Dementia is a progressive condition that affects a person’s cognitive abilities, including memory, language, and decision-making. There is no single test to diagnose dementia, and a combination of assessments and tests is usually required. This process can be carried out by a GP or a specialist at a hospital.
Taking a medical history
The diagnostic process usually begins with a history-taking session, which is generally conducted by a GP. A more detailed history is taken if a person is referred to a specialist. It’s helpful to have someone who knows the person well, such as a family member, accompany them to the appointment, as they can describe any changes or problems they have noticed.
During the history-taking session, the doctor will ask questions about when the symptoms started and how they affect the person’s daily life. They will also check whether any existing conditions, such as heart disease, diabetes, depression or stroke, are being appropriately managed. The doctor will review any medicines the person takes, including prescribed drugs, over-the-counter medications, and alternative products such as vitamin supplements.
Mental ability tests to diagnose dementia
Mental ability tests, also known as cognitive assessments, are carried out to diagnose dementia. These tests evaluate a person’s mental abilities, such as memory or thinking. A typical test used by GPs is the General Practitioner Assessment of Cognition (GPCOG), which involves a series of pen-and-paper tests and questions, each of which carries a score. While these tests cannot diagnose dementia, they may indicate that memory difficulties require further investigation.
The cognitive assessments evaluate several mental abilities, including short- and long-term memory, concentration, attention span, language, communication skills, and awareness of time and place. However, it’s important to note that a person’s level of education may influence test scores. For example, someone with a lower level of education may have a lower score, even if they do not have dementia. Similarly, someone with a higher level of education may achieve a higher score but still have dementia.
Blood tests to check for other conditions
Blood tests are also conducted to check for other conditions that can cause symptoms similar to dementia. The tests usually check liver function, kidney function, thyroid function, haemoglobin A1c (to check for diabetes), and vitamin B12 and folate levels. If there is a suspicion of an infection, a urine test or other investigations may be required.
Dementia brain scans
Once more straightforward tests have ruled out other problems, brain scans are often used to diagnose dementia. Memory tests and brain scans cannot diagnose dementia independently, but they are used as part of the broader assessment. Not everyone will need a brain scan, especially if the tests and assessments indicate that dementia is likely. These scans can also check for evidence of other possible problems that could explain a person’s symptoms, such as a stroke or a brain tumour.
An MRI scan is usually recommended to confirm a diagnosis of dementia and the type of disease-causing dementia. In addition, it can provide detailed information about the blood vessel damage that happens with vascular dementia or show areas of shrinkage that can indicate frontotemporal dementia and Alzheimer’s disease.
A CT scan can be used to check for signs of a stroke or a brain tumour. Still, it cannot provide detailed information about the brain’s structure. So even if a brain scan does not show any noticeable changes, it does not necessarily mean that someone does not have dementia.
Other scans and procedures to diagnose dementia
In some cases, other scans and procedures, such as a SPECT or a PET scan, may be recommended if the result of an MRI or CT scan is uncertain. These types of scans look at how the brain functions and can pick up abnormalities with blood flow in the brain. An EEG may also be taken if a specialist suspects that.
While receiving a dementia diagnosis can be daunting, it’s essential to remember that early diagnosis can help manage the condition and plan for the future. Additionally, support and care are available for people with dementia and their families, including information and resources from dementia charities and support groups. Ultimately, seeking medical advice and support as soon as possible is crucial for people concerned about symptoms of dementia or who have a family history of the condition.
Eximius can help
Here at Eximius, we provide dedicated and compassionate live-in care to people with various conditions, including dementia. If you want to learn more about how we can help you or a loved one, we’d love to hear from you. You can contact us here.