Confused Or Loss Of Memory Could It Be Dementia?
Individual people will experience Dementia (or Alzheimer’s which is a form of Dementia) or the symptoms differently; in most cases individual’s with suspected Dementia are likely to be suffering from: a decline in memory, reasoning, communication skills, a gradual loss of skills that are required to carry out daily living tasks and confusion. Getting a diagnosis for Dementia is essential because these symptoms could mask other illnesses or conditions including: depression, chest and urinary infections, severe constipation, vitamin and thyroid deficiencies or brain tumours.
Making a diagnosis of Dementia is difficult, especially in the earlier stages. The time in which it takes for Dementia to be diagnosed can greatly vary depending on the level of investigation required. The diagnosis process generally varies between 4-12 weeks (on waiting lists) and 6-12 months depending on whether or not monitoring is required before a diagnosis can be made.
If a person is feeling confused, agitated or forgetful then the first assessment stage is with their GP. The assessment with the GP will normally cover: analysis of background information, physical examination and tests, and mental tests.
Analysis of background information is where the GP will spend some time talking to an individual in order to establish some of the symptoms they or the person concerned are experiencing. The GP may also look at both the individual concerned and their family member’s medical histories.
During the physical examination a GP will conduct a number of tests including blood and urine for any likely source of confusion.
Mental tests are a series of questions used by GP’s in order to test an individual’s thinking and memory.
If Dementia is suspected then the GP will refer the individual to a specialist. A second opinion is worthwhile and a specialist can conduct specialised investigations including brain scans and memory testing. Depending on initial diagnosis referral will be to different consultants including: neurologists, specialists in medicines for older people, general adult psychiatrists, and old age psychiatrists.
The individual may, also, be referred to the hospital outpatients for further assessment and scanning. A brain scan can be done in a number of forms including: CT or CAT scans, MRI scans, SPECT scans. CT and CAT scans use x-rays and a computer in order to build up a picture of the brain. MRI scans also create an image of the brain but these use radio signals produced by the body in response to a magnet within the scanner. SPECT scans look at the blood flow through the brain as opposed to looking at the brains structure.
CT and MRI scans may show brain shrinkage, if there is any, and SPECT and PET scans show up any areas of the brain that have a loss of function. The memory tests that were performed on the individual may also show problems in particular areas… However if there are no apparent changes on the scan, the individual may still be suffering from Dementia in its earlier stages as it can be difficult to distinguish from the effects of normal ageing.
If Dementia is diagnosed some professionals feel that the individual should not be told directly because they may not cope with the knowledge. The news is sometimes given to relatives instead for them to pass onto the individual.
Once diagnosed an individual will see their GP on a regular basis for ongoing assessment. This gives the individual a chance to discuss any problems they may be having. The individual my also be referred to a specialist to help to assess changes and for advice about the way an individual can deal with particular difficulties. The GP and a hospital specialist are usually jointly responsible for prescribing any treatment for Dementia.
The Mini Mental State Examination (MMSE) is a commonly used test for memory problems when Dementia is suspected. The MMSE is a series of questions and tests in which an individual can score points when answering correctly. This tests a wide range of mental abilities including memory and language. The maximum score for this test is 30 points. A score below 27 may be an indicator that a person may have an impairment of their mental abilities, and this could be a possible sign that an individual has Dementia. The MMSE can also be used after Dementia has been diagnosed to assess changes in an individual’s mental abilities.
On average it is estimated that those who have Dementia who are not receiving treatment for their condition will lose two to four MMSE points each year. The score that a person obtains from an MMSE test is taken into consideration to determine what medications could be particularly useful for the individuals. The MMSE score can be impacted, though, by an individual’s education level.
The overall message is to get professional help as soon as Dementia or Alzheimer’s is suspected.