Geriatrician explains how dementia is diagnosed
Dr. Leslie Kernisan, a San Francisco Bay Area geriatrician, is often asked by family members if their older adult has Alzheimer’s or dementia. Because so many people have asked “how is dementia diagnosed?” she wrote an article explaining how doctors typically evaluate someone for dementia.
In the full article, she describes the basic diagnostic tests, what types of information are needed, and how long it will take. Here are the key points from her article.
5 key features of dementia
Dr. Kernisan explains the issues that people with dementia will experience.
- Difficulty with one or more types of mental function, like learning, memory, language, judgement
- Problems that are a change compared to the person’s usual abilities
- Problems that make it difficult for them to manage everyday life responsibilities, like work or family
- Problems that aren’t caused by another mental disorder, like depression
5 steps doctors take to diagnose dementia
Doctors typically go through 5 areas of evaluation to figure out whether someone has dementia. The doctor needs to check each area and document what they find.
- Difficulty with mental functions
Usually evaluated with a combination of an office-based cognitive test and finding out about real-world problems by talking with their patient and people close to them.
- Decline from previous level of ability
This can be harder for a doctor to determine, so they need to talk with people who know their patient well to understand their previous abilities versus what they can do today. For example, if a former accountant can no longer do basic math, that’s a decline from their previous ability.
- Impairment of daily life function
This can also be tough to see right away. The doctor will ask about what types of help the person is getting in their daily life and what problems family members have seen.
- Reversible causes of cognitive impairment
Certain conditions can cause temporary dementia-like symptoms. Delirium can seem like Alzheimer’s or dementia and is usually caused by illness, infections, or a hospitalization and can last from weeks to months. Other medical problems that interfere with thinking skills include thyroid problems, electrolyte imbalances, B12 deficiency, depression, substance abuse, and medication side effects.
- Other mental disorders
Depression is a common mental health issue for older adults and can sometimes be confused with dementia symptoms. And sometimes, seniors have depression and dementia at the same time. It’s also important to consider the person’s mental health history. Paranoia or delusions could be related to mental health conditions like schizophrenia.
Dementia cannot be diagnosed in a single visit
As you can see, the 5 areas a doctor needs to evaluate are complex and require gathering a lot of information. Unless all the info above can be provided within one visit, it’s highly unlikely that a doctor could make a diagnosis right away.
Do some doctors diagnose in a single visit? Yes
Unfortunately, some doctors do jump quickly to a diagnosis in only one visit. Even worse, they don’t properly document what led to their decision.
Yes, there is a high chance that those symptoms could mean dementia. However, there are reversible causes for dementia-like symptoms so a thorough evaluation is needed for an accurate diagnosis.
How to prepare if your senior needs to be evaluated for dementia
If you’re concerned that your older adult could have Alzheimer’s or dementia, Dr. Kernisan provides a list of the types of information you can gather to help the doctor with their evaluation.