How is dementia diagnosed?

There is no single test that can diagnose dementia. The journey to a diagnosis often involves several steps, including the initial medical examination, tests for mental ability, laboratory tests and brain scans. The doctor will then combine and review all the information obtained to help pinpoint the problem.

History

During a medical examination, the doctor would go through your medical history. During a dementia assessment, patients are encouraged to be present with a caregiver or family member. They can also provide useful information such as changes or problems that the patient has experienced.

Information that the doctor will note includes but are not limited to the following:

  • When and how the symptoms started
  • If the symptoms affect your daily life
  • Existing medical conditions (e.g. diabetes, hypertension, stroke, depression)
  • Review of medications that you might be taking, including traditional medicines and supplements (e.g. vitamins)


Tests for Mental Ability

Several different tests, also known as cognitive assessments, are used to check memory and thinking. Most tests involve a series of pen-and-paper tests and questions that each carry a score.

Specifically, several mental abilities in the tests include:

  • Short- and long-term memory
  • Concentration and attention span
  • Language and communication skills
  • Awareness of time and place (Orientation)



Psychiatric Evaluation

During a psychiatric evaluation, the doctor would be able to determine whether depression or other mental health condition is the cause of the symptoms that are confused with dementia. This is also done to rule out other possible conditions.

Blood tests can help exclude other causes of symptoms that could be confused with dementia. Common blood tests ordered are as follows:

  • Liver function
  • Kidney function
  • Thyroid function
  • Hemoglobin A1c (to check for diabetes)
  • Vitamin B12 and folate levels
     

If there is a suspicion of an infection, you also may be required to perform urine tests or other investigations.

Spinal fluid is sometimes examined for infection, inflammation or markers of some neurodegenerative diseases.

Brain scans allow the detection of treatable causes such as strokes, tumors, and vascular malformations. The scans are also valuable for detecting imaging biomarkers of disease to aid in the diagnostic workup.

MRI Dementia Biomarker Screen (MR Dementia Screen)

  • MRI brain volumetry imaging is performed using AI (Artificial Intelligence) software to detect imaging biomarkers of dementia and neurodegenerative diseases.
  • Routine MRI imaging of the brain is performed simultaneously to exclude other diseases that can present with dementia, such as tumors and stroke.
  • MR Angiography of the brain (circle of Willis) and carotids are included to exclude vascular malformations and assess for vessel narrowing (stenosis) that could give rise to strokes (MRI Dementia Screen Plus only)
  • For patients who have already performed a recent MRI brain imaging, you have the option of evaluating just the imaging biomarkers (MRI Volumetry Only)

CT scans can be used to check for signs of stroke or a brain tumor. However, it cannot provide detailed information about the structure of the brain.

PET scans

  • 18FDG PET/CT Brain shows patterns of brain activity that can be seen early in the disease and help differentiate types of dementia
     
  • Amyloid PET/CT Brain shows whether amyloid, a hallmark of Alzheimer's disease, is deposited in the brain



To learn more about dementia services, reach out to us at +65 6363 1818 or send an enquiry here. Alternatively, you could also click here to make an appointment.