Dementia is a set of symptoms that affect memory, thinking, and behavior. Although it is more common as people age, it is not a standard part of aging. Dementia is progressive and can affect a person’s ability to perform everyday activities and quality of life. Doctors can diagnose it using various tests, including medical imaging, genetic tests, and cognitive tests.
Early diagnosis and treatment for dementia are important. However, it is a multistep process, and there is no singular test to diagnose the condition. Instead, doctors may use a combination of medical history, physical exams, and cognitive testing to diagnose it. They can administer tests to measure memory, thinking skills, and changes in behavior. In some cases, doctors may also order imaging tests, such as CT scans or MRI scans, to look for atypical characteristics in the brain.
There is no one-size-fits-all approach to dementia diagnosis or treatment, but early intervention can help people with dementia live independently for longer.
This article examines how doctors diagnose dementia and how people with the condition can find help and support.
How to diagnose dementia
If a person has concerns about their memory or other thinking abilities, they can consult a doctor. The typical first steps that doctors take to diagnose dementia include:
- assessing a person’s medical history
- asking about any changes in mood or behavior
- performing a physical exam and ordering blood tests to look for other potential causes of the symptoms, such as an underactive thyroid gland or vitamin E or B12 deficiency.
A doctor care primary usually refers a person with suspected dementia to a specialist, such as a neurologist, psychiatrist, or geriatrician. No one test can diagnose dementia — doctors need to apply a combination of tests and observations.
The specialist performs tests specifically for dementia. These can help measure a person’s
- problem-solving abilities
- language skills
- changes in the brain
Doctors can typically say that someone has dementia with a high degree of certainty. However, it is more challenging to determine the type of dementia because symptoms and physical brain changes often overlap.
Doctors must perform a comprehensive physical and neurological examination to diagnose dementia.
Tests may include:
- Brain imaging: Doctors can use CT, MRI, and PET scans to help them identify strokes, tumors, or other problems that could cause dementia. Scans also show changes in the brain’s structure and function.
- Genetic tests: Some types of dementia have genetic causes. If a family member has the condition, genetic testing can help assess the person’s risk of developing dementia.
- Blood tests: Doctors can order a blood test to measure other conditions that can mimic dementia, such as a vitamin B12 deficiency or thyroid disease.
Cognitive and neurological tests are important tools for dementia diagnosis and monitoring disease progression. They help doctors assess a person’s memory, thinking, and language skills.
Common tests include:
- mini-mental status examination
- Montreal Cognitive Assessment
- Addenbrooke’s Cognitive Examination–Revised
- modified mini-mental state examination
- Rowland Universal Dementia Assessment Scale
Neurological exams assess a person’s muscle strength, coordination, reflexes, and sensation. They can help doctors differentiate standard aging from dementia and identify the type of dementia someone has.
A psychiatric evaluation is a valuable part of the dementia diagnosis process. It can help rule out other conditions that can cause dementia-like symptoms, such as depression and anxiety.
The psychiatrist performs evaluations to assess the following:
- behavior and mood
- memory and thinking
- thought processes
- knowledge of time and place
- body posture, eye contact, and speech
- decision making
- social skills
The psychiatrist may use questionnaires and rating scale tests that consist of 20 to 30 short questions.
They will also take a medical history to determine if the person takes any medications and how they function, sleep, eat, and manage everyday activities. The psychiatrist may ask the person’s family or close friends about changes they have noticed in behavior or thinking.
Some evaluation results are available immediately, although someone may need to wait for results from other tests for the psychiatrist to diagnose.
When to contact a doctor about possible dementia
People with dementia may not be aware they are having difficulties. A family member or close friend can contact a doctor if they notice any potential symptoms. Some potential symptoms to look out for include:
- seeing someone struggling to remember new information
- having trouble concentrating or making decisions
- experiencing changes in mood or behavior
Early diagnosis is crucial because it gives people with dementia and their families time to plan for the future and access treatments that can improve their quality of life. It also allows individuals to enroll in clinical trials that test new dementia therapies.
What to do after a dementia diagnosis
After receiving a dementia diagnosis, the first thing to do is take some time to process and come to terms with the news. This can be difficult, but a person can seek out whatever support they need during this time, whether from loved ones, friends, or mental health professionals.
The person with dementia and their family can also work with a doctor to develop a treatment and management plan. The plan may include:
- medications to treat dementia symptoms
- therapies to improve cognition and function
- home care and safety measures
- dietary changes
- support groups
The goals of treatment are to improve the person’s quality of life and help them maintain their independence for as long as possible.
People with dementia also need help with practical affairs, such as managing their finances and legal documentation. There also needs to be a plan for their eventual care as the disease progresses and they require more assistance.
It is vital to have conversations about these things early on while the person can still decide their future and care. One consideration is a power of attorney, which gives someone else the legal authority to make decisions on the individual’s behalf.
Support for families
If a loved one receives a dementia diagnosis, families can find support and information from the Alzheimer’s Association.
Caring for someone with dementia can be overwhelming, and caregivers need to take care of their physical and mental health. Support groups can provide caregivers with information, practical tips, and emotional support. These groups can be a lifeline for caregivers, helping them to feel less isolated and more confident in their caregiving role.
Families can also find information on planning for the future and what to expect as the disease progresses.
Dementia is a serious condition that causes changes in thinking, behavior, and function. Early diagnosis is important so that people with dementia and their families can plan for the future and access treatments that can improve their quality of life.
There is no singular test for dementia diagnosis. Instead, doctors use a variety of lab and imaging tests and assessments of the person’s cognitive and functional abilities. They make the diagnosis according to these results and after ruling out other potential causes of the symptoms.