Dementia can be difficult to diagnose, particularly at earlier stages. Most dementia types also have a long preclinical phase where there is accumulation of changes in the brain with little or no symptoms. This is challenging as any potential disease-modifying therapies are most likely to be effective if delivered early in the disease. Early diagnosis also enables a person with dementia to be involved in planning their future care.
There is no single diagnostic test for any form of dementia. Diagnosing dementia requires consideration of a person’s family and medical history and testing of thinking and memory abilities. Changes to the person’s behaviour or personality are also considered when diagnosing dementia. In some people with dementia, changes in their brain’s structure can be seen using medical imaging. Symptoms of dementia overlap with other conditions such as nutrient deficiencies, depression or medication side-effects, and these need to be excluded as part of the diagnosis.
There is a potential for specific diagnostic biomarkers to help in the diagnosis of dementia and its different causes. Most research in this area has been in the field of Alzheimer’s disease, where measurement of Alzheimer’s disease pathology using medical imaging (PET) or spinal fluid analysis can identify the underlying disease process and can complement clinical assessment. However, these tools are not routinely available in the clinic and are largely research-based tools due to their cost, difficulty of access, and invasiveness. Many groups are currently actively investigating the potential for a blood test to measure these changes quickly, accurately and non-invasively which would revolutionise dementia diagnosis.
There are medications that help treat the symptoms in some forms of dementia, but they do not cure this condition. People with early-stage dementia may choose to plan for their future requirements such as selecting future forms of assistance and deciding on their living arrangements. Occupational therapy can help people with dementia adjust their environment to meet their changing needs, and improve their safety. Exercise may also help to slow cognitive decline in certain forms of dementia. Close friends and family members can also be educated about effective ways to assist and communicate with people with dementia.
