Mental test for dementia

How The Test Works

If you are worried that you are getting more forgetful, or you have been feeling confused, anxious or low for a while, it is a good idea to visit your GP. If you are concerned that someone close to you has been experiencing these difficulties, or has been behaving out of character, you may like to suggest that they visit their GP and that you accompany them for the appointment. This factsheet outlines the process and benefits of assessing someone for possible dementia and then making and sharing a diagnosis.

The changes listed above may be caused by several conditions, but they may also be an indication of dementia. The term 'dementia' describes a set of symptoms that occur when the brain is damaged by certain diseases, such as Alzheimer's disease or a series of small strokes.

Each person will experience dementia differently, but there will usually be problems with:

  • concentrating, planning or organising
  • judging distances and seeing objects properly (not caused by poor eyesight)
  • orientation (eg confusion about the day or month, or where they are).

These changes are often small to start with, but for someone with dementia they have become severe enough to affect daily life. For example, the person or their family may notice that they now struggle to use the phone or regularly forget to take their medicine.

Assessment for possible dementia is not a single step but a process that takes time. It often starts with the person or family members realising that there is something wrong. Assessment proceeds through various stages and tests, and ends with sharing of the diagnosis. For the person and those close to them, this journey is often an uncertain, anxious and emotional one.

Why get a diagnosis?

A thorough and timely assessment for possible dementia is essential, in order to:

  • rule out other conditions that may have similar symptoms and may be treatable, including depression, chest and urinary tract infections, severe constipation, and vitamin and thyroid deficiencies
  • rule out other possible causes of confusion (eg poor sight or hearing), emotional changes and upsets (eg moving house or bereavement), or the side effects of certain drugs or combinations of drugs
  • provide a person with dementia with an explanation for their symptoms, removing uncertainty and allowing them to begin to adjust
  • allow a person with dementia to access treatment as well as information, advice and support (emotional, practical, legal and financial)

If the outcome of the assessment is a diagnosis of dementia, it is important that the type (eg Alzheimer's disease or vascular dementia) is also diagnosed. Knowing the dementia type will help to understand symptoms, predict how the dementia might progress, and suggest how best to manage it. For example, certain drugs will be prescribed for Alzheimer's disease (but not vascular dementia), although these do not cure the condition.

Making a diagnosis

Making a diagnosis of dementia is often difficult, particularly in the early stages. This is because there is no one simple test and early symptoms can be similar to those of lots of other common conditions, as mentioned above. A thorough assessment (as detailed below) will often accurately diagnose the type of dementia, and people will usually be told the type, though this may only be confirmed after death if a post-mortem is done.

In some cases an assessment starts in hospital. This is because anyone over 75 who is admitted urgently to hospital should now be assessed for confusion and memory problems.

Similarly, GPs may now ask certain patients who are at increased risk of dementia whether they are concerned about their memory. This includes people with Parkinson's disease or those who are over 60 and have diabetes or a heart condition, or have had a stroke. The GP may ask such patients about memory problems even if they are visiting them about something else.

In either of these situations, if dementia is suspected the person will have further assessment and will generally be referred to one of the specialists listed below.

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