Upon taking my mom to the doctor I have noticed that the questions asked to help determine her level of dementia/AD are not "fair". If a person has no knowledge of some word to start out with how can they ask her what it is and expect a correct answer to figure out if her illness is worse. For example, she grew up in the 1920's in a Hispanic South Texas farm and she should not be expected to readily recognize a hippo in a drawing. If she does she may know the name in Spanish and not in English. Concessions should be made for cultural differences in testing to get accurate results.

I went through a similar experience with my mother, and I simply asked her if she ever knew what the object was in her native language. I then asked her to name a few other wild animals (in the case of a bear) and describe them, which she did. She knew about foxes and weasels because they killed chickens and stole eggs on her farm. For the future, I found a picture of each and gave them to the doctor for the next test. Following your parent to the test and having the courage to insist on fair tests is vital if we want to get accurate information. The clinical tests are pretty inadequate and much too loose for their purpose. They have to be used with wisdom and understanding. It would be great if tests were developed that did not rely on these cultural biases.