How is dementia diagnosed?

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How is dementia diagnosed?

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I've read many articles about dementia, but I never find them to be helpful. They never give examples of anything and every case is different. Can someone explain how it's diagnosed, particularly in the early stages? I mean, everyone forgets things no matter how old they are. Some people are very forgetful and remember events incorrectly, but they don't have dementia or any other disorder that would cause forgetfulness. Going by these articles, I would say everyone has dementia. I have seen people younger than 30 who have the symptoms mentioned in the dementia articles. In the case of my grandmother, she's been saying questionable things going back at least 15 years. I never knew whether she was confabulating, lying, just trying to make conversation, or simply confused. She is someone whose nature is to kind of play dumb (say she didn't know when she very well did know). She's always been lazy and never wanted to be bothered. The only things she enjoyed were driving and socializing. When she couldn't do either of those due to mobility issues after cancer treatment, that's when I really noticed changes in her. I remember about six years ago she was so "off" that I thought by December 2016 she would have full blown dementia, but she didn't. With her, I can't tell if she has dementia or if what I'm seeing is her laziness and not wanting to be bothered to think mentally. I do think that maybe she has mild dementia, but where do you draw the line between dementia and normal forgetfulness (keeping in mind that some people are naturally super forgetful)?

Alzheimer's & Dementia Cognitive Decline Diagnostic Criteria

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Naturally forgetful people forget where they put their keys. People with dementia forget what keys are for. Naturally forgetful people say, "Dang! Where did I put my sunglasses?" People with dementia say, "Someone snuck in and stole my sunglasses!" I knew something was very wrong when my husband couldn't remember how to make tea from the tea bag and pot of water the waitress brought him.

It is not so much just the frequency of forgetting as the nature of what is forgotten and their reaction to it.

Dementia has other components in addition to memory loss. (Different kinds of dementia have different characteristics.) These may include hallucinations, delusions, paranoia, problems with depth perception, sleep disturbances, difficulty in coming up with even obvious solutions, anxiety over decision making, loss of sense of smell, and many more.

If grandmother develops additional symptoms that could be dementia, it may be time to get her evaluated.

For now, you know what grandmother's behavior is like. Whether you have a label for it or not, it is what it is and it is what you have to deal with. There are no cures for dementia and very little in the way of treatment plans.

In what way do you think having a diagnosis would change things for you?

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For my mom she was given cognitive tests, multiple ones. These are repeated each time she goes to the doctor. They are simple simple things like can you draw the face of a clock, or a box, do simple math, follow directions, remember words, etc.. She was also given thorough physical exams, mri, and blood work plus a sleep study. All these things plus her symptoms of odd behavior, anxiety, sleepwalking, delusions helped make the diagnosis. Forgetfulness is just the beginning.

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There's no concrete diagnosis. It's not like a virus or bacterial they can identify. There's no medical test for dementia. It's basically a diagnosis based on behavior.

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Our doctor says dementia is a condition that typically displays itself in loss of memory and changes in behavior - in general, the loss of memory results in changes in behavior. Lapses of memory as in - where car keys or glasses are - happen to everybody sooner or later and seem to increase as we age WITHOUT being dementia. And, there's loss of short-term memory vs loss of memory of most of the past. You'll find that a lot of older people will be able to talk knowledgeably of the past recalling names, dates, places, old addresses - but don't know what they had for lunch. A friend, for whom I advocate, has short-term memory loss - yet she DOES remember some current or recent history. I've tried to figure out what about the things she DOES remember might have made the difference, but there's seemingly no common denominator. She knows what I gave her for Christmas, mentions it often; but probably won't know the next day that we went out to eat the evening before. So, what she remembers doesn't seem to be related to whether it was a pleasant or bad experience. I can say this: she clearly reacts badly to the word "dementia," relating it, I think, to "demented" which conjures up the picture of an insane asylum in the 1800s that we've seen in movies. She is not nearly so fearful of the idea of "memory loss." There are just soooooooooo many variations.

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I have found that Teepa Snow has some wonderful information and videos on dementia and resources to. Just Google her name and you will find every thing you need.

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I would find a doctor who is familiar with dementia and knows more than an average doctor about it. The reason, is that some doctors aren't that up on the condition, imo. The doctor then, can evaluate your LO and help with questions. They can refer you to a neurologist if needed. Also, I'd check out the Teepa Snow videos as mentioned above and read sites online.

From my experience, cognitive decline and/or dementia doesn't always initially present itself with memory problems. What I observed was more in the line of POOR judgment, apathy and agitation. I couldn't figure out why my LO wouldn't do things that they would have in the past, like wash hands before handling food? Why would they insist on wearing diapers, when they were perfectly capable of going to the bathroom? Why would they be so cross and disagreeable, for no reason? I struggled with this and even questioned health care workers, who said the patient was lazy and spoiled. But, they were wrong. It was dementia in the early stages. Later, it became clear what was happening.

During this time, someone asked me about dementia and I said, NO way, her memory is fine. But, then the memory went too. Even though I had seen the odd behavior, I was still shocked when her GP diagnosed with dementia in an office visit with a Mini Eval.

So, I'd make a list of your observations and discuss with a professional who will be familiar with symptoms and able to order appropriate tests, if that is what you feel you need. When dementia is obvious, some people, don't get further tests to determine why and more details. I did have further tests with a neurologist with my LO and it confirmed the GP's diagnosis of Vascular Dementia, but, my LO was so young (62), I felt that further testing was appropriate.

I hope you can find the answers you are looking for.

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In my mother's situation cognitive testing was done (questioning simple things like who the current president is), both an EEG and an MRI was done. This was done after 4-6 minor car accidents, extreme forgetfulness (several times a week she was having house and car keys made only to find the originals in her purse, couldn't find where she parked her car, etc). Her temperament went from irritated to hostile with everyone. She was going to the bank 3x every week to see that her act was balanced. These are some issues I saw along with the testing/diagnosis that determined Dementia/Alzheimer's, there was significant damage to blood vessels (determined by MRI) to come up with the 95% diagnosis. Her Dr said 100% diagnosis could only be done with an autopsy due to insurance not covering a very expensive test. These are some characteristics I've found and information I've learned, I hope this is of some help, my best advise is be there, be supportive of your loved one, HUGS to all going through this.

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Just reviewed the replies (always in search of something that might help my friend), and agree generally that Dementia is characterized as memory loss and changes in behavior. I was remiss in not relating the whole experience of diagnosis. My friend's doctor did perform a quick cognitive test - remember 3 words - which my friend failed to retrieve from memory 5 minutes later. He also sent her for a battery of blood and medical and physical tests to ascertain that there were not other potential causes. There are situations were the lack of an enzyme or essential vitamin or mineral cause memory loss, so it is important to rule out other potential causes.

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This is slightly off topic---but then again maybe not.
When my DIL was in MEd School DH and I had flown out to CT to visit the "kids". We were both seriously jet-lagged from the redeye flight and exhausted--the kids had slept all night and were full of energy. We wanted to go to sleep, DIL said "Come for a drive, we'll show you New Haven and I can practice my dementia testing on two people I KNOW don't have dementia!" Ok, we go for the ride and we are so both exhausted that we failed, and failed EPICALLY the "verbal" dementia test. We didn't know what county we were in, we weren't sure what the date was, we didn't know the name of the mayor or governor or what "our" address what.

My DIL got a real kick out of that. I've never forgotten the completely "lost" feeling I had. I truly DIDN'T know a lot of the answers, as I didn't live in CT and had actually never been there before, but due to being so tired, I wasn't even sure who the President was. Made me a lot more sensitive to my parents as they went down that slope. It's very frustrating--esp when you know you know something, but can't drag it out of the recesses of your mind. I imagine real dementia feels like that.

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Cognitive disorders (the correct term for what we used to call "dementia") are diagnosable. You need to begin with a neurologist (who will order, among other things, an MRI) and then move on to a neuropsychologist. The testing done by the neuropsychologist is very sophisticated. There is a huge difference between the normal forgetfulness mentioned in some responses and a cognitive disorder. The people who discuss these are right. Don't ignore your grandmother's problems -- some of them are treatable and how you and her care providers deal with her should be based on actual data, not assumptions.

How is dementia diagnosed?

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