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Dementia is a decline in cognitive function. It may affect memory, thinking, language, judgment, and behavior. Traditionally, a diagnosis of dementia is based on noticeable signs of decline.
In April 2011, the National Institute on Aging (NIA) of the National Institutes of Health (NIH) and the Alzheimer’s Association published specific criteria for diagnosing dementia.
Dementia is diagnosed only when the following three criteria are met:
In addition, your symptoms must include at least two of the following:
Your doctor may be able to diagnose dementia based on a physical exam and health history. The exam will include tests to check your mental function. This is called a mental status examination. If this is not enough for a diagnosis, more tests may be required.
A detailed patient history will include:
The doctor will also request information from your close friends and family members. This is important because those closest to you may have observed changes in your personality, behavior, memory, and cognitive skills.
A physical exam includes checking your hearing, eyesight, heart, lungs, temperature, blood pressure, and pulse. Your doctor may also order lab tests to help eliminate or identify other health problems, particularly those associated with reversible causes of mental status changes. Possible tests include:
The most common test of this kind is the Mini-Mental State Exam (MMSE). The MMSE includes 11 questions/tasks designed to evaluate your basic mental status. Questions/tasks include:
Pictures of your brain may help your doctor make an accurate diagnosis. It is important to know the cause of your symptoms. This will help determine if your condition can be treated or reversed.
Magnetic resonance imaging (MRI) and computed tomography (CT) scans can help find or rule out brain tumors or blood clots that might be causing dementia.
A PET (positron emission tomography) scan allows the doctor to see how your brain is functioning.
A functional MRI (fMRI) measures the changes that take place in active parts of the brain.
A single photon-emission computed tomography (SPECT) shows the distribution of blood in the brain, which generally increases with brain activity.
Magnetoencephalography (MEG) shows the electromagnetic fields produced by the brain's neuronal activity.
Written by: Wendy Leonard, MPH
Medically reviewed on: Sep 15, 2014: Kenneth R. Hirsch, MD
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