Diagnosing Dementia

“The doctor diagnosed my mom’s dementia. I don’t know what form of the disease she has, but they seem the same to me. He put her on some medication he said might help.”

Statements like this make me shudder. Would we say this about any other disease? “The doctor said my mom has cancer. The disease might be in her liver or breast, he’s not sure. He put her on some medication which might help.”

Ridiculous, right? Yet so many elders don’t receive a complete or accurate diagnosis, which affects the effectiveness of their treatment. Some general practitioners aren’t familiar with the many diagnostic tools available, or some of the less common forms of the disease.

Here are steps to an accurate diagnosis and treatment:

1. Be Proactive and Thorough
Diagnosis needs to occur early in the disease. Because people with dementia can become experts at covering their mistakes, it may take months for family members to realize the problem. If you don’t live together, symptoms can elude you. When it becomes evident that your loved one struggles with memory or other issues, take them to see their family doctor. Here you start your search.

When you visit the doctor, make a list of all the changes they experienced. Perhaps areas like hygiene or tidiness at home changed. Do you notice a variance in mood or stamina? Ask for a physical, and bring a complete list of their medications. Provide as much information as possible. When you have the results of this investigation, you’re ready for the next step.

2.  Get Expert Medical Input
Ask your doctor for a referral to a geriatrician. All the testing done to this point can go with you and will lay a groundwork for what comes next. A specialist can diagnose the kind of dementia and follow up with treatment. Prescriptions for medications specific to your diagnosis and suggestions for treatment will follow.

3. Be Sure to Follow-up 
Nurture your relationship with your specialist. Regular visits will keep the doctor abreast of changes and should give you a forum to ask questions and gain support. Some of the original tests will become a baseline and further testing will help you understand how the disease progresses.

Last week we looked at some of the most common forms of dementia. Other, rarer forms underline the need for an accurate diagnosis. Not as well known, they can easily be missed or misdiagnosed. With several of them, early diagnosis makes a significant difference.

Wernike-Korsakoff Syndrome
Two separate syndromes which might or might not occur at the same time, this type of brain disorder, caused by a lack of vitamin B1, or thiamine, and can present with vision difficulties, leg tremors and confusion. The disease can be associated with alcoholism.

Creutzfeldt-Jacob Disease
Because the first symptom isn’t confusion, but depression and mood changes, diagnosis can be difficult. Life expectancy is short and other changes such as deterioration in physical coordination soon develop. A correct diagnosis gives the opportunity to prepare for the future.

Frontotemporal Dementia (Pick’s Disease)
Often affecting a younger population, this shows as changes in personality and behavior. You can understand, especially in a younger person, how this would be difficult to diagnose. People with Pick’s disease often develop aphasia or difficulties with speech.

Huntington’s Disease
This inherited disorder causes the death of brain cells. The resulting symptoms leave the person struggling with difficulties with walking, communication, thinking and swallowing.

This list, though not complete, illustrates how varied a diagnosis of dementia could be. Dementia can be associated with many different diseases and must be correctly analyzed for appropriate treatment.

As a care partner, perhaps just starting on this journey, you want to care for your elder as best you can. This most loving act ensures your elder gets comprehensive testing and a correct diagnosis.

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Diagnosing Dementia