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How To Diagnose Someone With Dementia

Types Of Lewy Body Dementia

How to get a diagnosis of dementia?

It’s important to know which type of LBD a person has, both to tailor treatment to particular symptoms and to understand how the disease will likely progress. Clinicians and researchers use the “one-year rule” to help make a diagnosis. If cognitive symptoms appear at the same time as or at least a year before movement problems, the diagnosis is dementia with Lewy bodies. If cognitive problems develop more than a year after the onset of movement problems, the diagnosis is Parkinson’s disease dementia.

Regardless of the initial symptoms, over time, people with either type of LBD often develop similar symptoms, due to the presence of Lewy bodies in the brain. But there are some differences. For example, dementia with Lewy bodies may progress more quickly than Parkinson’s disease dementia.

What Are The Different Types Of Dementia

Various disorders and factors contribute to the development of dementia. Neurodegenerative disorders result in a progressive and irreversible loss of neurons and brain functioning. Currently, there are no cures for these diseases.

The five most common forms of dementia are:

  • Alzheimers disease, the most common dementia diagnosis among older adults. It is caused by changes in the brain, including abnormal buildups of proteins, known as amyloid plaques and tau tangles.
  • Frontotemporal dementia, a rare form of dementia that tends to occur in people younger than 60. It is associated with abnormal amounts or forms of the proteins tau and TDP-43.
  • Lewy body dementia, a form of dementia caused by abnormal deposits of the protein alpha-synuclein, called Lewy bodies.
  • Vascular dementia, a form of dementia caused by conditions that damage blood vessels in the brain or interrupt the flow of blood and oxygen to the brain.
  • Mixed dementia, a combination of two or more types of dementia.

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At this stage, individuals may start to become socially withdrawn and show changes in personality and mood.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
  • Disorientation
  • 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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How Long Do Dementia Patients Live After 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.

Dont Just Talk Loudly

Diagnosing Dementia

Not every person with dementia has a hearing impairment, and using a loud tone can make them feel like you are yelling at them. Use a clear, normal tone of voice to start a conversation with someone.

If the person doesnt respond or you become aware that they have a hearing problem, you can increase your volume. Speaking in a slightly lower register can also help if someone has a hearing problem.

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What To Do If A Doctor Jumps To A Diagnosis In A Single Visit

Unfortunately, some doctors do jump quickly to a dementia diagnosis in only one visit. Even worse, they dont properly document what led to their decision.

If this happens, you may want to seek a second opinion from a doctor who is willing and able to do more thorough evaluation and testing.

Yes, there is a chance that your older adults symptoms could mean that they have dementia.

Thats why an accurate diagnosis is essential for proper treatment.

Where To Find Help

When your loved one is displaying troubling symptoms, a trip to a primary care physician is often the first step. But to get a definitive diagnosis, youll need to see a specialist such as a neurologist, geriatrician or geriatric psychiatrist.

If you cant find one, the National Institute on Aging recommends contacting the neurology department of a nearby medical school. Some hospitals also have clinics that focus on dementia.

Ailments can mimic dementia

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Who Can Diagnose Dementia

Visiting a primary care 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 are often consulted to diagnose dementia. Geriatric psychiatrists, neuropsychologists, and geriatricians may also be able to diagnose dementia. Your doctor can help you find a specialist.

If a specialist cannot be found in your community, contact the nearest medical school neurology department for a referral. A medical school hospital also may have a dementia clinic that provides expert evaluation. You can also visit the Alzheimers Disease Research Centers directory to see if there is an NIA-funded center near you. These centers can help with obtaining a diagnosis and medical management of conditions.

How Is Dementia Treated

How is dementia diagnosed?

Treatment of dementia depends on the underlying cause. Neurodegenerative dementias, like Alzheimers disease, have no cure, though there are medications that can help protect the brain or manage symptoms such as anxiety or behavior changes. Research to develop more treatment options is ongoing.

Leading a healthy lifestyle, including regular exercise, healthy eating, and maintaining social contacts, decreases chances of developing chronic diseases and may reduce number of people with dementia.

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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.

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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What Are The 10 Warning Signs Of Dementia

10 Early Signs and Symptoms of Alzheimers Memory loss that disrupts daily life. Challenges in planning or solving problems. Difficulty completing familiar tasks. Confusion with time or place. Trouble understanding visual images and spatial relationships. New problems with words in speaking or writing.

Information To The Patient And The Relatives

Vast majority of dementia patients donât receive specialty diagnosis or ...

Within the diagnostic framework, it is important that the patient’s relatives are well informed by the physician about the possible causes of the dementia and about the test results in order to obtain a satisfactory impression about the steps which have been undertaken.

Everybody has the right to be informed about medical diagnoses, even if the diagnosis is hard to cope with. This might enable the patient to decide how to spend their time and to make their own decisions for the future. There are varied opinions in medical circles about disclosure of the diagnosis of dementia. Disclosing a diagnosis should always be followed by joint discussions about the next steps to be undertaken. The current point of view is that every patient, according to the stage of illness and to their personality, has the right to know but also the right not to know. This results in a step by step procedure for the information process. The patient is given part of the information in a way s/he can understand and s/he is asked if s/he wants to know more. Informing the relatives almost always needs prior consent of the patient.

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Information For Your Doctor

Itâs a good idea to put together the following for your first appointment:

  • A list of symptoms — include everything youâre feeling, even if you donât think it could be related to dementia
  • Any sources of major stress or recent life changes
  • A list of all medications you take, including vitamins and supplements, and the dosage
  • A list of any questions you have

What Are The Symptoms Of Dementia

Early symptoms of dementia include :

  • Forgetting recent events or information
  • Repeating comments or questions over a very short period of time
  • Misplacing commonly used items or placing them in usual spots
  • Not knowing the date or time
  • Having difficulty coming up with the right words
  • Experiencing a change in mood, behavior or interests

Signs that dementia is getting worse include:

  • Ability to remember and make decisions further declines
  • Talking and finding the right words becomes more difficult
  • Daily complex tasks, such as brushing teeth, making a cup of coffee, working a tv remote, cooking, and paying bills become more challenging
  • Rational thinking and behavior and ability to problem solve lessen
  • Sleeping pattern change
  • Anxiety, frustration, confusion, agitation, suspiciousness, sadness and/or depression increase
  • More help with activities of daily living grooming, toileting, bathing, eating is needed
  • Hallucinations may develop

The symptoms mentioned above are general symptoms of dementia. Each person diagnosed with dementia has different symptoms, depending on what area of the brain is damaged. Additional symptoms and/or unique symptoms occur with specific types of dementia.

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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:

Caring For Somebody In The Later Stages Of Dementia

Getting diagnosed with dementia – Christine and Jennifer-Rose – early onset

Caring for a person in the later stages of dementia can be rewarding, but also very challenging. When a person with dementia moves into residential care, it can have a big impact on the carer as well.

It is important to seek support for any feelings you might have. For support or to find out what help is available in your area, call our support line or use our local services directory.

Dementia Connect support line
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Early Diagnosis And Drug Treatment

Talking about being diagnosed with dementia at the age of 50, Norman McNamara says on his YouTube video:

Being diagnosed with something like this absolutely devastates you, but for me diagnosis and this is going to sound really strange was probably the best news I had at the time. Because… I thought I was losing my mind. I thought there was a conspiracy against me. I was right and everybody else was wrong. An early diagnosis of dementia is so, so important. Once diagnosed, I knew what I was up against. As they say: know your enemy. If I hadnt been diagnosed early and I hadnt been seen by consultants on a regular basis, I wouldnt be as well as I am today. I dont know what my future holds, but at least Im prepared for it.

You may also be interested to read Supporting carers at the time of diagnosis in the section on Carers of people with dementia.

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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Side Effects And Complications

All drugs have possible side effects. Some of the drugs often prescribed for behavioural symptoms in people with dementia can have severe side effects and may increase the persons confusion and their risk of falls. Some people in the later stages of dementia are prescribed drugs that are no longer appropriate to their needs, or in doses that are too high.

If you are concerned about the effects of the persons medication, talk to their GP about changing the dose or medication.

Stage : Mild Cognitive Impairment

Understanding the Stages of Dementia

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.

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At Your Appointment With The Specialist

It’s important to make good use of your time with the specialist. Write down questions you want to ask, make a note of any medical terms the doctor uses, and ask if you can come back if you think of more questions later. Taking the opportunity to go back can be very helpful.

The specialist may organise more tests. One of these might be a brain scan, such as a CT scan, or an MRI scan.

They may also do further, more detailed memory tests.

If the specialist is still not certain about the diagnosis, you may need to have further, more complex tests. But most cases of dementia can be diagnosed after these assessments.

What Is The Clock Test For Dementia

The clock test is a non-verbal screening tool that may be used as part of the assessment for dementia, Alzheimers, and other neurological problems. The clock test screens for cognitive impairment. The individual being screened is asked to draw a clock with the hour and minute hands pointing to a specific time. Research has shown that six potential errors in the clock testthe wrong time, no hands, missing numbers, number substitutions, repetition, and refusalcould be indicative of dementia.

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

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.

Diagnosing Lewy Body Dementia: For Professionals

Early onset dementia, diagnosis, younger people with dementia: Ann’s story

Lewy body dementia can be difficult to diagnose. Talking to both patients and caregivers helps doctors make a diagnosis. It is important to ask the patient and their care partners about any symptoms involving thinking, movement, sleep, behavior, or mood. Certain medications can worsen LBD symptoms be aware of all current medications and supplements the patient is taking.

Dementia with Lewy bodies is often hard to diagnose because its early symptoms may resemble those of Alzheimer’s disease or a psychiatric illness. As a result, it is often misdiagnosed or missed altogether. As additional symptoms appear, making an accurate diagnosis may become easier.

The good news is that doctors are increasingly able to diagnose LBD earlier and more accurately, as researchers identify which symptoms and biomarkers help distinguish it from similar disorders.

Visiting a family doctor is often the first step for people who are experiencing changes in thinking, movement, or behavior. If a persons primary doctor is not familiar with LBD, they may have patients seek second opinions from specialists, like a geriatric psychiatrist, neuropsychologist, or a geriatrician to help diagnose LBD. If a specialist cannot be found in your community, ask the neurology department at a nearby medical school for a referral. Neurologists generally have the expertise needed to diagnose LBD.

Difficult as it is, getting an accurate diagnosis of LBD early on is important so that a person:

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