Dementia is caused by different diseases, like Alzheimer's disease and vascular dementia. These diseases damage different areas of the brain and cause different symptoms. Brain imaging allows doctors to see where damage has occurred. Brain scanning and imaging has led to more accurate ways to diagnose dementia.
Brain scans cannot identify vascular dementia by themselves, but they can be used along with other information to help confirm the diagnosis. A CT or MRI scan may show evidence of a recent stroke or of other changes in the brain.
Currently MRI is the radiological test of choice. As well as ruling out treatable causes of dementia, MRI can reveal patterns of brain tissue loss, which can be used to discriminate between different forms of dementia such as Alzheimer's disease and frontotemporal dementia.
Brain scans also can identify changes in the brain's structure and function that suggest Alzheimer's disease. The most common types of brain scans are computed tomographic (CT) scans and magnetic resonance imaging (MRI).
Patient assessment tools:
The GPCOG is a screening tool for cognitive impairment designed for use in primary care and is available in multiple languages. Mini-Cog - The Mini-Cog is a 3-minute test consisting of a recall test for memory and a scored clock-drawing test.
The Mini-Cog test.
A third test, known as the Mini-Cog, takes 2 to 4 minutes to administer and involves asking patients to recall three words after drawing a picture of a clock. If a patient shows no difficulties recalling the words, it is inferred that he or she does not have dementia.
The five-minute cognitive test (FCT) was designed to capture deficits in five domains of cognitive abilities, including episodic memory, language fluency, time orientation, visuospatial function, and executive function.
There is no single definitive test for diagnosing dementia. Assessment will account for behavioural, functional and psychosocial changes, together with radiological and laboratory tests. The assessment process may take three to six months to achieve.
Introduction: The five-word test (5WT) is a serial verbal memory test with semantic cuing. It is proposed to rapidly evaluate memory of aging people and has previously shown its sensitivity and its specificity in identifying patients with AD.
Researchers developed a blood test that could detect Alzheimer's disease-promoting compounds in the blood long before symptoms emerged. The findings may lead to early diagnostic tests for Alzheimer's and other neurodegenerative diseases.
The SAGE test is a 12-question exam that measures cognitive functioning and may help a physician determine whether Alzheimer's is present.
In Radiology, patients pose this question often. “Can MRI show if I have dementia?” In fact, we scan patients every day with a diagnosis of dementia, memory loss, Alzheimer's, and confusion, among a variety of other neurological disorders. The truth is that MRI is NOT the test to formally diagnose dementia.
Memory problems
Memory loss is often the first and main symptom in early Alzheimer's disease.
For most people with Alzheimer's — those who have the late-onset variety — symptoms first appear in their mid-60s or later. When the disease develops before age 65, it's considered early-onset Alzheimer's, which can begin as early as a person's 30s, although this is rare.
Researchers found that chronic stress is a significant risk factor for dementia. Because this study looked at several previous studies, its findings are particularly convincing. A study of 1,700 seniors with an average age of 77 found a link between depression—which can both cause and be caused by stress—and dementia.
The Six Item Cognitive Impairment Test (6CIT) is a brief cognitive function test which takes less than five minutes and is widely used in primary care settings. It involves three orientation items – counting backwards from 20, stating the months of the year in reverse and learning an address.
Perseveration clock-drawing errors are likely due to impairment of executive function in the prefrontal area of the frontal lobe, which is found in many dementia disorders.
The main sign of mild cognitive impairment is a slight decline in mental abilities. Examples include: Memory loss: You may forget recent events or repeat the same questions and stories. You may occasionally forget the names of friends and family members or forget appointments or planned events.
The MoCA is a 30-item test that allows healthcare providers to find out how well a person's thinking abilities are functioning. The MoCA test checks language, memory, visual and spatial thinking, reasoning, and orientation skills.
Dementia is caused by damage to brain cells. This damage interferes with the ability of brain cells to communicate with each other. When brain cells cannot communicate normally, thinking, behavior and feelings can be affected.
Dementia vs. Alzheimer's Disease: What is the Difference? Dementia is a general term for a decline in mental ability severe enough to interfere with daily life, while Alzheimer's is a specific disease. Alzheimer's is the most common cause of dementia.
If you had a crazy day and forgot five things but can still settle into a nice bath or feed yourself well at the end of the day, you're probably experiencing normal forgetfulness. Very poor hygiene or missing meals, on the other hand, is a sign of dementia and a warning sign for Alzheimer's.
Neurological Evaluation
People may be asked to name objects, follow verbal and written commands, write a sentence, or draw a complex shape. Doctors may ask you to walk a short distance, because problems with gait can signal other conditions involving memory loss, such as normal pressure hydrocephalus.