Diagnosing Dementia

Editor’s note: Although much is reported about dementia and its effects on patients and caregivers, there may be less to read about how dementia is diagnosed. Here, from the National Institute on Aging, is an explanation of how that works:

To diagnose dementia, doctors first assess whether a person has an underlying treatable condition such as depression, abnormal thyroid function, normal pressure hydrocephalus, or vitamin B12 deficiency. Early diagnosis is important, as some causes for symptoms can be treated. In many cases, the specific type of dementia a person has may not be confirmed until after the person has died and the brain is examined.

A medical assessment for dementia generally includes:

Patient history. Typical questions about a person’s medical and family history might include asking about whether dementia runs in the family, how and when symptoms began, changes in behavior and personality, and if the person is taking certain medications that might cause or worsen symptoms.
Physical exam. Measuring blood pressure and other vital signs may help physicians detect conditions that might cause or occur with dementia. Such conditions may be treatable.
Neurological tests. Assessing balance, sensory function, reflexes, vision, eye movements, and other functions helps identify conditions that may affect the diagnosis or are treatable with drugs.

Tests Used to Diagnose Dementia

The following procedures also may be used to diagnose dementia:

Cognitive and neuropsychological tests. These tests measure memory, problem solving, attention, counting, language skills, and other abilities related to mental functioning.
Laboratory tests. Blood and urine tests can help rule out possible causes of symptoms.
Brain scans. These tests can identify strokes, tumors, and other problems that can cause dementia. Scans also identify changes in the brain’s structure and function. The most common scans are: ◦Computed tomography (CT), which uses X-rays to produce images of the brain and other organs

◦Magnetic resonance imaging (MRI), which uses magnetic fields and radio waves to produce detailed images of body structures, including tissues, organs, bones, and nerves

◦Positron emission tomography (PET), which uses radiation to provide pictures of brain activity

Psychiatric evaluation. This evaluation will help determine if depression or another mental health condition is causing or contributing to a person’s symptoms.
Genetic tests. Some dementias are caused by a known gene defect. In these cases, a genetic test can help people know if they are at risk for dementia. People should talk with family members, a primary care doctor, and a genetic counselor before getting tested.

Who Can Diagnose Dementia?

Visiting a family doctor is often the first step for people who are experiencing changes in thinking, movement, or behavior. However, neurologists—doctors who specialize in disorders of the brain and nervous system—generally have the expertise needed to diagnose dementia. Geriatric psychiatrists, neuropsychologists, and geriatricians may also be skilled in diagnosing the condition.

If a specialist cannot be found in your community, ask the neurology department of the nearest medical school for a referral. A hospital affiliated with a medical school may also have a dementia or movement disorders clinic that provides expert evaluation.

For More Information About Diagnosing Dementia:

NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center

1-800-438-4380 (toll-free)

adear@nia.nih.gov

www.nia.nih.gov/alzheimers

The National Institute on Aging’s ADEAR Center offers information and free print publications about Alzheimer’s disease and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.

Alzheimer’s Association

1-800-272-3900 (toll-free, 24/7)

1-866-403-3073 (TTY/toll-free)

info@alz.org

http://www.alz.org/

National Institute of Neurological Disorders and Stroke

1-800-352-9424 (toll-free)

braininfo@ninds.nih.gov

http://www.ninds.nih.gov/

Reprinted courtesy of the National Institute on Aging.