Dementia Screening

Age-related memory changes are a part of life for many people. Many older adults will forget where they set down their keys or struggle to remember an internet password. For most people, small memory lapses are not a cause for concern. However, memory problems that appear suddenly or get progressively worse can be a sign of dementia.

If you or a loved one have symptoms of dementia, you can ask your doctor for screening tests that assess cognitive ability. These tests are the first step to identifying dementia so that families can prepare to provide the best care possible to a loved one with dementia.

What Is Dementia?

Dementia is a term used to describe mental symptoms that affect memory, thinking, and social behavior. Dementia is more serious than typical age-related memory changes. The symptoms of dementia are significant enough to interfere with daily activities, and they become worse over time.1

Memory lapses can be the earliest sign of dementia, but dementia affects many aspects of thinking, reasoning, and behavior. Common dementia symptoms include:

  • Difficulty communicating
  • Difficulty finding words
  • Difficulty with spatial abilities, such as getting lost while walking or driving, even in familiar surroundings
  • Difficulty problem-solving
  • Difficulty completing complex tasks
  • Difficulty with planning and organizing
  • Loss of coordination and motor functions
  • Confusion and disorientation

Dementia can also lead to personality and behavior changes, including:

  • Agitation
  • Inappropriate behavior
  • Hallucinations
  • Paranoia
  • Symptoms of depression or anxiety

What Causes Dementia?

Dementia is caused by changes in the brain that affect how nerve cells connect. Some forms of dementia are progressive and get more severe over time. These conditions cannot be reversed, and there are limited options for treatment.

  • Alzheimer’s disease: Alzheimer’s disease is the most common form of progressive dementia, affecting more than 6 million Americans.2 It is caused by protein plaques that form on the brain and interrupt normal function. No treatment can reverse the effects, but new medications can slow the progression in some individuals.3
  • Lewy body dementia: Lewy body dementia is similar to Alzheimer’s, but it is caused by proteins called Lewy bodies that affect brain function. Lewy body dementia may cause hallucinations or body tremors along with cognitive decline.
  • Frontotemporal dementia: Frontotemporal dementia is caused by nerve breakdown in the frontal and temporal parts of the brain. This type of progressive dementia is often associated with personality and behavior changes.
  • Vascular dementia: Vascular is caused by damage to vessels that supply blood to the brain. This can damage the brain tissue due to a lack of proper oxygen and nutrients. It can also lead to an increased risk of stroke or mini-stroke.

Other causes of irreversible dementia symptoms include traumatic brain injuries, Parkinson’s disease, Huntington’s disease, or a rare illness called Creutzfeldt-Jakob disease.

In some cases, dementia symptoms can be caused by other health conditions such as malnutrition, metabolic conditions, infections, side effects from certain medications, or brain injuries such as subdural hematoma. These underlying conditions can be treated, which may alleviate the symptoms of dementia.

Who Should Be Screened for Dementia?

Dementia screenings are appropriate if you or someone you love is showing symptoms that may indicate dementia. Signs such as new or worsening memory problems, new or worsening confusion, or new or worsening difficulty with daily activities are a sign that you should speak to your doctor.

Getting screened as soon as you see symptoms is important. If dementia symptoms are caused by a reversible condition, testing can ensure that you get the correct treatment to alleviate symptoms. In the case of progressive dementia, early diagnosis can enable families to prepare for future care for their loved ones.

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What Happens During a Dementia Screening Test?

Dementia screenings are non-invasive tests that your doctor can perform in the office. It is often helpful for a person with dementia symptoms to bring a family member to the appointment. First, your doctor will go over your health history, including asking about any family history of dementia. They will ask you or your family members about dementia symptoms, how long they have been happening, and if they seem to be getting worse.

Your doctor will also perform a cognitive screening test. These Tests consist of questions or activities that are designed to measure cognitive abilities. One such test is the Mini-Mental Status Exam (MMSE). This screening takes about 10 minutes and assesses a broad range of cognitive functions, including:4

  • Individual’s sense of date and time
  • Individual’s sense of location
  • Individual’s ability to repeat a short list of prompts and recall them later
  • Attention and calculations to determine an individual’s arithmetic ability
  • Ability to name common objects,
  • Individual’s ability to repeat a given phrase
  • Following complex commands, such as instructions to draw an object

Another screening test is the Mini-Cog. It’s a shorter screening than the MMSE. Individuals are asked to complete three tasks:5

  • Repeating back a list of three words
  • Drawing a clock and positioning the hands at the specific time
  • Recalling the list of words from the earlier list

The tasks in each of these tests are assigned a point value. Points are tallied at the end of the test, and the overall grade corresponds to the individual’s level of cognitive impairment.

How Is the Cause of Dementia Diagnosed?

In addition to cognitive tests, your doctor might order additional testing to determine the cause of cognitive problems. Blood tests can identify issues such as metabolic conditions, infections, or immune conditions that are affective cognitive abilities. If your doctor suspects a medication is causing dementia-like systems, they may change your dosage or medication to see if symptoms improve.

Imaging tests and scans are also useful in identifying dementia causes, such as:

  • CT or MRI: A CT or MRI scan can create an image of your brain. This can reveal the presence of tumors or excess fluid, putting pressure on the brain.
  • PET scan: PET scan shows brain activity, and it can identify the presence of amyloid or tau protein deposits that indicate Alzheimer’s disease.

Where Can I Get a Screening for Dementia?

WellMed, formerly Healthcare Associates of Texas, offers dementia screenings in all of our locations. You can set up an appointment to discuss your concerns.

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References:

  1. “Dementia: Symptoms and Causes.” Mayo Clinic. No date. https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013
  2. “Alzheimer’s Disease Facts and Figures.” Alzheimer’s Association. No date. https://www.alz.org/alzheimers-dementia/facts-figures
  3. “FDA Grants Accelerated Approval for Alzheimer’s Disease Treatment.” FDA. January 6, 2023. https://www.fda.gov/news-events/press-announcements/fda-grants-accelerated-approval-alzheimers-disease-treatment
  4. “Diagnosing Dementia: The Mini Mental Status Exam (MMSE).” Dementia.org. July 2, 2015. https://www.dementia.org/diagnosing-dementia-mini-mental-status-exam
  5. “Mini-Cog.” Alzheimer’s Association. No date. https://www.alz.org/media/documents/mini-cog.pdf