Making a dementia diagnosis is not a straight-forward process. Sometimes it can take years for a firm diagnosis to be made.
What does an assessment involve?
Dementia diagnosis requires a team approach. As a minimum, assessment will involve:
- a case history (your GP will ask you questions about your past, your current concerns, what is working and what is troubling you), and
- cognitive assessment (your GP may do a ‘screening test’, or they may refer you to someone else for a full assessment, with a complete neuropsychological assessment being the current gold standard).
You might also be sent for medical investigations, such as blood tests or brain scans. If you are experiencing communication problems, you may be referred to a speech pathologist for assessment.
How is a dementia diagnosis made?
For a diagnosis to be made, you must demonstrate:
- Cognitive or behavioural impairment
- Problems carrying out everyday activities
- Decline over time
- No other identifiable cause (that is, your difficulties can’t have some other obvious explanation, such as stroke, vitamin deficiency, or some other medical issue)
Types of dementia
There are a number of dementia sub-types. These include Alzheimer’s disease, vascular dementia, dementia with lewy bodies, frontotemporal dementia, motor neurone disease, primary progressive aphasia, and progressive supra nuclear palsy (to name a few). Each sub-type has its own unique features, and unique approach to management.
Why should I seek a diagnosis?
This is the classic question. A person may (or may not) be aware that something isn’t quite right. There may be the odd memory lapse, or forgetting names of friends, or having trouble following the conversation at a party. Children or spouses are worried. Could it be dementia? How do you broach the subject? Do we really need a diagnosis? What’s the point? It is a tricky time….
The answer is: it’s up to you. This is a very personal decision. You might not be ready to hear a diagnosis of dementia. But you should know that there are benefits from having the diagnosis.
First, there is a very small chance that your dementia is caused by something that can be reversed. That alone might be motivating enough to see your GP. The second and obvious reason is that there are treatments available. There are pharmaceutical treatments (you can take medication), and there are allied health supports that can be put in place. You will qualify for funding to help cover costs of these treatments. We find that if we can start assessment early, we can teach people the best strategies to live well with their dementia. We don’t want you to get stuck in a rut, just because you didn’t know any better.
Where does speech pathology fit in all this?
“Language has been increasingly recognised as a marker for distinguishing between various dementias” (c/o Dr Jade Cartrwight, 2016, Speech Pathology National Tour – Dementia is our business).
Language changes are present in several dementia sub-types. You may have word finding difficulties, problems following instructions, difficulties writing a letter, a tendency to repeat ideas, a decrease in talkativeness, unclear explanations, or a failure to recognise humour.
A speech pathologist has expertise in assessing all aspects of communication. So for people with suspected dementia, particularly where there are early changes in language, a speech pathology assessment can help the diagnostic process. The speech pathologist will work closely with the GP, the individual, and any other professionals involved, to share information and support the individual through this tricky time.
Take home messages
Take home message #1: Diagnosing dementia is not a straightforward process, it needs a team approach.
Take home message #2: Living with dementia is a very personal thing. Seek help when you’re ready (but know that the earlier the better).
Take home message #3: See a speech pathologist if you have any communication problems due to dementia.
- Cartwright (2016), Speech Pathology Australia National Tour – Dementia is our business