What Are The Signs And Symptoms Of Dementia
Signs and symptoms of dementia result when once-healthy neurons, or nerve cells, in the brain stop working, lose connections with other brain cells, and die. While everyone loses some neurons as they age, people with dementia experience far greater loss.
The symptoms of dementia can vary and may include:
- Experiencing memory loss, poor judgment, and confusion
- Difficulty speaking, understanding and expressing thoughts, or reading and writing
- Wandering and getting lost in a familiar neighborhood
- Trouble handling money responsibly and paying bills
- Repeating questions
- Not caring about other peoples feelings
- Losing balance and problems with movement
People with intellectual and developmental disabilities can also develop dementia as they age, and recognizing their symptoms can be particularly difficult. Its important to consider a persons current abilities and to monitor for changes over time that could signal dementia.
Some Questions You May Wish To Ask You Doctor Regarding Tests Used In Diagnosing Dementia
- What tests will be conducted?
- Who will be performing the tests and how long will it take?
- Should I prepare for the tests in any way?
- Will any of the tests involve pain or discomfort?
- Will there be any cost involved?
- What follow-up will be necessary and who will follow up?
- How will I be informed of the test results and the diagnosis?
Who Gives The Diagnosis
The GP will, in most cases, tell a patient about a diagnosis of dementia. If the person has been referred to a specialist for further tests or brain scans, reports of those will be sent to the GP. In some cases, a doctor may decide a diagnosis is too much for the person to cope with and may initially inform a partner or close relative.
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Visiting Your Doctor: What To Expect
When seeking a diagnosis, the doctor may begin by asking you some general questions about your overall health:
- What kind of symptoms have you noticed?
- When did they begin?
- How often do they happen?
- Have they gotten worse?
- What other medical conditions exist?
They will look for problems with memory, reasoning ability, language and judgment, and how these affect day-to-day function.
The doctor may use the words probable Alzheimers disease.
Many doctors who make this diagnosis are accurate 80 to 90 percent of the time. The doctor may refer you to another specialist such as a psychologist, psychiatrist, neurologist, geriatrician, nurse, or a social worker.
A doctor will ask you and possibly your family members about your medical history, including current and past illnesses. The doctor will also look at your family history of medical conditions. It may be helpful for you to bring a list of current medications that you are taking.
Mental Status Tests
Mental status testing helps give the doctor a general idea of your mental functioning. One of the most common is the Mini-Mental State Examination . This part of the process tests things such as your sense of time and place, as well as your ability to remember things and do simple calculations. It may involve exercises such as recalling words and objects, drawing and spelling, and questions such as what year is it?
Physical Exam and Diagnostic Tests
What Doctors Need To Do To Diagnose Dementia
Now that we reviewed the five key features of dementia, lets talk about how I or another doctor might go about checking for these.
Basically, for each feature, the doctor needs to evaluate, and document what she finds.
1. Difficulty with mental functions. To evaluate this, its best to combine an office-based cognitive test with documentation of real-world problems, as reported by the patient and by knowledgeable observers
For cognitive testing, I generally use the Mini-Cog, or the MOCA. The MOCA provides more information but it takes more time, and many seniors are either unwilling or unable to go through the whole test.
Completing office-based tests is important because its a standardized way to document cognitive abilities. But the results dont tell the doctor much about whats going on in the persons actual life.
So I always ask patients to tell me if theyve noticed any trouble with memory or thinking. I also try to get information from family members about any of the eight behaviors that are common in Alzheimers. Lastly, I make note of whether there seem to be any problems managing activities of daily living and instrumental activities of daily living .
Driving and managing finances require a lot of mental coordination, so as dementia develops, these are often the life tasks that people struggle with first.
Checking for many of these causes of cognitive impairment requires laboratory testing, and sometimes additional evaluation.
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Stage : Moderate Dementia
Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.
While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.
Memory Tests Doctors Use For Dementia
The idea that your memory might be slipping is a scary one indeed. Its not always accurate, however, and there are memory tests that doctors can use to test whether its actually happening or not.
A certain amount of forgetfulness is normal as we grow older. We may forget someones name or fail to pay a bill. Such memory lapses are mild and usually a normal part of aging. We have all had instances of losing track of our keys and not remembering the name of the movie we saw last month.
For me, Ive always been great with peoples faces, but their names, or even worse dates forget about it .
There are, however, more serious signs that our short-term memory is failing and that we need to discuss the situation with a doctor. How do we tell the difference?
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Seeing Your Gp About Dementia
If youre concerned about having a dementia and see your GP, they will usually:
- ask about your symptoms and your health
- give you a physical examination
- organise blood tests
- ask about any medications you take, as medicine can sometimes cause symptoms similar to dementia
- ask you some questions or do mental exercises to measure your memory or ability to think clearly
What Happens If A Doctor Thinks It’s Alzheimer’s Disease
If a primary care doctor suspects Alzheimers, he or she may refer the patient to a specialist who can provide a detailed diagnosis or further assessment. Specialists include:
- Geriatricians, who manage health care in older adults and know how the body changes as it ages and whether symptoms indicate a serious problem.
- Geriatric psychiatrists, who specialize in the mental and emotional problems of older adults and can assess memory and thinking problems.
- Neurologists, who specialize in abnormalities of the brain and central nervous system and can conduct and review brain scans.
- Neuropsychologists, who can conduct tests of memory and thinking.
Memory clinics and centers, including Alzheimers Disease Research Centers, offer teams of specialists who work together to diagnose the problem. In addition, these specialty clinics or centers often have access to the equipment needed for brain scans and other advanced diagnostic tests.
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If You Are Diagnosed With Dementia
Obtaining an early and accurate diagnosis can improve the quality of life for people with dementia.
Talk to your doctor about treatment and ongoing assessment.
Support and information is available through the National Dementia Helpline on 1800 100 500.
Thanks to Associate Professor David Ames for reviewing this material.
Where To Get Help
- Your local community health centre
- National Dementia Helpline Dementia Australia Tel. 1800 100 500
- Aged Care Assessment Services Tel. 1300 135 090
- My Aged Care 1800 200 422
- Cognitive Dementia and Memory Service clinics Tel. 1300 135 090
- Carers Victoria Tel. 1800 242 636
- Commonwealth Carelink and Respite Centres Australian Government Tel. 1800 052 222
- Dementia Behaviour Management Advisory Service Tel. 1800 699 799 for 24-hour telephone advice for carers and care workers
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Be A Lifelong Learner
Seniors frequently do not get enough brain stimulation. In battling Alzheimers, it can be very helpful to take on new tasks, such as crossword puzzles or other hobbies. Again, according to Harvard Health Publication, the brain should be treated like a muscle that will improve with use and exercise.
Almost 20 percent of enrolled college students are over the age of 35. Some are working toward a degree, and many are simply taking classes that are of interest or that will broaden their horizon, such as learning a new language, photography, or how to play an instrument.
A crucial additional benefit to going back to school as a senior is that it can prevent the isolation from which many seniors suffer which can lead to depression. Those college tests might be the best memory tests of all!
Blood Tests To Check For Other Conditions
Your GP will arrange for blood tests to help exclude other causes of symptoms that can be confused with dementia.
In most cases, these blood tests will check:
- liver function
- haemoglobin A1c
- vitamin B12 and folate levels
If your doctor thinks you may have an infection, they may also ask you to do a urine test or other investigations.
Read more about blood tests.
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How Doctors Test For Dementia
More than 6 million Americans have been diagnosed with Alzheimers Disease the most common form of dementia. It afflicts one in nine Americans over the age of 65, and as our population lives longer, its expected to be a much bigger problem. There is no cure, so is it worth getting tested? And what does that involve?
Donald Trump will be remembered for many things, including his public description of a test used to measure cognitive function our ability to think, to remember, speak and solve problems.
Like youll go Person, Woman, Man, Camera, TV,: he told Fosx News. 10 minutes, 20 minutes later theyll say, Give us that again, and you go, Person, Woman, Man, Camera, TV. They say, Thats amazing! How did you do that?
Patients are also put through a series of mental exercises, asked to identify or draw pictures, to solve problems and list words from a given category.
Trump seemed to think the test measured intelligence. In fact, its used to help doctors pinpoint changes in our brains. Dr. Carol Manning, director of the Virginia Alzheimers Disease Center at UVA, says they may also order a scan using magnetic resonance imaging.
The first thing we do is a regular MRI, which just looks at the structure of the brain to see, Is there a lot of atrophy or brain shrinkage? Is there a lesion in the brain that would be the reason that the person is having cognitive decline.
And they can look for fragments of protein in the brain called amyloid.
Stage : Mild Dementia
At this stage, individuals may start to become socially withdrawn and show changes in personality and mood. Denial of symptoms as a defense mechanism is commonly seen in stage 4. Behaviors to look for include:
- Difficulty remembering things about one’s personal history
- Difficulty recognizing faces and people
In stage 4 dementia, individuals have no trouble recognizing familiar faces or traveling to familiar locations. However, patients in this stage will often avoid challenging situations in order to hide symptoms or prevent stress or anxiety.
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Is It Important To Diagnose Dementia What Is Involved What Can Doctors Do
In this article, we look at the tough issues relating to diagnosis. It may take time, and some tests may be involved. But for most people, getting a clear diagnosis is a vital first step towards getting good support for the years ahead.
Facing a dementia diagnosis
It is hard to face going through any diagnosis process or to try to coax a loved one to do so. And when it comes to dementia, it is especially hard. There is still a lot of stigmas associated with dementia. Embarrassment and fear make people avoid talking about the topic, let alone taking any action on it.
Many people will have lived with a strange sense of something being wrong for some time months or even years. They know they are having difficulties, but the reason for them is unclear. Family members and friends may suspect there is something wrong too, but feel unsure whether it is worth pushing for further investigations.
Over recent years, there is a growing consensus that it is a basic right for people living with dementia to be given clear information about the illness they are living with. This is accepted for any other illness so why not dementia? So yes, it is important to diagnose dementia.
In some situations, the person with suspected dementia may have a clearly stated wish not to know the diagnosis this is also their right and needs to be respected.
Have the tests and scans
Consider the treatment options
Other Scans And Procedures To Diagnose Dementia
Other types of scan, such as a SPECT scan or a PET scan, may be recommended if the result of your MRI or CT scan is uncertain.
However, most people will not need these types of scans.
Both SPECT and PET scans look at how the brain functions, and can pick up abnormalities with the blood flow in the brain.
If a specialist is worried that epilepsy may be causing the dementia symptoms, an EEG may be taken to record the brain’s electrical signals , but this is rare.
Page last reviewed: 3 July 2020 Next review due: 3 July 2023
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Take The Sage Test At Home
Anyone can take the SAGE test anytime. Its free and you can get it here on the Ohio State University website.
Print the test and take it with a pen or pencil. Theres no time limit, but most people finish in about 15 minutes.
Sample questions from the test:
- How many nickels are in 60 cents?
- You are buying $13.45 of groceries. How much change would you receive back from a $20 bill?
- Write down the names of 12 different animals.
- Draw a large face of a clock and place in the numbers.Position the hands for 10 minutes after 11 oclock. On your clock, label L for the long hand and S for the short hand.
Benefits Of An Early Dementia Diagnosis
Dementia is one of the health conditions people are most afraid of. That fear puts people off getting a diagnosis.
An accurate, timely diagnosis of dementia can have many benefits, including:
- an explanation for symptoms that might have been worrying you or your family
- access to treatments that can improve symptoms and slow the progress of the disease
- access to support and advice
- time to prepare for the future and plan ahead
A dementia diagnosis can come as a shock, but over time people come to view it in a positive way. This is because, while there is currently no cure for dementia, there are ways you can slow it down and maintain your memory function for longer.
With the right support and encouragement, those who have a dementia diagnosis can take an active role in managing their condition.
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Why Is It Important To Be Assessedclick For Answer
The testing and assessment process may provide the first opportunity to openly discuss the possibility of a diagnosis. It is important that assessment and testing not be delayed, as it prevents delay in establishing a diagnosis and options for treatment. Testing and a comprehensive evaluation leads to an accurate diagnosis and discussion of treatment, enabling greater control in your life by providing choices based on knowledge and understanding and opportunities to plan ahead.
How Does A Doctor Diagnose Dementiaclick For Answer
The diagnosis is mainly clinical, and no single test can provide an accurate conclusion. In fact, the diagnosis is mainly dependent on the kinds of symptoms presented, supported by the results of memory and thinking tests, laboratory, and possibly imaging tests. Unlike other diseases, such as hypertension or diabetes, where there is an objective test for diagnosis, an accurate dementia diagnosis requires interpretation of many pieces of information. There are persons who score within “normal” limits of memory and thinking tests and have dementia, and others who score abnormally and do not have dementia. Clinicians will also take a thorough history of the symptoms that may include talking to a family member who may provide helpful information. For example, family members may be asked what the individual can do for him/herself, and what activities the family member had to assist with or take over, and why?
Source: The information above comes from the Murray Alzheimer Research and Education Program . . Before/early diagnosis: An inspirational guide for partners in care of people living with memory loss. A “By Us For Us” Guide. Waterloo, Ontario: MAREP.
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What Is Dementia And What Causes It
Dementia is a syndrome that causes a person to develop difficulty and problems with their memory or their ability to think. Unlike the normal changes that happen in a persons memory and thinking over time, dementia affects someones ability to function in their daily life activities and their normal routine .There are different causes of dementia. These causes are typically underlying neurological conditions . One common cause of dementia is Alzheimers disease. Other causes include diseases that impact brain blood vessels. For example, strokes may cause what is commonly termed Vascular Dementia. Some causes include Lewy Body Disease and Parkinsons disease.