Diagnosing dementia is a complex and difficult process, requiring the time and expertise of skilled practitioners.
A dementia diagnosis can only be made after a systematic assessment that takes into account other possible causes for the symptoms. For example, symptoms that are associated with dementia could also be due to other conditions such as depression, thyroid or heart disease, infections, drug interactions or alcohol abuse. Thus, there is no single test that can tell that someone has or does not have Alzheimer’s or another dementia.
It is important to see a doctor as soon as you suspect problems.
Early detection and diagnosis of Alzheimer’s disease or another dementia is critical to ensuring proper support, care and treatment of the illness. It is also important because it allows people with the disease and their families to make key financial and care decisions while they are still functioning at the highest possible level.
The diagnosis of dementia often comes as a complete shock. However, many people feel relieved once they have identified the source of their worries after a diagnosis has been made.
Getting an early diagnosis will help you to move forward and gain more control over your life by taking the necessary steps to live better with the disease. Receiving an early diagnosis allows a person to:
- Understand the symptoms they are experiencing, and the changes that they can expect
- Gain access to information, resources and support
- Benefit from and explore treatment options
- Plan for the future
- Develop and engage support networks
- Maximize their quality of life.
When seeking a diagnosis, the doctor may begin by asking you some general questions about your overall health:
- What kind of symptoms have you noticed?
- When did they begin?
- How often do they happen?
- Have they gotten worse?
- What other medical conditions exist?
They will look for problems with memory, reasoning ability, language and judgment, and how these affect day-to-day function.
The doctor may use the words "probable Alzheimer's disease."
Many doctors who make this diagnosis are accurate 80 to 90 percent of the time. The doctor may refer you to another specialist such as a psychologist, psychiatrist, neurologist, geriatrician, nurse, or a social worker.
A doctor will ask you and possibly your family members about your medical history, including current and past illnesses. The doctor will also look at your family history of medical conditions. It may be helpful for you to bring a list of current medications that you are taking.
Mental Status Tests
Mental status testing helps give the doctor a general idea of your mental functioning. One of the most common is the Mini-Mental State Examination (MMSE). This part of the process tests things such as your sense of time and place, as well as your ability to remember things and do simple calculations. It may involve exercises such as recalling words and objects, drawing and spelling, and questions such as "what year is it?"
Physical Exam and Diagnostic Tests
A physical exam is helpful in ruling out other causes for the symptoms you are experiencing. The doctor will look for heart, lung, liver, kidney or thyroid problems that may be causing the symptoms.
To evaluate whether other nervous system disorders are causing the symptoms, the doctor will test muscle tone and strength, co-ordination, eye movement, speech and sensation.
If necessary, the doctor may request that further testing be done. This can include laboratory testing such as blood tests, x-rays, brain imaging or scanning.
As concern about Alzheimer's increases, some people have argued that population-based memory screening (also referred to as broad screening) should be offered for dementia.
Population-based means anybody can take the test, regardless of whether they've shown any symptoms. Memory screening, when used in the community, generally refers to the use of a simple mental status test that gives a numerical score to indicate whether an individual may or may not have memory problems.
However, based on advice given by leading dementia researchers and clinicians in Canada, the Alzheimer Society does not support population-based memory screening as a means to identify people who should be seen by a physician for a diagnostic evaluation.
The tools currently available are often inaccurate, resulting in false positives or false negatives.
False positives occur when a person fails or scores poorly on a test but does not have Alzheimer’s disease or another type dementia. False negatives occur when a person “passes” or scores well on a test but actually does have a type of dementia.
What you can do
Research to develop reliable early screening tools continues, and eventually we may be able to screen appropriately for Alzheimer's disease in the general population.
Until then, if you have any concerns about your memory, consult with your family doctor.
For further information, contact:
Cheryl Demasi, Client Service Coordinator
204-943-6622 or 1-800-378-6699
Or contact the Alzheimer Society nearest you.