When you or a loved one is concerned about the possibility of having a dementia, getting a thorough evaluation is the next step. Knowing and understanding what is happening will help you with interventions and planning.

So, what should you do? Here is a brief list of considerations and steps to take:

Select a physician.

• Consider the physician’s knowledge and comfort regarding working with older adults.
• Consider making an appointment with a geriatrician, a physician who is specially trained to diagnose and treat older adults. Don’t necessarily avoid other doctors, including family practitioners and internists, though; they often have the same knowledge and skills.
• Understand that additional specialists may be included in the diagnostic and treatment process. They may include neurologists, psychiatrists, psychologists, and other specialists as needed.

Schedule a doctor’s appointment, which will include several types of examinations.

• Physical exam, including
  • medical history
  • family medical history
  • physical exam
  • laboratory tests of blood and urine, particularly to rule out other possible causes of symptoms
  • review of prescribed medications, patient-opted medications, and supplements
• Social and behavioral profile, particularly a log of recent changes and concerns as seen by the patient and/or others
• Neurological exam
  • assessment of balance, reaction time, reflexes, coordination, muscle tone, speech, sensation, etc.
  • ruling out of conditions and diseases, such tumors and strokes
• Mental status test that evaluates awareness, memory, problem solving, executive function
• Psychological evaluation, often to rule out other causes of dementia symptoms, such as depression, anxiety, other mental illness concerns/illnesses
• Brain scans (not routinely administered)

Ask the doctor questions to be sure you understand the diagnosis.

• Diagnosis by name
• Evidence that underlies the diagnosis: What did the doctor see in exams and tests that led to the diagnosis?
• Doctor’s assessment of the current stage of the disease
• Possible interventions, including therapies and medications
• The role of the doctor going forward

Would you like help navigating the diagnosis process? Contact Dr. Cheryl Greenberg at TheAgeCoach@gmail.com to discuss your concerns and plan the next steps in getting and understanding a diagnosis.