What Is The Dementia Test?
Over 55 million people are thought to have dementia, according to the World Health Organization. However, a large percentage of people with dementia may be undiagnosed. Since dementia can lead to serious consequences, including death, it can be important for those who have it to receive an accurate diagnosis and appropriate treatment.
While there's currently no known cure for dementia, there are many treatment and management options to improve the lives of the people who have it. Understanding what dementia is and recognizing its early stages can help family members identify when to seek diagnostic tests for a person showing signs and symptoms of dementia. In many cases, therapy can be helpful for individuals with dementia and their caretakers, as it can be challenging to cope with a dementia diagnosis on one’s own.
What is dementia?
Dementia is generally seen as a set of symptoms rather than a specific disease. People who have dementia usually struggle with memory loss, thinking troubles, and an inability to keep up with normal daily activities. For many people, dementia begins mildly and worsens over time. Dementia can be associated with multiple disorders, and it can also occur for unknown reasons. 60% to 70% of people with dementia may develop dementia symptoms due to Alzheimer's disease.
Many factors can increase a person's risk of dementia. Dementia tends to be most common among people over 65 years of age. High blood pressure, high blood sugar, obesity, smoking, alcohol consumption, inactivity, social isolation, and depression can all be risk factors for dementia.
Early signs and symptoms of dementia
When a person begins to experience dementia, they may show some of these signs and symptoms:
- Forgetting what they planned to do or what has recently occurred
- Becoming lost on walks or drives
- Misplacing or losing items, like keys, a wallet, or a phone
- Becoming confused, even when doing a familiar activity or in a familiar location
- Struggling to solve problems or make decisions that wouldn't normally be difficult for them
- Struggling to keep up in a conversation
- Having trouble remembering the words they want to say
- Having difficulty engaging in tasks that normally aren't hard for them, like doing laundry or writing checks
- Not keeping track of time as well as usual or being unsure of the date or time
- Incorrectly estimating the distance between them and an object
- Feeling upset about their memory losses or thinking struggles
- Experiencing personality changes
- Acting in ways that are inappropriate given the situation
- Withdrawing from friends, family, and work
- Seeming to be less interested in what others think and feel
Not everyone who has dementia experiences all or even most of these symptoms, especially in the early stages. If a person experiences even a few of these symptoms, seeing a doctor for evaluation could be a good idea.
How is dementia diagnosed?
- Patient and family medical history
- Cognitive examination
- Neurological and physical examinations
- Lab testing
- Brain imaging
Medical history
Taking a patient's medical history is thought to be the most important part of the dementia diagnostic process. A medical history can help the provider understand how a person has changed over time. Some people with dementia might have trouble remembering their own medical history or accurately sharing this information. For this reason, most doctors also take a patient's medical history from their family members or close friends.
During the medical history portion of the diagnostic process, a doctor may ask specific questions that uncover how a person's thinking and memory have changed. For example, they may ask about getting lost while driving or forgetting to pay bills. They may also ask if these changes came on suddenly or slowly over time. Often, doctors ask questions about physical health concerns, like high blood pressure, diabetes, or stroke, as well.
Finally, a family medical history is often taken along with an individual's medical history. Although dementia isn't always genetic, some rare forms are hereditary. Knowing if first-degree relatives have had dementia, especially early-onset dementia that began before age 65, can help a provider better understand a person's complete medical picture.
Cognitive examination
A cognitive examination can help the provider understand a person's mental status and ability to think and remember things. Common cognitive examinations given to people suspected of having dementia are the Montreal Cognitive Assessment and the Mini-Mental State Exam. Many providers use both tools to increase the odds of detecting cognitive impairment. Both assessments can be done fairly quickly, and they typically assess a person's short-term memory, cognitive function, attention, awareness of time and place, visual ability, and language ability.
The Montreal Cognitive Assessment may be particularly effective at identifying mild cognitive impairment (MCI). When a person has MCI, they typically have some signs and symptoms of dementia, but have not yet progressed to a full dementia diagnosis. With MCI, memory loss and cognitive impairment are usually present, but not yet severe enough to regularly interfere with daily living.
Other cognitive tests sometimes used when looking for dementia include the General Practitioner Assessment of Cognition, the Ascertain Dementia 8-Item Questionnaire, and a shorter exam called the Mini-Cog.
Neurological and physical examination
A neurological examination usually involves checking a person for trouble speaking or understanding words, trouble making certain movements or performing tasks that involve movement, and trouble understanding sensory information.
A physical exam is often conducted alongside a neurological exam. A physical examination may include checking a person's blood pressure, temperature, and pulse. It may also include looking at the eyes and ears, listening to the lungs and heart, checking reflexes, and asking a person to engage in simple tasks, like standing and walking.
Lab testing
Laboratory testing often helps doctors rule out conditions that can cause dementia-like symptoms. Common lab tests involve collecting urine and doing blood tests. A doctor may use tests to check for diabetes, anemia, hypothyroidism, kidney disease, and vitamin deficiencies.
If a person's medical history warrants other testing, a person with potential dementia symptoms may be sent to specialists who can conduct additional tests. Other testing could include heart testing, like an echocardiogram, or tests for signs of autoimmune disorders.
Less commonly, doctors may order genetic testing or the testing of cerebrospinal fluid. These tests aren't usually routine, however. These tests are normally more likely to be used among people participating in clinical trials, which can be thought of as research designed to learn more about dementia and related illnesses.
Brain imaging
Brain imaging is often used when a person is being evaluated for dementia. Commonly used types of brain imaging include magnetic resonance imaging (MRI) and computed tomography (CT) scans. In some people, brain imaging can identify an alternative cause of symptoms or confirm the type of disease that is causing a person's dementia. However, brain imaging doesn't always lead to this type of clarity for everyone with dementia.
Remote therapy for dementia
While therapy may not treat dementia directly, it can be a useful tool to help a person with dementia cope with the illness they are experiencing and any related life changes. Remote therapy, in particular, may be especially useful, since it doesn't require a person with dementia to travel to a therapist’s office. Remote therapy is usually available from the comfort of a person's home or any location they prefer, so long as an internet connection is available. BetterHelp is a remote therapy platform that can connect individuals with the best therapists for their needs.
Researchers haven't yet studied the efficacy of remote therapy for dementia, but online therapy, in general, has been researched in multiple studies. A large body of evidence suggests that online therapy can produce the same client outcomes as its in-person counterpart.
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