How is dementia diagnosed?

People with dementia

People with dementia

If you are worried about your memory or think you may have dementia, it’s a good idea to see your GP. If you’re worried about someone else, who you think has dementia, encourage them to make an appointment and perhaps suggest that you go along with them.

If you are forgetful, it doesn’t mean you have dementia. Memory problems can also be caused by depression, stress, drug side effects, or other health problems. It can be just as important to rule out these other problems or find ways to treat them. Your GP will be able to run through some simple checks and either reassure you, give you a diagnosis, or refer you to a specialist for further tests.

An early diagnosis gives you both the best chance to prepare and plan for the future, and receive any treatment. With treatment and support from healthcare professionals, family and friends, many people are able to lead active, fulfilling lives.

What to expect when you see your GP about dementia

Your GP will ask about your symptoms and other aspects of your health, and will give you a physical examination. The doctor will organise some blood tests and ask about any medication you are taking, as these can sometimes cause symptoms similar to dementia.

You will also be asked some questions or given some mental exercises to measure any problems with your memory or your ability to think clearly.

Read more about the tests used to diagnose dementia.

Referral to a dementia specialist

Dementia can be difficult to diagnose, especially if your symptoms are mild. If your GP is unsure about your diagnosis, they will refer you to a specialist such as a neurologist (an expert in treating conditions that affect the brain and nervous system), an elderly care physician, or a psychiatrist with experience of treating dementia.

The specialist may be based in a memory clinic alongside other professionals who are experts in diagnosing, caring for and advising people with dementia and their families.

It’s important to make good use of your consultation with the specialist. Write down questions you want to ask, make a note of any medical terms the doctor might use, and ask if you can come back if you think of any more questions. Taking the opportunity to go back can be very helpful.

The specialist may want to organise further tests, which may include brain scans such as a computerised tomography (CT) scan, or preferably a magnetic resonance imaging (MRI) scan.

If they are still not certain about the diagnosis, you may need to have further, more complex, tests.

Getting your dementia diagnosis

Once you’ve had the necessary tests, your doctor should ask if you want to know your diagnosis.

They should explain what having dementia might mean for you, and should give you time to talk more about the condition and ask any questions you may have.

Unless you decide otherwise, your doctor or a member of their team should explain to you and your family:

the type of dementia you have, or if it is not clear, what the plan to investigate further will entail; sometimes, despite investigations, a diagnosis may not be clear, in which case the doctors will review you again after a period of time to reassess you

details about symptoms and how the illness might develop

appropriate treatments that you might be offered

care and support services in your area

support groups and voluntary organisations for people with dementia and their families and carers

advocacy services

where you can find financial and legal advice

You should also be given written information about dementia.

Questions to ask about your dementia diagnosis

In case you can’t think of any questions to ask you’re doctor, it may be worth asking:

which type of dementia you have

details about the tests or investigations you should have

how long you will have to wait until you have the tests

how long it will take to get the results of these tests

what will happen after you get the results

Ongoing dementia assessment

Once you have been given a diagnosis, your GP should arrange to see you from time to time to see how you’re getting on. Because dementia is a progressive condition, the doctor may arrange another appointment with the specialist, perhaps after six months or a year.

The GP and the specialist may also jointly prescribe medications that may be helpful in treating some of the symptoms of dementia. However, not everybody will benefit from these drugs.

An ongoing assessment of your dementia may be a good time to consider your plans for the future, perhaps including a Lasting Power of Attorney to take care of your future welfare or financial needs, or an advance statement about your future care.

Dementia – What are the early signs of vascular dementia?

Memories to help with dementia

Memories to help with dementia

Vascular dementia causes problems with mental abilities and a number of other difficulties.

The symptoms can come on suddenly or gradually. They tend to get worse over time, although treatment can help slow this down.

Early symptoms

Early signs of vascular dementia can include mild:

slowness of thought

difficulty with planning

trouble with understanding

problems with concentration

mood or behavioural changes

problems with memory and language (but these aren’t as common as they are in people with Alzheimer’s disease)

As this point, these problems may be barely noticeable or mistaken for something else, such as depression. But they indicate some brain damage has occurred and that treatment is needed.

Later symptoms

The symptoms often continue to get worse over time. This may happen slowly, or in sudden steps every few months or years.

The symptoms depend on the part of the brain that’s affected, but can include:

significant slowness of thought

feeling disorientated and confused

memory loss and difficulty concentrating

difficulty finding the right words

severe personality changes, such as becoming aggressive

depression, mood swings and lack of interest or enthusiasm

finding it difficult to walk and keep balance, with frequent falls

loss of bladder control (incontinence)

increasing difficulty with daily activities

Some people also have some symptoms of Alzheimer’s disease.

Getting medical advice

See your GP if you think you have early symptoms of dementia, especially if you’re over 65 years of age.

If it’s spotted at an early stage, treatment may be able to stop the vascular dementia getting worse, or at least slow it down.

If you’re worried about someone else, encourage them to make an appointment with their GP and perhaps suggest that you go with them.

Symptoms of dementia can have several causes. Your GP can do some simple checks to try to find out the cause and may refer you to a specialist for further tests.

Ten Signs of Alzheimer’s – What you Need to Know!

The thought of Alzheimer’s is very concerning. Especially when it affects family and friends!

But the earlier Alzheimer’s (and other forms of dementia) are diagnosed the better the treatments available.

So we are sharing this list of signs and symptoms of Alzheimer’s disease from the Alzheimer’s Association.

Know the 10 signs – An infographic by the team at Alzheimer’s Association

Music therapy – how music therapy is helping older people and persons with dementia.

Music therapy for dementia

Music therapy for dementia

Leicester’s Hospitals are working together with OPUS, a leading provider of music in healthcare settings, to bring music onto wards for older people and for those with a dementia.

Following the success of their previous visits to Older Peoples wards, OPUS will now visit all three sites of Leicester’s Hospitals on a weekly basis over the next two years.

Two musicians will be visiting the hospital for a day each week, providing music and song on various wards. OPUS musicians engage with patients, visitors and staff in music-making, creating an environment conducive to health and well-being. The musicians also carry a variety of instruments for patients to use.

Music and singing creates an opportunity for patients to reminisce and retrieve memories which at other times may be lost. This initiative has been supported by the Arts Council and Leicester Hospitals Charity.

Justine Allen, Older Peoples Sister, said: “The first visit from OPUS was inspiring and overwhelming to say the least.  Patients with dementia who had found it difficult to communicate beforehand began to respond. They clapped, touched, opened their eyes, smiled, tapped and sang.

“It was amazing to be part of and was great to see the positive impact OPUS had on the overall environment, for both staff and visitors to the ward.”

OPUS Music Community Interest Company (CIC) is a UK leader in taking music-making into healthcare settings.  The core team of musicians from OPUS are Nick Cutts, Richard Kensington, Oli Matthews and Sarah Matthews.

Nick Cutts, Director and musician at OPUS, added: “We are delighted to be extending our practice at Leicester’s Hospitals to include work with older patients and those with dementia. We know from our experience, and from recent research, that live music-making makes a huge difference within hospitals both to the health and wellbeing of the patients, but also to the visitors and staff.”

The OPUS visits began this September, to support national Older People’s Month, among a calendar of events and ward celebrations arranged by Leicester’s Hospitals patient experience team.

For more information about OPUS, please visit www.opusmusic.org

Dementia with Lewy Bodies. What are the signs and symptoms DLB and how can it be treated?

Dementia with Lewy Bodies

Dementia with Lewy Bodies

As many of you know this month is Alzheimer’s Awareness Month. So, somewhat counter intuitively, I have decided to have a look at other form of dementia.    In this case I’d like to focus on a condition called Dementia with Lewy Bodies.

Dementia (and this form of dementia in particular) has been on my mind for the last few weeks.  There are a couple of reasons for this.  Firstly as I get older my family members age as well.  Secondly because the man after whom this medical condition is named (albeit some decades apart) went to the same medical school as my cousin.

So I wanted to look at Dementia with Lewy bodies a bit more closely.

As you know Alzheimer’s disease is not the only type of dementia.  In fact Dementia with Lewy bodies may be responsible for around 10% of dementia cases.  Though it should be noted that typically in only 4% of cases are actually diagnosed as Dementia with Lewy bodies (DLB) by healthcare professionals.  So there is more than a bit of uncertainty about a diagnosis.

Okay so let’s start from the beginning.  What exactly are Lewy bodies?

Lewy bodies are “tiny deposits of protein in nerve cells” – currently scientists are not clear as to why they appear.  Though, in fact, they are present in both DLB and Parkinson’s disease.  In fact DLB shares symptoms with both Alzheimer’s disease and Parkinson’s disease.  And also with some other progressive neurological conditions as well.  As of today scientists are still unclear as to how Lewy bodies operate.  Thought it does seems that the Lewy bodies interfere with chemical signals between nerve cells.

So what are the symptoms of Dementia with Lewy bodies?

As with Alzheimer’s disease people with DLB suffer from memory and judgement issues but they also have issues with concentration and visual perception.  By visual perception we mean how a person sees objects in space and general recognition of those objects.

As with Parkinson’s they may suffer from tremors, slowed-down movements and stiff limbs.

In some cases the patient may suffer from hallucinations.  Fatigue and disrupted sleep is also very common for person with Dementia with Lewy Bodies.  And in a few cases falling and fainting will occur.

Many patients suffer from swings in concentration.  This might mean a swift change from general alertness to simply just starring into space.

While Dementia with Lewy Bodies’ symptoms can be treated current there is no cure for the condition.  Therapies are generally used for particular symptoms so treatment regimens will vary for patient to patient.  For example Acetylcholinesterase inhibitors can be used for cognitive dysfunction, hallucinations and drowsiness.

As with other neurological conditions physiotherapy can be used alongside occupational therapy. And in many cases speech and language therapy as well.

Patients may also be exposed to other therapies. Cognitive stimulation which involves taking part in activities and exercises designed to improve memory, problem-solving skills and language ability. Reality orientation therapy reduces feelings of mental disorientation, memory loss and confusion, while improving self-esteem.

It should be mentioned that if you or a loved one has been diagnosed with any kind of dementia it is vital to get legal advice to make sure your or their affairs are in order.

If you have seen one of our discussion blog post at Patient Talk before you will know that the most important part is to start a discussion among our readers and those in the Dementia with Lewy bodies’ community.  So we were hoping some of you may be able to help with the following questions which will help to educate others about the condition.   We are keen to hear from friends, family and caregivers as well as people with Dementia with Lewy bodies.

So here goes:-

What were the earliest signs and symptoms of Dementia with Lewy bodies?

How did Dementia with Lewy bodies’ progress?

What treatments were offered to you or a loved one? How effective were those treatments for Dementia with Lewy bodies?

What advice would you give to a person

And their families who has just been diagnosed with Dementia with Lewy bodies?

Thanks very much in advance.  Please note that these are just guide lines.  Anything you have to say will be of massive interest to our readers.

Finally if you want or need more information why not have a look the web site of the Dementia with Lewy bodies Society in the UK and its fraternal organisation in America, Canada and Australia.