Industry story
Four Years, Four Doctors: The Fight to Get a Dementia Screening
alzheimers dementia-prevention healthcare patient-perspective
Sean Terwilliger spent four years and four primary care doctors trying to get a cognitive screening after a TIA left him struggling with word-finding, numbers, and balance. Every one of those doctors told him he was fine. The fifth administered the MoCA, a standard 30-point screening that takes minutes, and Terwilliger missed the cutoff by one point. That single point triggered a neurology referral, an MRI, a PET scan showing significant amyloid plaque buildup, and an Alzheimer's diagnosis at 60. If your concerns are being waved off, his account makes the case plainly: ask for the test by name.
Full analysis
Sean Terwilliger noticed cognitive changes — word-finding difficulty, trouble with numbers, balance problems — after a TIA (a brief, stroke-like event) in 2018, and spent four years asking doctors for a cognitive test. Moving through three states and four primary care physicians, he was repeatedly told he was fine. A fifth doctor in Massachusetts finally administered the MoCA (Montreal Cognitive Assessment), a standard 30-point cognitive screening, and Terwilliger failed it by a single point — enough to trigger a neurology referral. That referral led to an MRI, a PET scan showing significant amyloid plaque buildup in the brain, and an Alzheimer's diagnosis at age 60. Terwilliger's account is a direct warning to anyone whose cognitive concerns are being dismissed: failing a widely available screening by one point was all it took to unlock a full diagnostic workup. He argues that a patient's self-reported concern should be sufficient reason for a doctor to administer the test.
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