How is Elderly Dementia Diagnosed in the UK?

As we grow older changes to our brain can affect how we recall information and how good our memory is. We have all heard the term “senior moment” and often there is little to worry about other than perhaps being a little less on the ball than we once were.

However, in some cases these changes can be early warning signals of cognitive decline caused by dementia. In the UK around 900,000 people are living with some form of dementia, many of whom elderly people. While there is no “cure” for the condition– early detection can make a big difference to the outcomes for the patient.

By knowing that you have dementia you are better positioned to make choices early about your future and care. And in some cases, particularly with vascular dementia, may be able to take medications or make lifestyle changes that can slow the progress of symptoms down.

Additionally, some behaviours that may look like early-stage dementia may instead by indicative of a different illness which may be perfectly treatable, so speaking with your GP may help to put your mind at rest.

If you or a loved one is presenting with any symptoms that look like they could be dementia, it’s important to see your GP to understand what might be happening.

There is no one test that can diagnose dementia, and the condition can often be difficult to identify in its early stages. However, there are a number of ways that doctors can assess whether someone may be experiencing cognitive decline, and these usually involve a combination of physical examinations, cognitive tests and brain scans.

For many it may seem a frightening prospect but knowing what to expect can be helpful. With this in mind, we explore how dementia is diagnosed.

When should you consider seeing your GP for a dementia diagnosis

Feeling forgetful, changes to memory and behaviour can all be part of getting older. After all, how many of us have walked into a room and forgotten why we are there or forgotten the name of someone we know well?

However, there can be certain symptoms that should be investigated which include:

• finding activities and tasks that require concentration more difficult
• changes to personality and mood
• periods of mental confusion
• difficulty finding the right words or not being able to understand conversations as easily

While these symptoms may be an indication of early stage dementia, it’s also perfectly possible that they have a cause rooted in something else, such as an infection or other condition.

Understanding your medical history

In order to rule out other causes of memory problems, your GP will first take a detailed medical history and carry out some simple tests, such as checking blood pressure and thyroid function.

Your doctor may ask you questions about your lifestyle and whether you are experiencing any other symptoms, such as depression or anxiety. The purpose of these questions is to rule out other possible causes of your memory problems, such as side effects of medication or stress.

Your doctor may also ask you about how you are managing your everyday tasks such as your personal care (washing and dressing), cooking, shopping and managing your bills. This is to enable them to ensure that you have an appropriate level of support.

If your GP suspects that you may be experiencing cognitive decline, they may refer you to a memory clinic or other specialist for further assessment.

What is a memory clinic?

In some areas of the UK, you may be referred to a memory clinic.

This are clinics which are staffed by specialist doctors, nurses and psychologists who are qualified in diagnosing and treating memory problems. These services are designed to properly assess and diagnose the nature of an individual’s memory issues before reporting back to the GP or other specialists.

In addition to NHS memory clinics, there are also a range of private memory clinics around the UK.

Cognitive assessments for dementia diagnosis

The purpose of cognitive tests is for a doctor to best understand where there are difficulties that require further investigation.

Cognitive tests for dementia diagnosis usually assess memory, attention, language and problem-solving skills. These tests can help to determine whether someone has dementia or another condition that is causing cognitive decline.

Most tests will involve a series of pen and paper tests and questions which each carry a score.

These tests may cover different areas of recall and cognition such as

• using your memory to recall a list of items
• understanding your recall of factual information, for example about the time and place
• interpreting shapes
• solving problems.

There are several different types of tests that may be used by professionals to diagnose dementia, but one of the most common is General Practitioner Assessment of Cognition (GPCOG).

If the cognitive assessment suggests that you may have dementia, you will be referred for brain scans. These scans can help to rule out other conditions that can cause similar symptoms, such as a brain tumour or stroke.

Brain scans to diagnose dementia in the elderly

The most common types of brain scans used to diagnose dementia are MRI (magnetic resonance imaging) and CT (computed tomography) scans. These tests can help to show whether there has been any shrinkage of the brain or damage to the blood vessels, which are common features of dementia.

An MRI scan can help to confirm a diagnosis of dementia and provide detailed information about any blood vessel damage that may be causing vascular dementia.

Additionally, an MRI can show shrinkage to parts of the brain to diagnose a form of dementia. For example, the frontal and temporal lobes are mainly affected by shrinkage in frontotemporal dementia, while usually just the temporal lobes are affected in the early stages of Alzheimer's disease.

SPECT scan for dementia

A SPECT (single photon emission computed tomography) scan is a type of brain scan that can be used to diagnose dementia. The scan works by injecting a small amount of radioactive material into the bloodstream. The material is then taken up by the brain cells, and the scanner can detect this activity.

PET Scan for dementia

A PET (positron emission tomography) scan is a type of brain scan that can be used to diagnose dementia. The scan works by injecting a small amount of radioactive glucose into the bloodstream. The glucose is then taken up by the brain cells, and the scanner can detect this activity.

PET scans can help to show whether there has been any shrinkage of the brain or damage to the blood vessels, which are common features of dementia.

EEG scan

An EEG (electroencephalogram) is a test that measures electrical activity in the brain. It can be used to diagnose dementia by looking for changes in the brainwaves that are characteristic of the condition.

More often an EEG is used to rule out dementia by looking for other conditions or causes of dementia such as epilepsy.

What happens after a dementia diagnosis?

After you've had the necessary tests (or sometimes before the tests), your doctor should ask if you want to know your diagnosis.

After a diagnosis of dementia has been made, unless you have chosen otherwise you will be offered support and advice on how to manage the condition. There is currently no cure for dementia, but there are treatments that can help to improve symptoms and slow down the progression of the disease.

While a dementia diagnosis can be frightening, there are plenty of organisations who can help.

Here at SureSafe we provide a range of personal alarms which can help an elderly person living with dementia, including our forthcoming dementia tracker that offers GPS tracking, geo-fencing and more. Get in touch with us on 0800 112 3201 and speak to one of our team for further information.