Diagnosing dementia and its type can be challenging. To diagnose the cause of the dementia, the doctor must recognize the pattern of the loss of skills and function and determine what a person is still able to do. More recently, biomarkers have become available to make a more accurate diagnosis of Alzheimer’s disease.
Your doctor will review your medical history and symptoms and conduct a physical examination. He or she will likely ask someone close to you about your symptoms as well.
No single test can diagnose dementia, so doctors are likely to run a number of tests that can help pinpoint the problem.
Cognitive and neuropsychological tests
Doctors will evaluate your thinking ability. A number of tests measure thinking skills, such as memory, orientation, reasoning and judgment, language skills, and attention.
Doctors evaluate your memory, language, visual perception, attention, problem-solving, movement, senses, balance, reflexes and other areas.
- CT or MRI.These scans can check for evidence of stroke or bleeding or tumor or hydrocephalus.
- PET scans.These can show patterns of brain activity and whether the amyloid or tau protein, hallmarks of Alzheimer’s disease, have been deposited in the brain.
Simple blood tests can detect physical problems that can affect brain function, such as vitamin B-12 deficiency or an underactive thyroid gland. Sometimes the spinal fluid is examined for infection, inflammation or markers of some degenerative diseases.
A mental health professional can determine whether depression or another mental health condition is contributing to your symptoms.
Most types of dementia can’t be cured, but there are ways to manage your symptoms.
The following are used to temporarily improve dementia symptoms.
Cholinesterase inhibitors. These medications — including donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) — work by boosting levels of a chemical messenger involved in memory and judgment.
Although primarily used to treat Alzheimer’s disease, these medications might also be prescribed for other dementias, including vascular dementia, Parkinson’s disease dementia and Lewy body dementia.
Side effects can include nausea, vomiting and diarrhea. Other possible side effects include slowed heart rate, fainting and sleep disturbances.
Mematine. Memantine (Namenda) works by regulating the activity of glutamate, another chemical messenger involved in brain functions, such as learning and memory. In some cases, memantine is prescribed with a cholinesterase inhibitor.
A common side effect of memantine is dizziness.
Other medications. Your doctor might prescribe medications to treat other symptoms or conditions, such as depression, sleep disturbances, hallucinations, parkinsonism or agitation.
Several dementia symptoms and behavior problems might be treated initially using nondrug approaches, such as:
- Occupational therapy.An occupational therapist can show you how to make your home safer and teach coping behaviors. The purpose is to prevent accidents, such as falls; manage behavior and prepare you for the dementia progression.
- Modifying the environment.Reducing clutter and noise can make it easier for someone with dementia to focus and function. You might need to hide objects that can threaten safety, such as knives and car keys. Monitoring systems can alert you if the person with dementia wanders.
- Simplifying tasks.Break tasks into easier steps and focus on success, not failure. Structure and routine also help reduce confusion in people with dementia.
Lifestyle and home remedies
Dementia symptoms and behavior problems will progress over time. Caregivers and care partners might try the following suggestions:
- Enhance communication.When talking with your loved one, maintain eye contact. Speak slowly in simple sentences, and don’t rush the response. Present one idea or instruction at a time. Use gestures and cues, such as pointing to objects.
- Encourage exercise.The main benefits of exercise in people with dementia include improved strength, balance and cardiovascular health. Exercise might also help with symptoms such as restlessness. There is growing evidence that exercise also protects the brain from dementia, especially when combined with a healthy diet and treatment for risk factors for cardiovascular disease.
- Engage in activity.Plan activities the person with dementia enjoys and can do. Dancing, painting, gardening, cooking, singing and other activities can be fun, can help you connect with your loved one, and can help your loved one focus on what he or she can still do.
- Establish a nighttime ritual.Behavior is often worse at night. Try to establish going-to-bed rituals that are calming and away from the noise of television, meal cleanup and active family members. Leave night lights on in the bedroom, hall and bathroom to prevent disorientation. Limiting caffeine, discouraging napping and offering opportunities for exercise during the day might ease nighttime restlessness.
- Keep a calendar.A calendar might help your loved one remember upcoming events, daily activities and medication schedules. Consider sharing a calendar with your loved one.
- Plan for the future.Develop a plan with your loved one while he or she is able to participate that identifies goals for future care. Support groups, legal advisers, family members and others might be able to help.
The following techniques may help reduce agitation and promote relaxation in people with dementia.
- Music therapy, which involves listening to soothing music
- Light exercise
- Watching videos of family members
- Pet therapy, which involves use of animals, such as visits from dogs, to promote improved moods and behaviors in people with dementia
- Aromatherapy, which uses fragrant plant oils
- Massage therapy
- Art therapy, which involves creating art, focusing on the process rather than the outcome
Coping and support
Receiving a diagnosis of dementia can be devastating. You’ll need to consider many details to ensure that you and others are as prepared as possible for dealing with a condition that’s unpredictable and progressive.
Source: The Mayo Clinic Staff