How is a diagnosis made?
There is no simple test for dementia. There is new research into development of blood tests that can help detect Alzheimer’s disease, but this remains at an early stage.
Diagnosis is a process that begins with getting good information on what has been happening in terms of the development of symptoms. It is really useful to get that information from the person affected and also from family or friends that know them well. The doctor is likely to ask you when your symptoms started and how they impact on your life. Next comes an examination of mental processes, such as tests of memory and depression, and of your physical state to help work out your strengths and difficulties and whether you have a treatable underlying condition, such as anxiety, depression, a vitamin deficiency, an infection, or sensory impairments.
It is worth bringing a family member or someone close to you for the initial appointment, so they can support you, but also share any changes they have observed.
If necessary, the doctor may refer you to a specialist for further tests. These can include cognitive testing – such as tests of memory, attention, language and verbal fluency, and visuospatial abilities (copying a diagram or picture). You may also be asked about how you function in everyday tasks such as washing and dressing, driving, or cooking. You may also be referred for a scan (an MRI or CT) to examine the brain for any abnormalities.
If possible, consider asking someone to come with you to the appointment. Not only is it nice to have the support, but it often helps when someone else can listen to what the clinician has said.
If a diagnosis of dementia is found, this should be communicated sensitively and clearly, with time for the person being diagnosed and their loved ones to ask questions and discuss next steps and possible pathways to support, both immediately and with regular follow up. The impact of a dementia diagnosis depends greatly upon how it is made and imparted, and how people are supported afterwards by services.
Evidence suggests that when people with dementia and their families are well prepared and supported, initial feelings of shock, anger and grief are balanced by a sense of reassurance and empowerment.
Too few people receive a diagnosis
In low- and middle-income countries, as few as 10% of those affected receive a diagnosis. In higher income countries, approximately half of individuals receive a diagnosis, but in all countries post diagnostic support, treatment and access to care remain significant barriers to living well.
At ADI, we feel this needs to change. Our hope is that every country will have national dementia plans in place to ensure and encourage timely diagnosis and strong post-diagnostic support for all people affected by dementia.