The Process of Being Diagnosed with Dementia
Imagine yourself in a doctor’s office, with its sterile, white walls and bright, clinical lighting. You perch awkwardly on the exam table, listening to the sound of paper rustling beneath you as you wait for the doctor to finish typing on their computer. It’s not the most inviting setting to share personal details in. Your nervousness causes you to fidget uncomfortably, and you can’t help but feel a chill from the cold surface of the examination table. But it’s important, to be honest about your symptoms and do your best to communicate them accurately.
During this check-up, your doctor may conduct a mini-cog assessment. This includes two parts: a memory test consisting of three words and a task where you are asked to draw a clock to assess cognitive abilities such as language, motor skills, and executive function. For accurate results, I recommended performing these tests at different times of the day and then taking an average score. This way, any variations in performance can be accounted for. Someone may do well on the test at 10:00 a.m. but struggle at 3:00 p.m.
While conducting a cognitive assessment, one of the first things I personally do is ask the person to walk from one side of the room to the other and back. I am looking for any signs of a shuffling gait and balance loss. I have observed that those who are living with dementia tend to keep their heels closer to the ground as they progress. It seems that lifting their feet higher requires more effort and focus. I also observe how they turn, checking if they are dragging their foot on the floor, basically swinging it while turning. It is fundamental to monitor any decline in their motor skills.
For a diagnosis of dementia, doctors rely on observing the decrease in cognitive functions and evaluating any remaining capabilities. Biomarkers have become increasingly important in identifying Alzheimer’s disease (AD) with more precision. However, if AD is eliminated as a potential cause, other tests will still need to be conducted.
After the initial check-up, your doctor will review your medical history and ask about any symptoms you have been experiencing. It is necessary to be honest and thorough when discussing your medical history and symptoms with your doctor, as this can help them make an accurate diagnosis.
Dementia does not have a single diagnostic test, so a combination of tests should be administered to determine the condition. These assessments evaluate different cognitive abilities, including spatial awareness, logical reasoning, language comprehension, motor skills, balance, reflexes, and focus.
Imaging techniques like CT or MRI can identify problems like stroke, bleeding, tumors, or fluid buildup in the brain. However, PET scans are capable of revealing patterns of brain activity and detecting the presence of amyloid or tau proteins, both indicative of Alzheimer’s disease.
Medical examinations, including blood tests, can detect physical ailments that may impact brain function, such as any deficiency in the vitamin B family. Doctors may also analyze spinal fluid for signs of infection, inflammation, or evidence of degenerative disorders.
A mental health professional may perform a psychological assessment to determine if symptoms are a result of depression or another mental disorder.
The bottom line is that there is something in your body causing you to become cognitively impaired; now the question is, what? If your general physician is only giving you a diagnosis of dementia, that is not good enough. You should be seeing a neurologist for an accurate diagnosis.
