How Your Doctor Will Evaluate You for Dementia
You will be evaluated by your primary care provider or a team of providers that may include a neurologist, neuropsychiatrist, neuropsychologist, nurse, and genetics.
Evaluation involves:
- Getting a history of your symptoms:
- What was your first symptom? When did you first notice it? What was your second symptom? When did that start? Can you give examples of these symptoms? Are you concerned about the symptoms? Is your family concerned but you disagree with them?
- Are daily tasks affected: trouble with driving, forgetting to pay bills, paying bills twice, forgetting how to write checks, having to look up recipes you knew by heart, leaving the stove on by mistake, forgetting medications or taking medications twice, can no longer do projects such as repairs, woodworking, quilting, or crocheting, need help figuring out how to do something you previously did very well.
- Getting a history of factors that put you at risk for dementia:
- Do you have a family history of dementia?
- Do you have any of the following: hypertension, hyperlipidemia, heart disease, history of stroke or transient ischemic attack, sleep apnea, alcohol abuse, history of head injury. Has your sense of smell changed?
- Getting images of your brain, such as a CT scan, an MRI, or a PET scan (links to each describing it).
- Having blood work done to check for other causes of symptoms, to check for blood markers associated with dementia, and to check for genetic risk factors associated with different types of dementia.
- Your doctor may order a lumbar puncture to rule out infection or look for indicators of a rapidly progressive dementia or other dementia.
- Having a neurological exam to test reflexes and motor abilities.
- Having a neuropsychological exam to test thinking skills such as memory, language, visuospatial skills, and problem solving. This involves sitting with an examiner, a bit like being in school, and being asked to remember things, put things together, think through problems, do math, and so forth. You may also be given questionnaires to assess for mood changes.
Putting together the findings from all of these information sources will help:
- Determine if you have a dementia
- Give clues as to which type of dementia (or dementias) it may be
- Allow your team of doctors to recommend possible medications
- to help slow the progression of the disease
- to help treat motor symptoms
- to help treat symptoms such as agitation or hallucinations or depression
- to reduce behavioral symptoms such as impulsivity
- To make recommendations for other interventions
- Speech therapy
- Occupational therapy
- Physical therapy
- Home safety evaluation for grab bars, ramps
- To make recommendations for support and community resources
- Participation in support groups
- Connecting with pallative care
- Connecting with dementia-specific groups for information and support, e.g., the Alzheimer’s Association, National Organization for Rare Disorders (NORD)
- Connecting with caregiver groups, e.g., Caregiver Alliance
Your team will also try to help prepare you for what to expect for the future, such as other changes in thinking, the possibility of wandering or becoming lost, worsening of function at night “sundowning,” or transitioning to assisted living or memory care.