I don't know much about Mayo except my own experience, which was not... fruitful and insurance did not cover it well - so I ended up paying a lot for getting very little.
Alzheimer's is pretty well known, and there are fantastic hospitals where you are? I hope you got copies of all tests to ensure your dad was properly diagnosed as in all other things ruled out, like thyroid, vitamins etc.
Do you know the stage(s) your Father is in?
Below is my dad's medical record:
Memory deterioration for 8 years, dizziness and headache for 2 years
Present illness summary:
Patient appeared memory deterioration began 8 years ago, his working skills performed ingravescent decline, verbal comprehension ability reduced, the patient raised repeated dizziness and headache within recent 2 to 3 years, accompanied with upper limb numbness, but without nausea, vomit, chilly, fever, obnubilation, rotating vision, limbs convulsion, movement, disturbance, syncope, chest stress or chest discomfort.
The main problem
is memory deterioration, comprehensionability reduction and lower reaction, for example, the patient only got 26 points in the MMSE testing, for the memory testing (could you give three subjects just memorized) the patient got 0 point (full point is 3),and the other mission: folio the paper, the patient cannot immediately understand the word“folio”. In daily life, patient cannot differentiate similar vegetables (for example: the patient thought the cucumber is the zucchini after stir fried).
Aug 06, 2014, the result showed patient kept social connection,etiquette, living skills, without getting lost, but with anxiety emotion, blank interest, low self‐assessment, feel fatigue, and inattention. His total mark of MMSE showed 26 points (among 30), and thus his physician gave him antidepressant drug: 50mg sertraline Hydrochloride Tablets daily.
Sep 05, 2014: Re‐examination on skull MRI description and conclusion: 1.Ischemia within the bilateral centrum semiovale; 2.Appeared old infarction focus within the bilateral basal ganglia and the right side of the centrum semiovale; 3.Atrophy on the temporal lobe and hippocampus;
Sep 05, 2014: T3, T4, TSH, HIV, RPR, and VitB12 within the normal range.
The physician confirmed as: “Alzheimer Disease, AD”, medication dosage: 5mg Donepezil Hydrochloride daily (every night), 5mg Memantine tablet daily (every morning), 50mg Sertraline Hydrochloride tablets daily (every morning).
More,my father got depression and used Sertraline to help,In February 2013, because of the long term dizziness and headache, the physician confirmed as “insufficient blood supply”.
Based on the information you gave, it appears that your dad is actually more in the earlier stages. Later stages have more a physical deterioration.
With the stoke and lack of O2, I would find out if adding oxygen to his regimen may help.
How about vitamin D?
Is the atrophy in normal limits?
Then I know you will have many questions about the course of the disease, so perhaps the doctor may or may not know as each person goes down the path a bit differently and the stages are general and people hit them not always in order, and sometimes a few at a time. It helps to have a lot of backup caregivers and support for yourself as well.
Also know that the medications may work now, but may stop, and he may sundown, and the only constant is change. It helps to talk about old times and not to argue. Enjoy what you can with him. He can have some lucid moments even in late stages. It is one crazy nasty evil disease.
Mayo's sencond opinion:（excerpt ）
A few questions are posed the medical records. The first question is that of whether the patient has Alzheimer's
disease. I think that neuropsychological testing would best answer this question. On an MRI from April 2014, there
is some mild bilateral hippocampal atrophy. Perhaps performing a lumbar puncture with measurements of Ab42, tau
protein, and phospho-tau protein would be of help. I think the patient also needs to be physically active. Another
question is whether the patient should continue with donepezil. If indeed he has difficulties with cognition, that would
be a reasonable choice.
Indeed, the diagnosis of Alzheimer's disease would need to be based on neuropsychological testing, functional and
structural neuroimaging, and even perhaps CSF markers of Alzheimer's disease. If this could be performed, it would
very much aid in determining Mr. Zhang's difficulties with cognition.
#1 Memory complaints