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How Long Does It Take To Diagnose Dementia

How Long Do Dementia Patients Live After Diagnosis

What to do after a dementia diagnosis!

Dementia symptoms typically progress slowly. People with dementia will progress from mild to severe dementia at varying speeds and may be diagnosed earlier or later in life. Some people with dementia may live for up to 20 years after their diagnosis, though according to the Alzheimer’s Association research shows that the average person lives for four to eight years after a diagnosis of dementia. It’s important to point out that the diagnosis of dementia is often missed, delayed, or diagnosed when the illness is moderate or advanced. The impact of that variable may not be accurately reflected in the research regarding the years of life post-diagnosis.

Referral To A Specialist

You may be referred to a specialist service for further assessments. This might be a memory assessment service, memory clinic or other specialist service within a community mental health team. These services are set up especially to assess people with memory problems. They have teams of different types of health professionals who can look at your case in more detail.

Normally it will be the GP that refers you to a specialist centre for further assessment, if they think this is necessary. If you feel that a referral would be helpful, but the GP has not yet suggested it, you can ask them to refer you.

Sometimes people choose not to carry on with any further assessments – for example if they choose not to find out if they have dementia. If this is the case, you can tell the GP that you do not want to be assessed any further. A specialist will have more knowledge and experience of assessing dementia than a GP. They will also have more time allocated for appointments and access to more specialised investigations such as brain scans and in-depth mental testing. Once you have been referred, you should not have to wait longer than 4-6 weeks to see a specialist.

The GP will make the referral to a consultant with special expertise in a particular area of medicine. Who they refer you to may depend on your age and symptoms, and the kind of consultant available in your area. The main types are explained below.

Variables Impacting Life Expectancy Calculations

Gender. Men dont live as long with Alzheimers as women. A study of more than 500 people diagnosed with Alzheimers disease between 1987 and 1996 found that women with Alzheimers live, on average, 20% longer than men. Age. Someone diagnosed at 65 lives an average of about eight years, while someone over 90 who gets a diagnosis typically lives about three-and-a-half more years. Strength of Symptoms at Diagnosis. If someone is showing especially severe dementia-related problems at the time of diagnosis, this usually leads to an earlier death. Someone who wanders, is prone to falling, and experiences urinary incontinence , will typically not live as long. A lower mini-mental state examination score at the time of diagnosis will also not live as long. Other Health Problems. A person with a history of heart problems or asthma or diabetes, for example, will not live as long as someone without those underlying issues.

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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.

Current Practice In Diagnosing Dementia

Dementia

The remainder of this information will provide an overview of the diagnosis process and a guide to what happens after diagnosis.

It is important to remember that there is no definitive test for diagnosing Alzheimers disease or any of the other common causes of dementia. Findings from a variety of sources and tests must be pooled before a diagnosis can be made, and the process can be complex and time consuming. Even then, uncertainty may still remain, and the diagnosis is often conveyed as possible or probable. Despite this uncertainty, a diagnosis is accurate around 90% of the time.

People with significant memory loss without other symptoms of dementia, such as behaviour or personality changes, may be classified as having a Mild Cognitive Impairment . MCI is a relatively new concept and more research is needed to understand the relation between MCI and later development of dementia. However, MCI does not necessarily lead to dementia and regular monitoring of memory and thinking skills is recommended in individuals with this diagnosis.

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Promoting Early Diagnosis Of Dementia

The early symptoms of dementia can include memory problems, difficulties in word finding and thinking processes, changes in personality or behaviour, a lack of initiative or changes in day to day function at home, at work or in taking care of oneself. This information does not include details about all of these warning signs, so it is recommended that you seek other sources of information. If you notice signs in yourself or in a family member or friend, it is important to seek medical help to determine the cause and significance of these symptoms.

Obtaining a diagnosis of dementia can be a difficult, lengthy and intensive process. While circumstances differ from person to person, Dementia Australia believes that everyone has the right to:

  • A thorough and prompt assessment by medical professionals,
  • Sensitive communication of a diagnosis with appropriate explanation of symptoms and prognosis,
  • Sufficient information to make choices about the future,
  • Maximal involvement in the decision making process,
  • Ongoing maintenance and management, and
  • Access to support and services.

If The Diagnosis Is Dementia

Dementia is one of the health conditions that people are most afraid of.

A study by the Alzheimer’s Society has shown that more than half of people wait for up to a year before getting help for dementia symptoms, because they feel afraid. But an accurate and early diagnosis can have many benefits.

After you’ve had the necessary tests , your doctor should ask if you want to know your diagnosis.

They should explain what having dementia might mean for you and give you time to talk about the condition and ask questions.

Unless you decide otherwise, your doctor, or a member of their team, should talk to you and your family or carer about:

  • the type of dementia you have or, if it’s not clear, they should talk to you about being assessed again in the future
  • the symptoms and how the condition might develop
  • the treatments you might be offered
  • the name of a health or social care professional who will co-ordinate the different types of support you need
  • care and support services in your area, including support groups and voluntary organisations for people with dementia, their families and carers
  • advocacy services
  • how dementia will affect your driving or employment, if this applies to you
  • where you can get financial and legal advice

You should also be given written information about dementia.

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Could It Be Rapidly Progressive Dementia

RPD can be difficult to diagnose. However, accurately diagnosing these conditions is critical in order to identify any treatable causes and protect against further brain cell damage. An early hospital assessment by a specialist can help pick up problems so that, where available, appropriate treatment can be initiated. Cancers, infections, toxins and autoimmune conditions could all cause a fast decline in mental function, as well as the more common neurodegenerative causes of dementia such as Alzheimers, strokes and Parkinsons disease.

Can Dementia Be Inappropriately Diagnosed In A Single Visit

What it means to be diagnosed with dementia

Sadly, yes. Although its common for doctors to never diagnose dementia at all in people who have it, I have also come across several instances of busy doctors rattling off a dementia diagnosis, without adequately documenting how they reached this conclusion.

Now, often these doctors are right. Dementia becomes common as people age, so if a family complains of memory problems and paranoia in an 89 year old, chances are quite high that the older person has dementia.

But sometimes its not. Sometimes its slowly resolving delirium along with a brain-clouding medication. Sometimes its depression.

It is a major thing to diagnose someone with dementia. So although its not possible for an average doctor to evaluate with as much detail as the memory clinic does, its important to document consideration of the five essential features as listed above.

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Dementia Stages: How Fast Dementia Progresses Stages Of Dementia And More

Dementia is a progressive impairment of cognitive function caused by damage to the brain. Over time, a person with dementia will have increased difficulty with memory, understanding, communication, and reasoning.

Healthcare providers frequently speak about a persons dementia in terms of stages. This can be helpful for communicating with family or other healthcare providers regarding the persons illness, and it is important for determining an appropriate care plan.

How Fast Does Dementia Progress?

It is important to note that dementia progresses at different speeds for every person, and for different types of dementia. The most well-known form of dementia, Alzheimers disease, is just one specific type of dementia, and tends to have the slowest progression of all types. Some factors that affect the rate of progression include:

  • Age
  • Repeated infections

What are the Stages of Dementia?

There are a few different systems used to grade dementia — at the most basic there is early, moderate, and end. Many providers use the system developed by Dr. Barry Reisberg of New York University which includes 7 stages. The Reisberg scale is also known as the GDS or Global Deterioration Scale for Assessment of Primary Degenerative Dementia. This scale focuses primarily on cognitive abilities.

Dementia Stages in the Reisberg Scale

Dementia Stages in the FAST Scale

Dementia Stages in the CDR Scale

Can Dementia Be Diagnosed During A Single Visit

So can dementia be diagnosed during a single visit? As you can see from above, it depends on how much information is easily available at that visit. It also depends on the symptoms and circumstances of the older adult being evaluated.

Memory clinics are more likely to provide a diagnosis during the visit, or shortly afterwards. Thats because they usually request a lot of relevant medical information ahead of time, send the patient for tests if needed, and interview the patient and informers extensively during the visit.

But in the primary care setting, and in my own geriatric consultations, I find that clinicians need more than one visit to diagnose dementia or probable dementia. Thats because we usually need to order tests, request past medical records for review, and gather more information from the people who know the senior being evaluated. Its a bit like a detectives investigation!

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Do Treatments Add Time To Life Expectancy

Experts simply dont know whether treatments help a person live longer with Alzheimers disease. AD and other similar dementias progress no matter what. Treatments like medications and therapies have been conclusively shown to help manage symptoms, meaning they make it easier to live with the disease, but they do not reverse symptoms. The memory of a person with dementia who takes medications like cholinesterase inhibitors, for example, will be slightly better than the memory of someone who is not on medication. Quality of life therefore improves with treatment. This means better years with dementia, but probably not more years.

How Quickly Does Dementia Develop

Technology to detect Alzheimer

Rapidly progressive dementias are dementias that progress quickly, typically over the course of weeks to months, but sometimes up to two to three years. RPDs are rare and often difficult to diagnose. Early and accurate diagnosis is very important because many causes of RPDs can be treated.

What is the life expectancy of someone with dementia?

Generally speaking, the life expectancy of a person with dementia depends on the type of dementia they are diagnosed with, their age and health. Most studies seem to show that the average number of years someone will live with dementia after being diagnosed is around ten years.

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What Causes Dementia

The causes of Alzheimers and related dementias can vary, depending on the types of brain changes that may be taking place. While research has found that some changes in the brain are linked to certain forms of dementia, in most cases, the underlying causes are unknown. Rare genetic mutations may cause dementia in a relatively small number of people.

Although there is no proven prevention, in general, leading a healthy lifestyle may help reduce risk factors that have been associated with these diseases.

How Is Ftd Diagnosed

Assessments

Blood tests and a full physical examination are important to rule out other possible causes of symptoms.

A specialist normally an old age psychiatrist or neurologist may think a person has FTD after talking to them and to someone who knows them well. The specialist will take a detailed history of the persons symptoms and ask questions to understand the persons behaviour and abilities better.

Standard tests of mental abilities, which mostly focus on memory loss, can be less helpful in diagnosing FTD. More specialised tests of social awareness or behaviour may be needed.

Scans

CT and MRI scans are used to see what parts of the brain are most damaged. They can also rule out other possible causes of a persons symptoms, such as a stroke or tumour.If further tests are needed, more specialised brain scans will be carried out, such as PET and SPECT to measure the persons brain activity.

These scans are useful as they may find lower activity in the frontal and/or temporal lobes before a CT or MRI scan can find changes to the brain tissue of these lobes.

Further tests may include a lumbar puncture, which involves collecting and examining liquid from inside the spine and is carried out mainly in younger people.

Genetic testing

A specialist may recommend that a person with FTD symptoms has a genetic test. This can show if the persons condition is caused by a specific faulty gene.

Post-mortem examination

Getting assessed for dementia

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How Does A Doctor Test For Dementia

There is no single diagnostic test for Alzheimers disease and other causes of dementia. Dementias are diagnosed by evaluating and understanding a persons memory and thinking patterns. Doctors will consider a persons memory, grasp of language, mood states, problem-solving skills, ability to maintain focus and perform complex tasks. Evaluation may include in-office cognitive screening , physical examination, and review of labs. Labwork helps to determine whether there are vitamin deficiencies or hormonal changes at play. In some cases, evaluation may require neuropsychological testing, brain imaging , and genetic testing.

At What Age Can You Test Someone For The Signs Of Dementia

How long does dementia last?

There is no one particular age that someone must meet before they can be assessed for signs of dementia, although dementia is more common in people over 65. Early-onset dementia can begin in people who are in their 30s, 40s, and 50s. Diagnosing dementia in its early stages is important as early treatment can slow the progression of symptoms and help to maintain mental functions.

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Disproportionate Impact On Women

Globally, dementia has a disproportionate impact on women. Sixty-five percent of total deaths due to dementia are women, and disability-adjusted life years due to dementia are roughly 60% higher in women than in men. Additionally, women provide the majority of informal care for people living with dementia, accounting for 70% of carer hours.

Can I Go To A Loved Ones Gp Appointment

You can go with someone to their GP appointment if they agree. However, everyone has the right to confidentiality from their doctor its up to your loved one if theyd prefer to go alone. If they do go alone, the GP may ask to see you separately or phone you later. Without permission, they usually wont be able to give you any details about the persons care, but they can listen to any information that you give them.

You cant force someone to see their GP. Try to talk to your loved one about why it might be a good idea. If they dont want to go, you can still contact their GP to tell them about your concerns. If they think necessary, the GP might then speak to your loved one and try to persuade them to come to the surgery.

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Getting Your Dementia Diagnosis

Once youve had the necessary tests, your doctor should ask if you want to know your diagnosis.

They should explain what having a dementia might mean for you. They should also give you time to talk more about the condition and ask questions.

Unless you decide differently, your doctor should discuss with you and your family:

  • the type of dementia you have, or if it is not clear, how they will investigate further if a diagnosis may not be clear, the doctors will reassess you after a certain time
  • symptoms and how the illness might develop
  • appropriate treatments you might be offered
  • care and support services in your area
  • support groups and voluntary organisations for people with a dementia and their families and carers
  • advocacy services
  • where you can find financial and legal advice

They should also give you written information about dementia.

What Kind Of Doctor Tests For Dementia

How long can you live with a dementia disorder?

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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