Diagnosing dementia

How is dementia diagnosed?

Although many people are reluctant to admit they are experiencing the symptoms of dementia, getting a diagnosis is important. An accurate diagnosis will enable them to access available treatments, obtain the right level of care and support and allows them to plan for the future. However diagnosing dementia is difficult, particularly in the earlier stages of the disease, because:

  • There is no single test that will definitively diagnose dementia.
  • The earlier symptoms of dementia can overlap with other conditions such as depression or a urine infection, which can cause similar symptoms.
  • Everybody experiences dementia differently and the type of dementia will have a significant impact on the earlier symptoms.

People often ask, ‘what tests are used to diagnose dementia?’ or ‘how is a person diagnosed with dementia?’ But there is no single test that can definitively diagnose dementia rather a number of stages involved as follows:

Stage 1 – GP Visit

When someone is worried about their memory or is experiencing some of the other symptoms of dementia such as confusion, feeling anxious or depressed the first step to getting a diagnosis would be to visit their GP. It is best if they are accompanied by a close relative or friend who is aware of the changes that have occurred.

The GP will carry out a number of actions including:

  1. Review the person’s medical history and ask questions about their symptoms and how long ago they appeared.
  2. Carryout a physical examination. This will include taking blood samples to rule out illnesses such as a urine infection which can cause similar symptoms as dementia.
  3. Perform a cognitive test, often the General Practitioner assessment of Cognition (GPCOG) test, click here for more details.

These tests will rule out other possible causes of the symptoms. If the GP is concerned that dementia may be the cause he will make a referral to a specialist.

Stage 2 – Referral to a specialist

If a GP is concerned that someone may have dementia they will refer them for further assessment to a specialist or Memory Clinic. Where they are referred will depend on their age, symptoms and the services available where they live, but may include either a:

  • Psychiatrist who specialises in mental health, sometimes specialising in the mental health of older people (old age psychiatrist)
  • Geriatrician who specialises in the illnesses and physical disabilities of older people.
  • Neurologist who specialises in diseases of the brain and nervous system. Neurologists tend to see people with rarer types of dementia or people with early onset dementia.

The specialist will carry out a more in depth assessment than the GP as follows:

  1. The specialist will review in more detail a person’s medical history including the symptoms and the rate of progression.
  2. They may carry out any physical examinations missed by the doctor.
  3. Carry out further more in depth memory and cognition tests, there are many different types of test, for more details click here.
  4. Perform brain scans. Click here for more details on the types of brain scans available.

If a person is diagnosed with dementia any support and care they need will be organised between the NHS and Social Services. Following her diagnosis Mum’s care was transferred from her GP to her consultant psychiatrist i.e. the specialist who made the diagnosis; she was assigned a community psychiatric nurse (CPN) and an approved social worker (ASW).

So while many people are reluctant to obtain a diagnosis of dementia, including Mum, the advice, help and support that was provided by Mum’s assigned team (see below) was invaluable not only to Mum (although she didn’t necessarily realise or appreciate it) but to us, her family, as we were really struggling to cope.

  • Prescribed medication to try and improve the symptoms of dementia and alleviate anxiety and depression.
  • Made practical suggestions on how to improve safety within the home such as pressure mats on the door so we knew if Mum had left the house.
  • Provided nutritional advice and prescribed nutritional supplements when we were struggling to get Mum to eat.
  • Gave advice on any benefits we were entitled to including the Attendance Allowance.
  • Provided any objective opinion and advised us when Mum needed to be hospitalised for her own safety.
  • Helped in the selection of a suitable care home when the time came.

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