What Conditions Can Be Mistaken For Dementia
The term dementia refers to a specific group of symptoms related to a decline in mental ability. Often, people who experience subtle short-term memory changes, are easily confused, or exhibit different behaviors or personality traits are mistakenly thought to have dementia. These symptoms could be the result of a variety of other conditions or disorders, including other neurocognitive disorders such as Parkinsons disease, brain growths or tumors, mild cognitive impairment , and mood disorders, like depression.
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.
How Is Dementia Diagnosed
To diagnose dementia, doctors first assess whether a person has an underlying, potentially treatable, condition that may relate to cognitive difficulties. A physical exam to measure blood pressure and other vital signs, as well as laboratory tests of blood and other fluids to check levels of various chemicals, hormones, and vitamins, can help uncover or rule out possible causes of symptoms.
A review of a persons medical and family history can provide important clues about risk for dementia. Typical questions 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.
The following procedures also may be used to diagnose dementia:
Early detection of symptoms is important, as some causes can be treated. However, in many cases, the cause of dementia is unknown and cannot be treated. Still, obtaining an early diagnosis can help with managing the condition and planning ahead.
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The Mmse Alone Cant Be Used For A Dementia Diagnosis
No matter what they score on the Mini Mental Status Exam, dont consider those results to be the final answer.
Many factors can influence someones MMSE score, both positively and negatively. This is only one of many dementia diagnosis tools.
The MMSE is a useful screening tool, but cant be used to diagnose dementia because there are many factors that could affect the test results.
Complicating factors include:
What Causes Dementia To Progress So Quickly
Dementia symptoms are typically mild at first and progress over time to moderate and then severe, over several years. The speed as which dementia progresses varies between individuals, but some factors can cause dementia to progress more quickly. These include the persons age, the type of dementia, and other long term health problems. Dementia tends to progress more slowly in people over 65 compared to younger people below 65.
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Psychological And Psychosocial Therapies
Psychological therapies for dementia include some limited evidence for reminiscence therapy , some benefit for cognitive reframing for caretakers, unclear evidence for validation therapy and tentative evidence for mental exercises, such as cognitive stimulation programs for people with mild to moderate dementia. Offering personally tailored activities may help reduce challenging behavior and may improve quality of life. It is not clear if personally tailored activities have an impact on affect or improve for the quality of life for the caregiver.
Adult daycare centers as well as special care units in nursing homes often provide specialized care for dementia patients. Daycare centers offer supervision, recreation, meals, and limited health care to participants, as well as providing respite for caregivers. In addition, home care can provide one-to-one support and care in the home allowing for more individualized attention that is needed as the disorder progresses. Psychiatric nurses can make a distinctive contribution to people’s mental health.
Some London hospitals found that using color, designs, pictures and lights helped people with dementia adjust to being at the hospital. These adjustments to the layout of the dementia wings at these hospitals helped patients by preventing confusion.
Personally tailored activities
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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Who Should Consider Taking The Sage Test
According to Scharre, anyone who is experiencing memory, language, problem-solving, or thinking problems should consider taking SAGE.
This may be especially important if you are noticing very mild symptoms, since SAGE is designed to pick up early deficits and allow your healthcare providers to diagnose and manage any potential conditions at an early stage,” he explains.
Friends or family members may want to encourage a loved to take the test if they notice issues related to memory or thinking.
You may also wish to take a SAGE to establish a baseline cognitive assessment to use for comparison in the future if you have a family history of dementia or thinking problems.
Typically, we would suggest repeating the test every six months unless significant cognitive changes are occurring,” advises Scharre.
You can download the test for free at the Wexner Medical Center website.
Theres also a digital version made for tablets produced by a company called BrainTest. It consists of identical test questions. This version is scored by a panel and results are sent to you so can take them to your primary care physician for further discussion. You can download the electronic version at BrainTest.com.
Dementia Care Tips From Experienced Caregivers
Caring for someone with dementia isnt intuitive and doesnt come naturally. Theres a lot to learn, but you dont have to figure everything out the hard way.
In a helpful article at Verywell, social worker Esther Heerema shares 12 dementia care tips that caregivers have learned and wished theyd known sooner.
This advice isnt meant to add pressure or expectations to your already tough job. Theyre tips from caregivers who have been there and done that that can lighten your load, reduce stress, and help you cope with the challenges.
Here, we share highlights from Esthers article along with some of our own insights.
1. Its not worth it to argue with someone who has dementiaAlzheimers and dementia causes your older adults brain to malfunction. When they say things that dont make sense or are clearly untrue, they believe what theyre saying because its what their brain is telling them.
Its frustrating to hear things that arent true and instinctive to try to correct or remind. But that will only lead to both of you arguing or getting upset. And you simply cant win an argument with someone who can no longer use reason or logic consistently.
2. Ignoring symptoms wont make them go awayWhen you notice your older adult struggling with memory, thinking, or judgement, its scary to think that they might have dementia. Because it can be so hard to accept, many people hope that the symptoms will go away on their own or that theyre mistaken.
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The Brief Alzheimer’s Screening Test
This short screening asks the test taker to repeat three words immediately after hearing them. Next, two tasks that distract from those three words are performed: a short version of the verbal fluency test where the person is asked to name as many animals as they can in 30 seconds and spelling “WORLD” backward. Finally, the person is asked to remember and recite the three words from the beginning of the screening process.
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.
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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.
Some Of The Commonly Used Cognitive Tests Include:
Mini-Mental Status Examination
This test is usually conducted by your doctor or specialist in their office and takes around 5 minutes to complete. The MMSE is the most common test for the screening of dementia. It assesses skills such as reading, writing, orientation and short-term memory.
Alzheimers Disease Assessment Scale-Cognitive
This 11-part test is more thorough than the MMSE and can be used for people with mild symptoms.
It is considered the best brief examination for memory and language skills.
It takes around 30 minutes and is usually conducted by a specialist in their office, or you may be referred to a psychologist for the test.
This involves a number of very sensitive tests administered by a neuropsychologist .
A typical testing session will take at least 2 hours and may be conducted over more than one visit.
A variety of tests will be used and may include tests of memory such as recall of a paragraph, tests of the ability to copy drawings or figures and tests of reasoning and comprehension.
Standard X-rays may be taken and those who smoke will commonly require a chest X-ray to rule out lung cancer, which may be causing a secondary brain tumour. \
Brain imaging techniques
Various brain-imaging techniques are sometimes used to show brain changes and to rule out other conditions such as tumour, infarcts and hydrocephalus these include:
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Types Of Tests For Dementia
The first type of tests are called mental status scales.
These are short bedside tests administered by the doctor that assess memory and other cognitive domains.
They provide a score, which is used to distinguish people with normal vs. impaired cognition and even screen for mild cognitive impairment .
Examples of the most widely used include the Montreal Cognitive Assessment and the Mini-Mental State Examination .
These are screening tests, meaning they are not diagnostic of any particular dementia or diagnosis, but when abnormal definitely can hint that cognition is impaired.
Moreover, these tests can be repeated over time to track the progression of the disease as well.
These tests assess memory, language, executive function, visuospatial skills, and attention/concentration.
The MMSE is scored on a 30 point scale. Specific items include orientation , memory , attention/concentration , language , and visuospatial function . A score of < 23 is abnormal and indicates cognitive impairment.
Note: you can find only MMSE test here.
The MOCA is also scored on a 30 point scale.
It assesses delayed word recall/memory , visuospatial function , language , attention/concentration , and orientation . A score of < 25 is abnormal and indicates significant cognitive impairment.
Note: you can also access MOCA test online.
Another similar test is the Saint Louis University Mental Status Examination which is scored similarly.
Alternative shorter tests
Why Should You Take The Test
We found SAGE to be an effective screening tool to identify people who would eventually develop dementia, probably six months earlier than the most used screening tool,Douglas Scharre, M.D., director of the division of cognitive neurology at Ohio State University told Today. He added that one of the main advantages of this self-administered test is patients can easily take the exam while sitting in the waiting room of their physicians office or at their homes every six months.
Memory and cognitive changes in older adults are often not identified until theyve progressed into serious diagnoses like dementia or Alzheimers. In an attempt to make earlier diagnoses and begin treatment at earlier stages, researchers compared the SAGE to a common clinician-administered test called the Mini-Mental State Examination .
The earlier youre detected with cognitive impairment, the more choices you have with these treatments and the better they work, Dr. Scharre said in a video posted with the press release.
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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.
Dementia Tests And The Assessment Process
This group of pages tells you what happens when someone has an assessment to find out if they have dementia. It explains the different steps involved, including what happens if a diagnosis is made. You might find it useful if you are worried about your own memory, or someone else’s.
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How The Mini Mental Status Exam Works
The MMSE is commonly used because it only takes 5 10 minutes and doctors or nurses dont need any equipment or special training.
The test has 30 questions that are each worth 1 point. These questions test memory, orientation, and math skills.
The MMSE includes questions that measure:
- Sense of date and time
- Sense of location
- Ability to remember a short list of common objects and later, repeat it back
- Attention and ability to do basic math, like counting backward from 100 by increments of 7
- Ability to name a couple of common objects
- Complex cognitive function, like asking someone to draw a clock
The grading scale is:
- 25 or more points = no problem
- 21-24 points = mild cognitive impairment
- 10-20 points = moderate cognitive impairment
- 0-9 points = severe cognitive impairment
If someone gets a score in the 0 to 20 range, it can indicate cognitive issues. But it doesnt mean that they have dementia.
What it does mean is that more physical and cognitive testing should be done to better understand whats causing the cognitive issues.
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.
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How Accurate Is It
This quiz is NOT a diagnostic tool. Mental health disorders can only be diagnosed by licensed healthcare professionals.
Psycom believes assessments can be a valuable first step toward getting treatment. All too often people stop short of seeking help out of fear their concerns arent legitimate or severe enough to warrant professional intervention.
If you think you or someone you care about may be experiencing symptoms of dementia or any other mental health condition, Psycom.net strongly recommends that you seek help from a mental health professional in order to receive a proper diagnosis and support. For those in crisis, we have compiled a list of resources where you may be able to find additional help at: https://www.psycom.net/get-help-mental-health.
Evaluating Cognitive Impairment And Dementia
Screening includes office-based assessments of cognitive function, as well as laboratory testing and neuroimaging. All patients suspected of having dementia should have a physical examination, including a screening neurological examination and review of medications, as a part of the evaluation.
Quick Cognitive Screening Tests
Mini-Mental State Examination
The Mini-Mental State Examination is an 11-item test that takes five to 10 minutes to administer .
- Scoring: suggested cut-off of 24 or less out of 30 should raise concerns about possible dementia.
- Performance affected by age and education
- Test items that are most sensitive to detection: orientation to date , delayed word recall and intersecting pentagons
- Pros: familiar and takes a relatively short time to administer
- Cons: takes longer than other similar tests tests a limited number of cognitive domains often not sensitive to early cognitive change
The Mini-Cog is a first-line cognitive screen for primary care, although it has not been evaluated as extensively as the MMSE or the Montreal Cognitive Assessment. The Mini-Cog combines the delayed three-word recall test and the clock-drawing test .
Delayed three-word recall test
This test involves one item, and takes one to two minutes to administer.
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