Dementia is a common and debilitating disease that is sometimes difficult to diagnose. There is no surefire way to diagnose dementia at home, so a visit to the doctor is highly recommended if you think you are showing symptoms. A friend or family member can take the Mini-Mental State Exam to get a general idea of your cognitive function, but the results will help a doctor make the correct diagnosis.
Steps
Method 1 of 2: Preparing for the doctor's visit
Step 1. Make an appointment with the doctor
The other sections of this article are about tests you can take at home. These can give you a bit of information if you have no other options, but are not a good substitute for the doctor's diagnosis, according to the Alzheimer's Association.
Step 2. Prepare your medical history
Certain medicines, medical conditions and genetics can put you at an increased risk of dementia. Other factors can mimic the symptoms of dementia, such as memory loss, but can be reversed once the doctor knows what's causing them. Make sure you can provide your doctor with the following information:
- Your diet, alcohol consumption, and (medicine) use. Bring containers of the medicines you are taking.
- Other, already known medical issues.
- Behavioral changes (especially in social situations and/or eating habits).
- Whether and which of your family members have had dementia or dementia-like symptoms.
Step 3. Have a physical exam
Because dementia can be caused by limited blood flow to the brain, the physical examination will include measuring blood pressure, pulse, and body temperature. In addition, the doctor may examine your balance, reflexes and eye movement. Depending on your specific symptoms, there are a number of other tests that your doctor might order.
Step 4. Do a cognitive exam
There are several types of mental exams used to test for dementia, some of which are discussed in this article. Frequently asked questions include:
- State today's date and location.
- Count backwards from one hundred, in increments of seven.
- Draw a clock whose hands point to ten to eight thirty.
Step 5. Undergo laboratory testing if necessary
If the doctor does not request a blood sample or other laboratory tests, you may want to ask for thyroid homones and vitamin B12 testing. These are tests that are taken regularly to narrow down the possible causes of your symptoms. Based on your specific medical history, the doctor may also request a number of other tests, but these are not necessary for every patient.
Step 6. Ask about brain scans
If you have symptoms that are not clear to you, the doctor may recommend a brain scan to see if they are caused by something other than dementia. CT scans, MRI scans, and EEG studies are the scans most commonly used to help diagnose dementia-like symptoms.
If your doctor is considering an MRI, tell them about any implants or modifications that cannot be removed-such as tattoos, pacemakers, replaced joints, and/or shards in the body
Step 7. Ask about genetic testing
Genetic research is controversial, because even a gene associated with an increased risk of dementia does not always mean that you are affected. Still, if dementia runs in the family-especially the early variant-genetic testing may be helpful to you and the doctor.
Method 2 of 2: Taking a Mini-Mental State Examination (MMSE)
Step 1. Understand that the MMSE cannot be used as an exclusive method of diagnosis
The Alzheimer's Association does not recommend that home tests be used as a substitute for a visit to the doctor. Use this ten-minute quick test if you don't have direct access to a doctor, or if you can't convince a friend or family member to see a doctor.
- Run this test not off if you are not fluent in the language of the test, or if you have a learning disability or dyslexia. Then pay a visit to the doctor.
Step 2. Understand how to take the test
The person who may have dementia-like symptoms should only listen to the instructions. A second person reads the steps below and gives instructions or asks questions to the person under investigation. Keep track of how many points the interviewee scores for each item. At the end of the test, add up the score. A score of 23 or lower (out of a total of 30) may indicate possible cognitive impairment-which in turn may indicate dementia or some other health issue.
- No calendars should be visible during the test.
- Most questions should be answered within ten seconds; questions involving spelling, writing or drawing must be answered within thirty to sixty seconds.
Step 3. Test the orientation in time (5 points)
Ask the person who suspects dementia the following questions, in order and in turn. Each correct answer is worth one point.
- What year is it?
- Which season is it?
- What month of the year is it?
- What is the date today?
- What day of the week is it?
Step 4. Test orientation in place (5 points)
In five different questions, ask where the person is right now. Each correct answer is worth one point.
- Which province are we in now?
- Where are we now?
- In which hospital/institution are we now? (Or, "What address are we at now?")
- What is the name of this department?
- What floor are we on now? (Or, "What room are we in now?")
Step 5. Test the registration power (3 points)
Name three simple objects (such as "table, car, house") and ask the person to repeat them immediately. You should pronounce them together, with a pause in between, and the interviewee should also repeat the words to you in one go. Also tell him/her that you want to hear it repeated after a few minutes.
- Each word that is successfully repeated at once is worth one point.
- Keep repeating the three objects until the interviewee succeeds. The correct answers are worth no more points in this case, but note how many repetitions it took to repeat all three objects. (Some extended versions of the test use this information.))
Step 6. TTest the attention span (5 points)
Spell the word WORST ("W-O-R-S-T"). Then ask the respondent to spell the word backwards. If successful within thirty seconds, it is worth five points; if that doesn't work, zero points.
- Some medical professionals find it helpful to record the respondent's exact response to this question.
- This step should not be directly translated to another language. Try to find a version of the MMSE in the native language to see which word is used for it.
Step 7. Test the memory (3 points)
Ask the person to repeat the three words you just mentioned. Each correct answer is worth one point.
Step 8. Test the language ability (2 points)
Point to a pencil and ask, "What is this?" Point to a watch and ask the same question. Count one point for each correct answer.
Step 9. Test the repeatability (1 point)
Ask the person to repeat the following sentence, "Now this, then that." Score one point if the answer is correct.
This is also a step that cannot be directly translated into another language
Step 10. Test your ability to follow complex commands (3 points)
Ask the person to follow a three-step command. For example, ask the person to pick up a piece of paper with their right hand, fold it in half and place it on their lap.
Step 11. Test the ability to follow written commands (1 point)
Write "Close your eyes" on a piece of paper. Give this sheet of paper to the interviewee and ask him/her to follow this command. If he/she does so within ten seconds, he/she earns one point.
Step 12. Test your ability to write a sentence (1 point)
Ask the person to write one complete sentence. If the sentence has a subject, a predicate, and a meaning, it is worth one point. Spelling errors don't bother.
Step 13. Test the ability to copy a drawing (1 point)
Draw a geometric design on a piece of paper: a pentagon with a second pentagon slightly overlaid. Ask the respondent to copy this design onto his/her own sheet of paper. If the following properties are met, you get one point:
- Two shapes, both pentagons.
- An overlap that creates a square (or how many sides your original figure had).
Step 14. Check the results
If the person in question has a score of 23 or lower, it is recommended to see a doctor. If he/she has no medical training, you should not tell us what the results are.
If the score is 24 or higher, but the symptoms are troubling nonetheless, try taking the Montreal Cognitive Assessment (MOCA test) as well
Tips
- You can also take the MOCA test. This is a newer test that is more sensitive to early cognitive changes.
- See another doctor for a second opinion if the doctor or home exam says there's nothing to worry about but the symptoms are getting worse.
- Cognitive changes in the elderly can indicate a number of reversible conditions, including vitamin deficiencies, thyroid abnormalities, drug side effects, and depression. Take your loved one to the doctor for a check-up for these conditions if you notice any troubling signs.