

Brief Answer:
Repeat Moca test after 4 weeks

Detailed Answer:
Hello XXXXX,
Low score in MOCA test due to serial 7 may be normal for persons with poor maths. If you have a confusion related to this then you can repeat the test after a gap of 4 weeks.
Clock draw is again dependent on good drawing skills and its score varies with the approximation of figure to perfect figure.
At this age if any memory impairment is suspected then complete workup including brain MRI and blood tests like vitamin B12, thyroid profile, liver function test, renal function test, blood sugar, homocysteine, folic acid may have to be done.
I have not seen MCI in such young patient.
I again assure you to let go the thought of MCI and take a repeat MOCA test after 4 weeks.
Regards
Dr Neeraj Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Neeraj Kumar (9 hours later)

Ye i did repeat the moca twice once scoring 29 and 28, despite scoring 23 the first time. I got all the memory questions right i just got the clock and serial 7's wrong mostly because I never was able to tell the time or do mental math. These seem like learned skills which seem unfair to test on. Do my high scores rule out mci?

Answered by Dr. Neeraj Kumar (2 hours later)

Brief Answer:
Yes, the score is normal

Detailed Answer:
Hello XXXX,
Yes repeated high scores at some interval of weeks is normal.
MCI person will have consistently low score if the test is performed at some weeks interval.
Hope you found the answer helpful.
regards
Dr Neeraj Kumar

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj