Tools For Dementia Assessment

June 6, 2019


50 million people around the world suffer from some sort of dementia, its most common causes being Alzheimer’s disease and vascular abnormalities. Testing to determine dementia’s specific origins involves a sophisticated process of elimination; there is no single assessment tool to unlock the mystery. Everything from diabetes to heart disease to kidney issues to vitamin deficiency must be looked for and eliminated before doctors can move on to consider other factors.

While conclusive diagnosis typically ends up involving a team of specialists (such as neurologists, neuropsychologists, and geriatricians), dementia assessment begins with your general practitioner, who’s likely to begin with the following:

  • Thorough medical history with special attention to behavioral and cognitive changes, as well as relevant family history;
  • Physical exam and diagnostic testing, including a review of all medications and dietary supplements to rule out associated side-effects;
  • Neurological screening to check reflexes, eye movement, speech, sensation, muscle coordination and strength.

Depending on the results, your physician will refer you to a neurologist for more targeted assessments. These include:

  • The Mini-Mental State Exam (MMSE) which tests a range of everyday cognitive skills, including basic orientation questions like “what state are we in?” and “what are your children’s birth dates?”
  • The Mini-Cog test, which asks a patient to complete two tasks: to remember and repeat the names of three objects, and to draw a clock face with a specific time given by the examiner.
  • The Cantab Mobile, Cognigram, Cognivue and other computer-based tests designed to further evaluate cognitive function. A big advantage to these tests lies in their consistency; because they’re given the exact same way each time, conclusions can be drawn without having to allow for human error or subjectivity.
  • Brain imaging such as an MRI or CT scan mostly to rule out other conditions like brain tumor or stroke that could be causing cognitive difficulty. While there is no imaging tool to conclusively pinpoint the presence of Alzheimer’s (again, dementia’s leading cause) there are other imaging techniques a neurologist may use to track high levels of beta-amyloid, a consistent hallmark of the disease.

Finally, some quick thoughts on home self-assessments and genetic testing, both of which are gaining attention. While there are several online screenings marketed directly to consumers, they are roundly dismissed by physicians as a potential substitute for a thorough medical evaluation. Genetic testing is available to locate certain risk factors associated with the development of Alzheimer’s; however much is still up for debate. Check out the Alzheimer’s Association genetic testing fact sheet for more information.

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