What Conditions Can Be Mistaken For Dementia
There are a number of medical conditions that may cause dementia like symptoms. Many of these conditions are treatable too.
Mental health conditions and stress can sometimes lead to memory loss and confusion. Anxiety for example, can fill a person with worry, which can take over how they think and process information making it more difficult to focus on or remember things.
Depression is also another mental health condition that could be confused for the early signs of dementia. Its estimated that in the UK, depression affects 22% of men and 28% of women over the age of 65. 85% of those receive little to no help for the condition.
Symptoms like low self-esteem, sudden changes in mood, low concentration and memory problems are all things that can be experienced by people living with depression or dementia.
Physical illnesses such as cardiovascular disease, kidney, liver, and lung problems can also produce dementia like symptoms. Very sudden changes in behaviour and thinking can sometimes be caused by an infection or brain tumour both are often treatable when caught early.
A change in someones vision or hearing may cause them to lose things more easily, bump into things at home, or struggle with conversation so its important to test these senses regularly.
To rule out these causes of dementia-like symptoms, your GP may choose to run some blood tests and take a thorough look at your medical history.
What To Expect When You See A Gp About Dementia
A GP will ask about your symptoms and other aspects of your health.
They’ll also ask if you’re finding it difficult to manage everyday activities such as:
- washing and dressing
- cooking and shopping
If possible, someone who knows you well should be with you at your GP appointment, so they can describe any changes or problems they’ve noticed. They could also help you remember what was said at the appointment, if this is difficult for you.
Memory problems do not necessarily mean you have dementia. These problems can have other causes, such as:
- an underactive thyroid
- side effects of some medicines
To help rule out other causes of memory problems, the GP will do a physical examination and may organise tests, such as a blood test and urine test.
You’ll also be asked to do a memory or cognitive test to check any problems with your memory or ability to think clearly.
Read more about the tests used to diagnose dementia.
The Truth About Dementia Tests
Certain tests for dementia don’t offer much diagnostic value in general, including genetic tests for Alzheimer’s. The only gene tests that can accurately determine whether you’ll get Alzheimer’s disease are for the autosomal dominant form, also known as familial early-onset Alzheimer’s disease. It is very rare, accounting for less than 5% of total cases, and it typically starts before middle age.
A blood test for the Alzheimer’s risk gene, APO-e4, also exists. However, the use of APO-e4 as a screening measure is controversial because it can’t determine for sure whether you will develop the disease.
Also of questionable merit are the do-it-yourself, at-home tests for dementia that are marketed directly to consumers. The Alzheimer’s Association doesn’t recommend these tests, because they don’t provide an adequate assessment of your risks. Distinguishing between normal, age-related memory changes and early signs of a more worrisome condition can be difficult. If you’re going to be evaluated for dementia, you want a neuropsychologist, neurologist, geriatrician, or geriatric psychiatrist to do the testing and help you understand the results.
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The Sage Test For Dementia
A few years ago the Self-Administered Gerocognitive Examination test was reported in the UK press as a 15 minute at home test for dementia. The test was developed in America by the Wexner Medical Center at Ohio State University, and is not widely used in the UK.
The test is a simple pen and paper test used to identify potential problems with cognition. The test is split into six sections assessing orientation, language, abstract thinking, visuospatial skills, problem-solving, and memory issues.
Its important to emphasise that any at-home assessments or quiz you do to test your thinking skills should only be done as supporting evidence to share with your doctor. They are not a means of ruling out or diagnosing dementia yourself.
Talking With A Doctor
After considering the persons symptoms and ordering screening tests, the doctor may offer a preliminary diagnosis or refer the person to a Cognitive Dementia and Memory Service clinic, neurologist, geriatrician or psychiatrist.Some people may be resistant to the idea of visiting a doctor. In some cases, people do not realise, or else they deny, that there is anything wrong with them. This can be due to the brain changes of dementia that interfere with the ability to recognise or appreciate the changes occurring. Others have an insight of the changes, but may be afraid of having their fears confirmed.One of the most effective ways to overcome this problem is to find another reason for a visit to the doctor. Perhaps suggest a check-up for a symptom that the person is willing to acknowledge, such as blood pressure, or suggest a review of a long-term condition or medication.Another way is to suggest that it is time for both of you to have a physical check-up. Any expressed anxiety by the person is an excellent opportunity to suggest a visit to the doctor. Be sure to provide a lot of reassurance. A calm, caring attitude at this time can help overcome the person’s very real worries and fears.Sometimes, your friend or family member may refuse to visit the doctor to ask about their symptoms. You can take a number of actions to get support including:
- talking with other carers who may have had to deal with similar situations
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What’s The Best Way Of Dealing With My Diagnosis
At first you may feel shock, disbelief or fear. You may also feel relieved that you can put a name to what’s going on.
There is no right or wrong way to feel. Take your time to process what it means for you. It can help to talk to someone and get support.
Talking about your diagnosis can be difficult. You might get emotional, which is perfectly natural. You may approach the topic differently with different people, and find it easier to talk about it with certain people. However you approach these conversations is personal to you and theres no right way to do it.
Counselling and therapy
You can talk to someone who isn’t family or a friend. For some, talking to someone you don’t know is easier than talking to someone close to you.
Counselling gives you a chance to speak openly with someone who will listen to you without judging you or your situation. It can help you feel clearer about your concerns and find ways to manage them. They may be able to help with feelings of fear and anger surrounding a diagnosis.
Stage : Age Associated Memory Impairment
This stage features occasional lapses of memory most frequently seen in:
- Forgetting where one has placed an object
- Forgetting names that were once very familiar
Oftentimes, this mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing. Concern for early onset of dementia should arise with respect to other symptoms.
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Common Warning Signs To Look Out For Include:
- A change in your thinking abilities that impacts your daily life.
- Difficulty performing daily tasks that youve been able to do in the past.
- Feeling disorientated when it comes to time and place.
- Poor judgement or finding it difficult to make decisions.
- Misplacing things or thinking people are moving things without telling you.
- Finding it more difficult to communicate.
Is There A Test To Detect Dementia Early
Its important to know that screening for dementia takes time. It cant be done in a single test. A qualified healthcare professional will likely do a number of mental and physical assessments as part of the diagnostic process.
As theres no cure for dementia, you may wonder why getting a professional diagnosis is so important. While a diagnosis of dementia is life-changing the earlier diagnosis happens, the more effective treatments are likely to be at managing symptoms, and potentially slowing down the progression of some symptoms.
An accurate diagnosis can also be an important step in ensuring people get the support they need from emotional and community support, to home adaptations that can make daily life easier.
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The Clock Test For Dementia
This is a commonly recognised test for impaired thinking or cognitive decline. It involves drawing a clock on a blank sheet of paper adding the numbers in the correct places, and drawing the clock hands indicating a specific time.
The drawing is judged on a number of criteria
- How well the person drew the circle i.e is it round, or does it veer off to one side
- Have they written all the numbers from 1 -12, in the right order?
- Are all the numbers on the clock face and in the right place and spaced fairly evenly?
- Did they draw both the hour and minute hand on the clock?
- Are the hands pointing to the time they were asked to draw?
The clock test has long been a quick screening tool for dementia with an accuracy between 59% and 85%. However, the clock test cannot distinguish between different forms of dementia. Its also worth noting that some illnesses and medication can make it difficult to complete the clock test accurately too. Being unable to complete the task wont always point to a dementia causing disease.
Is It Dementia Or Mild Cognitive Impairment
Sometimes, when an older person is having memory problems or other cognitive issues, they end up diagnosed with mild cognitive impairment.
Mild cognitive impairment means that a persons memory or thinking abilities are worse than expected for their age , but are not bad enough to impair daily life function.
The initial evaluations for MCI and dementia are basically the same: doctors need to do a preliminary office-based cognitive evaluation, ask about ADLs and IADLs, look for potential medical and psychiatric problems that might be affecting brain function, check for medications that affect cognition, and so forth.
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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 The Gp Will Ask
The doctor may ask about the persons medical history theyll want to know about any other conditions they have and medicines theyre taking. Theyll ask about symptoms and whether these have come on gradually or suddenly. They may ask about:
- memory problems and confusion
- changes in behaviour and mood, for instance, if the person has felt more depressed, anxious or angry than normal
- how symptoms are affecting normal daily activities such as preparing meals, housework and personal hygiene, for instance
The doctor may also use a special questionnaire or tool to assess symptoms. Find out more about this in the section below, Tests for dementia.
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What Are The Benefits Of Early Diagnosis
Early planning and assistanceEarly diagnosis enables a person with dementia and their family to receive help in understanding and adjusting to the diagnosis and to prepare for the future in an appropriate way. This might include making legal and financial arrangements, changes to living arrangements, and finding out about aids and services that will enhance quality of life for people with dementia and their family and friends. Early diagnosis can allow the individual to have an active role in decision making and planning for the future while families can educate themselves about the disease and learn effective ways of interacting with the person with dementia.
Checking concernsChanges in memory and thinking ability can be very worrying. Symptoms of dementia can be caused by several different diseases and conditions, some of which are treatable and reversible, including infections, depression, medication side-effects or nutritional deficiencies. The sooner the cause of dementia symptoms is identified, the sooner treatment can begin. Asking a doctor to check any symptoms and to identify the cause of symptoms can bring relief to people and their families.
Preparing For Your Appointment With A Specialist
You may have to wait between a few weeks or several months before you are able to see a specialist for further tests. How quickly you are seen depends on where you live, and how serious your symptoms are.
For many people, waiting is the hardest part of the diagnosis process.
You can ask the health professionals questions at any time during the assessment process. There are also several things you can do to live well while you wait for your assessment:
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How To Get A Dementia Diagnosis How To Get A Dementia Diagnosis
The dementia diagnosis process can vary for everyone. This page describes the typical steps involved in getting a diagnosis, including what might happen if you are referred to a specialist.
For many people, getting a dementia diagnosis can be quite simple and take just a few weeks. For others it can take much longer sometimes more than a year.
There isnt yet a simple test for dementia, so a diagnosis is normally based on a mixture of different types of assessment.
You will have several tests to give healthcare professionals enough information to tell you what is causing your symptoms.
For most people, the process usually follows these steps:
But the assessment process can vary, and will not be the same for everyone.
Talking to your GP about dementiaTalking to your GP about dementia .
What To Do If You Notice Dementia Symptoms
If youre worried that youve been forgetting things more than usual, its worth booking an appointment with your GP. Sometimes, your GP may ask you if you have any concerns about your memory, even if youre visiting them about something else. This might be if youre considered to be at increased risk of dementia due to other health conditions. You might also be assessed for dementia if youve been admitted to hospital for other reasons.
If you notice a loved one is having problems with their memory or other changes in behaviour, try to encourage them to visit their GP too. Its a good idea if someone who knows the person well, such as a close family member, goes too. Early symptoms of dementia are often more noticeable to friends and family than the person themselves.
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How The Sage Test For Dementia Works
SAGE stands for Self-Administered Gerocognitive Examination and was developed by researchers at The Ohio State University Wexner Medical Center.
The SAGE test has 12 questions that cover all aspects of cognition, including memory, problem solving, and language.
There are 4 different versions of the test. Theyre similar enough, but having multiple versions means that someone could take the test once a year and wouldnt improve their score each year just from the practice of taking it before.
This way, the test is slightly different each time.
Should You Be Tested For Dementia
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Widespread screening isn’t recommended, but symptoms are cause to get evaluated.
We routinely undergo mammograms and colonoscopies with the objective of catching breast and colorectal cancer early, when they’re most treatable. So why don’t we also get periodically screened for dementia using questionnaires, blood tests, or imaging scans? The U.S. Preventive Services Task Forcea panel of disease prevention expertsadvises that there is no proven value in screening women without cognitive problems.
The main reason for the difference in screening recommendations is that while there are effective treatments for cancer, such as chemotherapy, radiation, and surgery, there are no effective approaches for stopping the forward progress of dementia.
“There are certain diseases in which we know that early detection can lead to early intervention, which can stave off worse outcomes, but if you don’t have any kind of disease-modifying therapy at hand, it doesn’t make a whole lot of sense to screen people who don’t have symptoms,” explains Dr. Aaron Philip Nelson, assistant professor of psychology at Harvard Medical School and author of The Harvard Medical School Guide to Achieving Optimal Memory.
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Why Would Anyone Want An Early Alzheimers Diagnosis
The SAGE test is useful because it helps you understand if your concerns are something to be worried about.
If the results seem to indicate that there could be a problem, you might think theres no point in talking with the doctor because theres no cure for dementia.
The most important is that a treatable condition could be the cause of cognitive impairment. Finding out sooner means getting treatment ASAP to eliminate the cognitive symptoms.
If the cognitive impairment is caused by Alzheimers or dementia, a major benefit is that starting treatment early is far more effective in managing symptoms and delaying progression of the disease.