How Do You Diagnose Dementia

Questions To Ask After Getting A Dementia Diagnosis

You should feel free to ask your healthcare provider any questions you have about dementia and your diagnosis. These 12 questions are a good place to start, but it’s normal to have several waves of questions as you begin to adjust. Take time to write them down as you think of them so that you can address them at your next practitioner’s visit.

Misdiagnosis And Second Opinions

One of the common reactions to a difficult situation is denial. It’s not unusual to say, “I can’t believe this is happening.” Or, “I don’t think this is correct. It’s got to be something else.” While this questioning may be a part of the grieving process of this diagnosis, it could also have its merits.

It’s not a bad idea to get a second opinion. Occasionally, there have been misdiagnoses of dementia, when in truth the mental challenges were caused by something else that could be treated and at least partially reversed.

There are many possible causes of forgetfulness, and some of them are due to conditions such as stress, fatigue, or depression. Properly addressing them can result in significant improvements in cognitive functioning.

If a second opinion provides you with some peace of mind, it may be well worth it, even if it doesn’t change the diagnosis.

Cognitive Symptoms Of Lewy Body Dementia

LBD causes changes in thinking abilities. These changes may include:

• Visual hallucinations, or seeing things that are not present. Visual hallucinations occur in up to 80 percent of people with LBD, often early on. Nonvisual hallucinations, such as hearing or smelling things that are not present, are less common than visual ones but may also occur.
• Unpredictable changes in concentration, attention, alertness, and wakefulness from day to day and sometimes throughout the day. Ideas may be disorganized, unclear, or illogical. These kinds of changes are common in LBD and may help distinguish it from Alzheimer’s disease.
• Severe loss of thinking abilities that interfere with daily activities. Unlike in Alzheimer’s dementia, memory problems may not be evident at first but often arise as LBD progresses. Other changes related to thinking may include poor judgment, confusion about time and place, and difficulty with language and numbers.

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Caregiver Needs And Status/support System

Family caregivers are central to the PCP’s assessment and care of the patient with AD, and establishing and maintaining collaboration with caregivers is critical for care of the AD patient., Indeed, major physician organizations, such as the American Academy of Neurology and the American Association for Geriatric Psychiatry, have emphasized the importance of family caregivers by encouraging family physicians to form partnerships with families who care for dementia patients .

In addition, the physical and emotional health of the primary caregiver is crucial in obtaining optimal care for the AD patient. Caregivers suffer from increased rates of depression and physical illness, and family physicians need to monitor regularly the health of the primary caregiver as well as that of the patient with AD . Assessing caregiver status can lead to the implementation of measures that minimize patientâcaregiver stress and delay institutionalization of the patient.

What Is Mixed Dementia

It is common for people with dementia to have more than one form of dementia. For example, many people with dementia have both Alzheimer’s disease and vascular dementia.

Researchers who have conducted autopsy studies have looked at the brains of people who had dementia, and have suggested that most people age 80 and older probably have mixed dementia caused by a combination of brain changes related to Alzheimer’s disease,vascular disease-related processes, or another condition that involves the loss of nerve cell function or structure and nerve cell death .

Scientists are investigating how the underlying disease processes in mixed dementia start and influence each other. Further knowledge gains in this area will help researchers better understand these conditions and develop more personalized prevention and treatment strategies.

Other conditions that cause dementia-like symptoms can be halted or even reversed with treatment. For example, normal pressure hydrocephalus, an abnormal buildup of cerebrospinal fluid in the brain, often resolves with treatment.

In addition, medical conditions such as stress, anxiety, depression, and delirium can cause serious memory problems that resemble dementia, as can side effects of certain medicines.

Researchers have also identified many other conditions that can cause dementia or dementia-like symptoms. These conditions include:

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Building A Lewy Body Dementia Care Team

After receiving a diagnosis, a person with LBD may benefit from seeing a neurologist who specializes in dementia and/or movement disorders. Your primary doctor can work with other professionals to follow your treatment plan. Depending on an individual’s particular symptoms, physical, speech, and occupational therapists, as well as mental health and palliative care specialists, can be helpful.

Support groups are another valuable resource for people with LBD and their caregivers. Sharing experiences and tips with others in the same situation can help people find practical solutions to day-to-day challenges and get emotional and social support.

Future Directions In Diagnosis Research

Considerable research effort is being put into the development of better tools for accurate and early diagnosis. Research continues to provide new insights that in the future may promote early detection and improved diagnosis of dementia, including:

• Better dementia assessment tests that are suitable for people from diverse educational, social, linguistic and cultural backgrounds.
• New computerised cognitive assessment tests which can improve the delivery of the test and simplify responses.
• Improved screening tools to allow dementia to be more effectively identified and diagnosed by GPs.
• The development of blood and spinal fluid tests to measure Alzheimers related protein levels and determine the risk of Alzheimers disease.
• The use of sophisticated brain imaging techniques and newly developed dyes to directly view abnormal Alzheimers protein deposits in the brain, yielding specific tests for Alzheimers disease.

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How Do You Diagnose Frontal Lobe Dementia

A group of disorders caused by cell degeneration, frontotemporal dementia affects the brain, specifically its areas associated with personality, behavior and language. Once considered a rare disease, FTD may account for 20-50% of dementia cases in people younger than age 65, according to the Alzheimers Association.

FTD causes cell damage that shrinks the brains frontal and temporal lobes. The disease generally starts with personality and behavior changes and may eventually lead to severe memory loss.

Often miscategorized as psychiatric illness, frontotemporal dementia typically strikes between the ages of 45 and 65. However, the Association for Frontotemporal Dementia Degeneration indicates that cases have occurred as early as age 21 and as late as age 80.

What Is The Outlook For Frontotemporal Dementia

In the early stages, the symptoms and signs of frontotemporal dementia can be cared for and treated with good results. Late-stage frontotemporal dementia can take years to develop. As the disease progresses, 24-hour care may become necessary.

Frontotemporal dementia shortens a persons life span. The condition will eventually cause a person to have difficulty with bodily functions such as:

• swallowing

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Why Should I Get Diagnosed If Dementia Isn’t Treatable

Some people feel like they’d rather not know if they have dementia if there’s no cure available at this time. However, there are several benefits of an early diagnosis. It’s even possible that your symptoms could be from a reversible condition that, once treated appropriately, could improve. Most people would not want to miss that opportunity.

Even though receiving a dementia diagnosis is difficult, it can also help explain why you’ve been having a harder time with your memory or decisions lately. Some people report feeling relief in knowing the cause of these problems.

There’s also a benefit to knowing about your dementia so you can take the opportunity to make decisions for your future and communicate them to those around you. This is a gift to yourself and to your loved ones because it ensures that your choices and preferences are honored, and it also prevents your family members from having to guess about what you want.

What A Doctor May Check And Ask

Most people with suspected dementia will go to a doctors surgery to see their GP. Some doctors, however, will prefer to make a home visit to observe and assess someones behaviour in their own environment. A GP will check a persons blood pressure, temperature and pulse, listen to their heart and lungs and collect blood and urine samples for further tests to be carried out. The doctor will ask what potential signs of dementia have been noticed and when they began, how often they occur and whether they are getting worse.

The GP may ask a series of questions designed to test the persons memory and reasoning skills. The doctor is also likely to carry out a detailed review of any medication taken and ask about personal and family medical history, diet, smoking, intake of alcohol and exercise. The doctor will welcome notes perhaps kept by the patient, a partner, close family member or a care worker that outline when any symptoms or changes first happened. The GP may feel able to make a diagnosis at the conclusion of the assessment or may refer the person to a memory clinic or specialist.

Cultural diversity is an important consideration in the assessment process. Dementia assessments need to be culturally appropriate and recognise the impact of culture on individual behaviour. An interpreter may be vital for a proper assessment.

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Imaging Biomarkers In A Research Setting

Diffusion Tensor Imaging

Diffusion tensor imaging is an MRI imaging technique visualizing the diffusion of water molecules throughout the brain. It is used as a technique for white matter tractography .

Studies have shown that white matter damage is an early marker for disease in FTD, and DTI may be used as a tool to screen for such abnormalities at the presymptomatic stage . Reduced integrity of the uncinate fasciculus and anterior corpus callosum is typical for FTD, and the degree of damage is correlated to age and disease severity . Even here, specific patterns can be recognized for different clinical subtypes, and for carriers of different causal mutations. These abnormalities are consistent with characteristic brain atrophy distributions . The increase in white matter damage over time has been reported to be greater than that of gray matter atrophy, although only at the symptomatic stage, indicating the possible use of this technique as a marker for disease progression .

Studies comparing FTD cohorts with AD patients and with normal controls found significantly more white matter pathology mostly in bilateral uncinate fasciculus, cingulum bundle, and corpus callosum in FTD compared to both other groups . More studies are needed to consolidate these findings and define the diagnostic accuracy for FTD of DTI, as well as its power to distinguish FTD from other types of neurodegenerative brain diseases.

Resting-State fMRI

Tau PET Imaging

Key Features Of Dementia

A person having dementia means that all five of the following statements are true:

• A person is having difficulty with one or more types of mental function. Although its common for memory to be affected, other parts of thinking function can be impaired. The 2013 DSM-5 manual lists these six types of cognitive function to consider: learning and memory, language, executive function, complex attention, perceptual-motor function, social cognition.

• The difficulties are a decline from the persons prior level of ability. These cant be lifelong problems with reading or math or even social graces. These problems should represent a change, compared to the persons usual abilities as an adult.

• The problems are bad enough to impair daily life function. Its not enough for a person to have an abnormal result on an office-based cognitive test. The problems also have to be substantial enough to affect how the person manages usual life, such as work and family responsibilities.

• The problems are not due to a reversible condition, such as delirium, or another reversible illness. Common conditions that can cause or worsen dementia-like symptoms include hypothyroidism, depression, and medication side-effects.

• The problems arent better accounted for by another mental disorder, such as depression or schizophrenia.

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Stage : Mild Cognitive Impairment

Clear cognitive problems begin to manifest in stage 3. A few signs of stage 3 dementia include:

• Getting lost easily
• Noticeably poor performance at work
• Forgetting the names of family members and close friends
• Difficulty retaining information read in a book or passage
• Losing or misplacing important objects
• Difficulty concentrating

Patients often start to experience mild to moderate anxiety as these symptoms increasingly interfere with day to day life. Patients who may be in this stage of dementia are encouraged to have a clinical interview with a clinician for proper diagnosis.

What Do The Terms Mean

One of the challenges shared by people living with these disorders, families, clinicians, and researchers is what terminology to use. Here, we have used the term frontotemporal disorders to characterize this group of diseases and the abbreviation FTD, which is commonly used to refer to them. Other terms used include frontotemporal lobar degeneration and frontotemporal dementia, but it’s important to note that with some frontotemporal disorders, the primary symptoms are problems with speech or movement, rather than dementia symptoms. Physicians and psychologists diagnose the different forms of FTD based on a persons symptoms as well as the results of brain scans and genetic tests.

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People With Ftd May Develop Curious Obsessions

One of the key symptoms often seen in FTD is changes in personality and behaviour. This can be an aspect of the condition that is particularly upsetting for those around the person with FTD, as it is difficult to understand why the person you know so well is acting so differently.

These changes can also bring about new obsessions including: hoarding, refusing to throw anything away fiddling and touching everything around a symptom called utilisation behaviour and disinhibition, which can take many forms but commonly includes a loss of social graces. You can find an A-Z of FTD obsessions on the Rare Dementia Support Group website, www.raredementiasupport.org/ftd/what-is-ftd/a-z-of-picks-ftld-obsessions.

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What Kind Of Doctor Tests For Dementia

A primary care doctor can perform a physical exam and find out more about your symptoms to determine what may be the cause. They will likely refer you to one or several specialists that can perform specific tests to diagnose dementia. Specialists may include neurologists, who specialize in the brain and nervous system psychiatrists or psychologists, who specialize in mental health, mental functions, and memory or geriatricians, who specialize in healthcare for older adults.

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Vet Checkups For Dogs With Dementia

Your veterinarian will evaluate your dog periodically to monitor their response to therapy and the progression of symptoms.

However, if you notice any behavioral changes in your dog, notify your vet immediately.

In geriatric dogs, any change can be serious, so its important to talk to your veterinarian at the first sign. For stable patients, twice-yearly checkups are sufficient enough, unless new problems arise.

What To Do If A Loved One Is Suspicious Of Having Dementia

• Discuss with loved one. Talk about seeing a medical provider about the observed changes soon. Talk about the issue of driving and always carrying an ID.
• Medical assessment. Be with a provider that you are comfortable with. Ask about the Medicare Annual Wellness exam.
• Family Meeting. Start planning, and gather documents like the Health Care Directive, Durable Power of Attorney for Health Care, Estate Plan.

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Mental Ability Tests To Diagnose Dementia

People with symptoms of dementia are given tests to check their mental abilities, such as memory or thinking.

These tests are known as cognitive assessments, and may be done initially by a GP.

There are several different tests. A common one used by GPs is the General Practitioner Assessment of Cognition .

Although these tests cannot diagnose dementia, they may show there are memory difficulties that need further investigation.

Most tests involve a series of pen-and-paper tests and questions, each of which carries a score.

These tests assess a number of different mental abilities, including:

• short- and long-term memory
• language and communication skills
• awareness of time and place

It’s important to remember that test scores may be influenced by a person’s level of education.

For example, someone who cannot read or write very well may have a lower score, but they may not have dementia.

Similarly, someone with a higher level of education may achieve a higher score, but still have dementia.

What Are The Types And Symptoms Of Ftd

In the early stages, it can be hard to know which type of FTD a person has because symptoms and the order in which they appear can vary from one person to another. Also, the same symptoms can appear across different disorders and vary from one stage of the disease to the next as different parts of the brain are affected.

Symptoms of FTD are often misunderstood. Family members and friends may think that a person is misbehaving, leading to anger and conflict. It is important to understand that people with these disorders cannot control their behaviors and other symptoms and lack any awareness of their illness.

There are three types of frontotemporal disorders : behavioral variant frontotemporal dementia , primary progressive aphasia , and movement disorders.

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What Are The 5 Worst Foods For Memory

The Worst Foods for Your Brain5 / 12. Diet Sodas and Drinks With Artificial Sweeteners. 6 / 12. French Fries and Other Fried Foods. 7 / 12. Doughnuts. 8 / 12. White Bread and White Rice. 9 / 12. Red Meat. 10 / 12. Butter and Full-Fat Cheese. 11 / 12. Swordfish and Ahi Tuna. 12 / 12. Bottled Dressings, Marinades, and Syrups.More itemsOct 28, 2020