Dementia Diagnosis: Doctors and Questions

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.

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