- [Voiceover] So there isn't one stand-alone test
that will show whether someone has dementia
or Alzheimer's disease,
since the typical symptoms
like memory loss, confusion, and others,
can have a whole slew of potential causes.
That being said, it's not usually diagnosed
until a complete medical assessment is performed.
But what all does that entail?
Well, first off, a healthcare professional
might take a look at the patient's history.
They'll try to gather information
from the patients themselves
as well as from their friends and family.
They'll probably ask questions like
what kind of symptoms have you noticed?
Or when did you start noticing them?
How often do they happen?
And have you noticed them getting any worse?
They'll also try to evaluate the patient's emotional state.
A lot of the time the patient might be completely unaware
of their current state or they might be in denial about it.
And this can be tough because sometimes
even other family members will deny its progression
because many of the early signs of dementia
also tend to look just like normal signs of aging.
And this is just another reason why it makes
diagnosis of dementia very, very hard
and why we have to rely
on other methods of diagnosis as well.
So a physical examination can also be done.
In these, your doctor will check things like
your hearing or your eyesight, your heart and your lungs,
your temperature, your blood pressure, and your pulse.
And they may also take things like blood and urine samples.
Information from these can help the doctor figure out
if there are any other underlying health issues
that are causing or contributing to the dementia itself,
like heart problems and vascular dementia
or if there's another condition
that's mimicking symptoms of dementia,
since other conditions like anemia or depression,
infection, diabetes, kidney disease, and others
can also cause dementia-like symptoms,
like confused thinking and memory problems.
But besides physical exams,
a neurological evaluation may also be done.
And this'll look at the patient's nervous system
and will test things like balance
and sensory function using lights
and also your reflexes, using that tiny hammer
and lightly tapping it on the knee.
The doctor might also give the patient
a cognitive or a neuropsychological test,
which are used to kind of objectively measure
the patient's current memory, language skills,
math skills, and other abilities
as they relate to mental function.
And one big one's called the mini mental state examination
or MMSE.
And this test can be particularly helpful
in diagnosing dementia
because it looks at orientation, memory, and attention.
For example, it might ask to follow
verbal or written commands
or write down a sentence spontaneously
or copy a complex shape.
And depending on the score,
a certain level of dementia might be suggested.
Scores of about 20 to 24 suggest mild dementia,
13 to 20 suggests moderate dementia,
and less than 13 would suggest a severe case of dementia.
And typically patients with Alzheimer's disease
tend to drop two to four points on average every year.
Another more simple test that might be administered
is called the mini-cog test.
In this test the patient is asked to name three objects
and then repeat them back to the doctor,
like car, chair, and mug.
For the next part, the patient is asked
to draw an analog clock
and also asked to draw a specific time.
Thirdly, the patient's asked
what those three objects initially were,
car, chair, and mug.
If the patient fails one or all of these tests,
it might suggest signs of dementia
and may require a further evaluation.
Another potential test is
the psychiatric evaluation or mood assessment.
They'll try to assess the patient's
current level of well-being,
looking for signs of depression or other mood disorders
that can also contribute to symptoms
that overlap with dementia symptoms.
Finally, the patient might have brain scans.
With a brain scan the brain's actually visualized
through techniques like computed tomography or CT scans
or magnetic resonance imaging or MRI.
And there are several reasons why
we might want one these performed.
They might be useful in identifying larger masses,
like tumors, that can be contributing
to the cognitive impairment.
But it might also help in making a differential diagnosis,
meaning that we'll try to look to figure out
what type of dementia is at play.
Sometimes by looking at where the most atrophy
of brain tissue is localized,
we can figure out what type of dementia it is.
For example, atrophy that's localized to the hippocampus
might suggest Alzheimer's disease
or the frontal lobe might suggest frontotemporal dementia
or vascular pathologies that are visualized
might suggest vascular dementia.
And another reason for a brain scan
might be to monitor disease progression.
Several imaging sessions over several years
might show how the brain has changed over time.
More atrophy might be indicative of disease progression
whereas if the atrophy has stayed the same over time,
it might suggest that a different
or a more static cognitive disease is at play.
Finally, imaging is really, really valuable
for research purposes,
especially with respect to structural imaging
and figuring out which structures
are affected first by the disease
in addition to any chemical processes
that might be involved.
And this information helps physicians and researchers alike
understand dementia as a disease
and develop more effective treatments in the future.