Contrary to popular belief, there is no single memory test for dementia. To diagnose dementia, a combination of assessments and tests is required, which can be carried out by either a GP or a specialist at a memory clinic or hospital. If a person is referred to a specialist, a more detailed medical history will be taken. The doctor will ask about the onset and severity of symptoms and check whether any pre-existing conditions, such as heart disease or stroke, are being managed properly. Additionally, the doctor will review any medications being taken, including over-the-counter and alternative products.
Here we look at what’s usually part of the wider concept of a memory test for dementia, as well as specific tests that may be used to reach diagnosis.
Assessments and the Memory Test for Dementia
To begin the process of diagnosis, it is important to have a conversation with your doctor regarding any concerns you may have. To ensure all necessary information is provided, bringing along a trusted family member or friend can be helpful.
It is recommended to also bring a detailed list of any memory and cognitive changes you have experienced, along with the timeline of when they began and how often they occur. Additionally, bringing a list of current medications or bringing the medications themselves is a wise decision. This helps your doctor to get a good understanding of the symptoms you are experiencing and the context in which they are happening.
Your doctor may evaluate your situation and refer you to a specialist such as a geriatrician, neurologist, or psychiatrist to further assess any potential illnesses or disabilities related to ageing, disorders of the brain and nerves, or disorders of emotion and behaviour. Often, you will be referred to what’s called a memory clinic.
What Tests Will Happen?
Diagnosing dementia is somewhat complex and also involves
a lot of elimination of other potential causes of memory loss. This is why there is no single memory test for dementia. Instead, a number of different assessments and tests may take place, including:
- Personal medical history
When diagnosing dementia, the doctor will typically begin by discussing your personal medical history and gathering information about any changes you've noticed in your memory and thinking abilities. - Physical examination, blood tests and urine tests
Since symptoms of dementia can also arise from other potential causes such as vitamin deficiencies, infections, metabolic disorders, or drug side effects, ruling out these other possibilities is a crucial early step in the diagnosis process. To accomplish this, a physical examination and laboratory tests including blood and urine tests will likely be conducted. Blood tests may investigate factors such as anaemia, infection, electrolyte balance, liver function, vitamin B12 deficiency, thyroid function, and drug interactions. Urine tests may be used to investigate the presence of an infection. Urinary Tract Infections (UTIs) can cause delirium, which is sometimes mistaken for dementia.
- Cognitive tests
Cognitive tests are also a crucial component in diagnosing dementia, and are used to evaluate cognitive functions such as memory, concentration, visual-spatial awareness, problem solving, counting, and language skills. Doctors may use short cognitive screening tests initially in the memory clinic. Cognitive tests can also help differentiate between types of dementia and assess mood, potentially aiding in the diagnosis of depression which may exhibit symptoms similar to dementia.
There are many different types of cognitive test that can be used, some are a memory test for dementia, some test things like language skills. Tests include:
- The Mini-Mental Status Examinsation (MMSE)
The Mini-Mental Status Examination (MMSE), a common test for screening dementia, typically takes about 5 minutes to complete at the doctor’s surgery. This assessment evaluates skills such as reading, writing, orientation, and short-term memory. - Alzheimer’s Disease Assessment Scale-Cognitive
For individuals with mild symptoms, the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog), which consists of 11 parts, is a more comprehensive test than the MMSE. It is widely regarded as the best brief evaluation for memory and language abilities, and it generally takes around 30 minutes to administer. This is more likely to take place in a memory clinic. - The General Practitioner Assessment of Cognition (GPCOG)
The General Practitioner Assessment of Cognition (GPCOG) is a frequently used test by GPs. While these tests cannot provide a dementia diagnosis, they may indicate the presence of memory difficulties requiring further examination.
Most tests involve a set of pen-and-paper tasks and questions, each assigned a score. These evaluations evaluate several cognitive abilities, such as short- and long-term memory, attention span and concentration, language and communication skills, and orientation to time and place. A person may get different scores on tests according to their baseline education and ability, but this will be taken into account by the healthcare professional.
Dementia Brain Scans
After simpler tests have ruled out other conditions, brain scans are sometimes used to diagnose dementia. However, like memory tests, they cannot diagnose dementia on their own but are utilised as part of a broader evaluation.
Brain scans may not be necessary for everyone, particularly if other assessments suggest that dementia is a probable diagnosis. Additionally, these scans can reveal other possible issues that may explain a person's symptoms, such as a stroke or a brain tumour, which may themselves cause vascular dementia.
An MRI scan is sometimes used to confirm a diagnosis of dementia and determine the type of dementia. It can also provide detailed information about blood vessel damage that occurs in vascular dementia. It may even show shrinkage in specific areas of the brain, such as the frontal and temporal lobes, which are primarily affected by frontotemporal dementia, while only the temporal lobes are impacted in the early stages of Alzheimer's disease.
A CT scan may be used to identify signs of a stroke or brain tumour, but it does not provide detailed brain structure information.
Even if a brain scan does not reveal any apparent changes, it does not exclude the possibility of dementia. If the results of an MRI or CT scan are uncertain, other types of scans such as a SPECT or PET scan may be recommended. However, most individuals will not require these types of scans. Both SPECT and PET scans analyse brain function and can identify abnormalities in blood flow.
Finding Support
We understand that the diagnosis process for dementia can be a stressful and difficult time for families. While there are many elements to a memory test for dementia, it’s important that the patient and loved ones feel supported. Ultimately, dementia is degenerative and long-term care may provide the best support for families and people living with dementia.
If you’d like to learn more about dedicated dementia care in North Devon and Somerset, please get in touch.
