Introduction to Assessment & diagnosis

Dementia develops slowly and may not become obvious for some time. While it may be years before an assessment is considered, it is important to talk to a doctor or health professional as early as possible. Sometimes the person experiencing symptoms or their family may notice something is not right, and it is important that health professionals respond to such concerns. The person experiencing memory and thinking problems may be reluctant to visit a doctor, as they may be unaware of their symptoms or fearful of receiving a diagnosis. This can be a challenging time for both the person experiencing symptoms and their family.

Sometimes a diagnosis of dementia comes as a relief, helping the person with dementia and their family understand the changes that have been occurring. An early diagnosis is important as it allows the person and their family time to prepare and plan for the future. There are also treatments that are most effective in the early stages, so diagnosis increases availability of these options.

There is no simple test for dementia and diagnosing the condition can be a lengthy process. Most people will see their doctor for an initial assessment. Many people may also need to be referred to an aged care physician, psychiatrist or neurologist for further assessment. A thorough physical and neurological examination will be required to either confirm a diagnosis of dementia and its form, or to identify other medical conditions. The assessment will include talking with the person experiencing memory and thinking problems, and their family and carers to obtain information.

Medications taken by the person experiencing the symptoms will be reviewed, as some medications may make the symptoms of dementia worse. A physical examination may indicate a particular form of dementia. For example, features of Parkinsonism, such as stiffness or shakiness, may indicate dementia with Lewy Bodies. Blood tests are performed to exclude certain conditions that may make the symptoms of confusion worse such as thyroid abnormalities or Vitamin B12 deficiencies.

A computerised tomography (CT) scan is useful to diagnose strokes or other conditions that may contribute to symptoms. Scans such as magnetic resonance imaging (MRI) and positron emission tomography (PET) may also be used to identify specific changes in the brain and identify the form of dementia, particularly in the early stages. For example, changes in the hippocampal (memory centre) region are often noted on MRI in those with Alzheimer’s disease. In some instances further extensive cognitive testing by a neuropsychologist may be required to confirm the pattern of changes. Due to the complexity in reaching a diagnosis, a multidisciplinary team is important to provide the best treatment and advice.

Source: Department of Health and Ageing