How is dementia diagnosed?

If you think that you or someone close to you may have symptoms of dementia, it can be hard to know what to do. You might not know who to talk to, how to start the process of getting a diagnosis or what support is available. On this page, our dementia specialist Admiral Nurses explain how to recognise the common symptoms, why it is important to get diagnosed, and what to expect when seeking a dementia diagnosis.

Why is it important to get diagnosed?

Many different conditions can mimic the early signs of dementia, including infections, delirium, vitamin deficiency, menopause, depression, anxiety and diabetes. These conditions are often treatable, so it is important to visit a GP for tests to identify any potential underlying causes.

If these conditions have been ruled out and there are still concerns, the GP may refer the person to a specialist memory assessment team for further tests.

Getting an accurate diagnosis means the person can access treatment and support to help them manage their condition.

The benefits of early diagnosis

An early diagnosis of dementia can help the person and their family to understand what is happening. This includes finding out what type of dementia they have, why the changes are happening, and what can be done to manage them. It also enables the person and their family to access support, have conversations about how to live as well as possible with the diagnosis, and start planning for the future.

Accessing treatment and support

While dementia can’t be reversed, for some forms of the condition (especially Alzheimer’s disease), medication may help to slow the progression and ease some of the symptoms. These medications are usually most effective if the person starts taking them in the early stages, so getting a prompt diagnosis may mean they get more benefit from their treatment.

Additionally, an early diagnosis means support can be put in place – for example, the person may be able to access certain financial benefits, support groups and help from Social Services to identify their care needs, as well as support at work if they are still in employment.

Recognising the early signs of dementia

The early symptoms of dementia will depend on the type the person is diagnosed with but typically include changes in:

• short-term memory
• thought processes
• concentration
• communication, comprehension and word-finding
• motivation
• ability to perform everyday tasks
• personality, mood, behaviour or social functioning

However, all of these can be caused by other conditions, such as depression, an underactive thyroid, vitamin B12 deficiency or medication side effects, so experiencing these symptoms doesn’t mean a person definitely has dementia.

When to speak to a GP

If you are concerned about possible symptoms of dementia in yourself or someone close to you, make an appointment to see the GP, as the sooner a diagnosis is made, the sooner treatment and support can be put in place. It might be a good idea to book a double appointment to make sure there’s time to discuss everything.

What to expect when you see your GP

Questions they may ask

In an initial appointment, the GP should ask the person about:

• the problems they are having
• when they started, and whether it was sudden or gradual
• how they affect daily life
• whether there is any family history of dementia

It’s helpful if a partner, relative or friend goes to the appointment too, as they may have noticed changes that the person themself hasn’t.

The GP should also briefly test the person’s memory and cognitive abilities. This might include asking them to:

• state the day, date and year
• name some common objects, for example from pictures, or as answers to questions
• remember and repeat items to test concentration and short-term memory
• complete a drawing, such as a clock face

In addition, the doctor should do a physical examination and arrange blood and urine tests to rule out other possible causes of the person’s symptoms.

Dementia diagnosis referral process

After the initial appointment, if the GP suspects the person may have dementia, they should refer them to a specialist for further assessment. This could be:

• a psychiatrist with experience in dementia
• a doctor specialising in elderly care (geriatrician)
• a doctor specialising in the brain and nervous system (neurologist)

The person may be seen in a memory clinic, a hospital or a community setting like a GP practice.

Bear in mind that although dementia may be diagnosed by a doctor who specialises in old age, it can also affect younger people. In people aged 65 or under, it’s referred to as young onset dementia.

What if the person is reluctant to see their GP?

Some people with signs of dementia may not want to see their GP. They may not recognise that anything has changed, be in denial about their symptoms, or be afraid of getting a diagnosis and its impact on their life and those around them (for example, whether they will have to stop driving).

If someone is reluctant to see their GP, you could try explaining the benefits of getting a diagnosis. Sometimes, asking another family member or close friend to talk to the person may help – they may be more willing to take advice from someone who is slightly removed from the situation.

If the person simply refuses to go to the GP, you can contact the surgery by phone, email or letter to explain the situation. Mention the changes you have noticed, how they are affecting the person, and any ways in which these changes may be putting them at risk. The GP will not be able to breach the person’s confidentiality, but they should consider the information you have provided and may call the person in for a general check-up.

What to do while waiting to see the specialist

In some areas, there are waiting lists for a memory assessment or diagnosis. This can be frustrating and worrying for the person experiencing symptoms and those around them. However, there are steps you can take whilst you are waiting for an assessment:

• Keep a symptom diary to note any patterns, triggers or changes. You can show this to the specialist to give them a clearer picture of what is happening
• Starting a life story (a record of the person’s past and present life, values and future wishes) can be a good way to document their needs and preferences to help health and social care professionals understand what they are like as a person and what is important to them
• Support the person to stay as physically and mentally healthy as possible. While there is no guaranteed way to prevent dementia, lifestyle choices like eating a healthy diet, being physically active, stopping smoking and keeping alcohol within recommended guidelines could all help reduce the risk and slow the progression
• Try to engage the person in activities that you know they enjoy, like music, crafts, puzzles, sport, socialising or days out. These will help keep them mentally stimulated and provide a distraction from their worries
• If the symptoms the person is experiencing become difficult to manage, and you feel that you or they are not coping, you can see the GP to discuss help and support whilst waiting for the diagnosis

If you need any practical suggestions about how to cope while waiting for a dementia assessment, speak to one of our specialist Admiral Nurses.

Dementia diagnosis tests and assessments

Memory and thinking tests

At the appointment, the specialist should take a detailed medical and family history. In addition, they will ask questions about the person’s abilities with everyday tasks such as shopping, cooking, driving and self-care, such as washing and dressing.

The specialist should then assess the person’s cognitive abilities using tests of attention, memory, verbal fluency and language, and their visual and spatial abilities. This might include exercises such as:

• counting backwards from 20
• memorising an address and recalling it a few minutes later
• identifying objects
• copying a diagram
• drawing a clock face

As with the initial GP appointment, it’s a good idea for a family member or someone else who knows the person well to go with them and share any useful information. If they can’t, they may want to write a short letter outlining the issues.

Scans and medical checks

The person may be referred for a brain scan to check for changes in the brain that could indicate dementia, or other changes that could be causing their symptoms, such as a stroke or a brain tumour. This may be arranged by the GP or the specialist.

What to expect if dementia is diagnosed

If the person is diagnosed with dementia, the doctor should explain what type they have and discuss any treatments that may be available, including medication. There should be an opportunity to ask any questions. The specialist may also signpost the person towards other sources of support, such as support groups or Social Services.

Often, once a diagnosis is made, the person will be referred back to their GP for ongoing care and support.

Life after a dementia diagnosis

After a diagnosis of dementia, it’s natural to wonder what to do next and to be worried about what the future holds. Dementia is a progressive condition so the person’s abilities will deteriorate over time, but the right treatment and support can help them live as well as possible after the diagnosis.