How to Diagnose Dementia

When family or friends suspect a loved one has memory loss, an evaluation with a physician can determine whether the patient has mild cognitive impairment due to aging or something more severe, like dementia. In recent years, a greater understanding of dementia has enabled clinicians to diagnose earlier in the disease progression. Early diagnosis allows the patient and their loved ones to make plans for their medical care. Although patients in the earlier stages can still live independently, people with advanced dementia require constant care. Those planning on meeting with a physician for a dementia evaluation should take note — there isn’t just one test that can deliver a dementia diagnosis. A physician typically needs to conduct multiple tests and the process could take several weeks. Decoding Dementia Dementia is a disease that happens to many people, even if they don’t have a family history. In the 2019 World Alzheimer Report, 95 percent of people said they believed it could happen to them and 79 percent reported worrying they would one day develop dementia. Despite concerns about dementia, the study also concluded that many people globally don’t understand the disease and there needs to be an awareness initiative to educate people and reduce stigma. What is Dementia? Dementia is a progressive neurological disease that initially involves memory loss and then advances to the loss of cognitive functioning. Alzheimer’s Disease (AD) is the most common type of dementia. There are more than 100 types of dementia, and many patients are diagnosed with more than one type. Read More: The 4 Main Types of Dementia Is Dementia Hereditary? Depending on the type of dementia, genetics can play a role in the likelihood that a person will develop the disease. A 2019 JAMA article investigated medical records and found that people with a genetic risk for dementia are more likely than those without a genetic risk to develop the disease. In the study, researchers looked at records from a British “biobank” in which people shared their medical records including information about their lifestyle such as whether they drank alcohol heavily, smoked or had an exercise routine. The researchers analyzed data from about 200,000 people ages 60 and older and found people who had both a genetic risk and an unhealthy lifestyle were 2.5 times more likely to develop dementia than those with a healthy lifestyle and no genetic risk. Read More: Does Melatonin Cause Dementia? Diagnosing Dementia Early dementia involves the loss of episodic memory, meaning the person forgets to attend appointments they made, pay bills or take medication as prescribed. Although the patient will initially maintain long-term memories, they struggle with new information. They will fail to remember someone’s name or forget they recently attended an event, like a family picnic. How is Dementia Diagnosed? During an evaluation, a physician will consider a person’s family history with the disease as one of many factors. Evaluations typically begin with a discussion that assesses the patient’s behavior. This requires help from a close family member or friend who can either confirm the patient’s concerns or tell the physician what they have observed. During this appointment, the physician might move on to abilities testing. There are several types of tests a clinician can use to measure a patient’s memory, language capabilities and their sense of surroundings. These aren’t standalone tests, and physicians will use them along with other diagnostic tools. Testing for Dementia The mini-mental state examination or Montreal Cognitive Assessment are similar tests that take less than 15 minutes to complete. Each test is a page long and uses a 30-point rating scale. The patient is asked to perform memory recall tasks, including a delayed recall task that requires the person to repeat at least three of 10 words that were listed five minutes earlier. Patients also do a clock-drawing task. The clinician asks them to first draw a circle to represent a clock and then fill in the numbers. The clinician will typically ask the person to draw in arrows indicating the time is 10 minutes past 11 o’clock. Patients with early-stage dementia will be unable to complete the task. The evaluations also involve tasks regarding language assessment, as well as orientation to time and place. These tasks help indicate not only if the patient has dementia, but also what type. Patients with frontotemporal dementia, for example, experience a degradation of their front and temporal lobes, which can be revealed if they struggle with language assessment tasks. Can an MRI Detect Dementia? Yes, a Magnetic Resonance Imaging (MRI) can detect dementia. MRIs or a positron emission tomography (PET) can show if a person’s brain is deteriorating, developing lesions or the plaques and tangles associated with AD. Even before a person shows symptoms of memory loss, there are changes happening inside of their brain, which can be detected through imaging prior to a patient or their loved ones even realizing they have dementia. Read More: Can Cats Get Dementia?