Diagnosis : The Causes of Dementia

 

 

 

     Dementia is a syndrome resulting from brain disorders that affect memory, cognition, and the ability to perform daily activities. Therefore, diagnosis requires a comprehensive process to identify the underlying causes and develop an appropriate treatment plan for patients.

 

1. Preliminary Examination

1.1 Dementia Screening

• Gathering a medical history from the patient and close relatives, inquiring about symptoms such as memory loss, disorientation, and behavioral or emotional changes.
• Screening Tests such as the MMSE (Mini-Mental State Examination) or MoCA (Montreal Cognitive Assessment) are administered to assess the likelihood of dementia.

 

 

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These tests help evaluate memory, analytical thinking, and decision-making skills through tasks such as recalling words, identifying the current date, drawing, and performing calculations.

 

 

 

Example: MoCA (Montreal Cognitive Assessment) Test

 

 

1.2 Depression Screening

     Since depression can exhibit symptoms similar to dementia, such as poor concentration and memory decline, physicians use specific assessments to evaluate depressive conditions:

 

• PHQ-9 (Patient Health Questionnaire-9) A nine-question test for initial depression assessment.
• GDS (Geriatric Depression Scale) A 30-question test designed to assess depression levels in older adults.

 

Read More: 5 Signs of Dementia – Frequent Forgetfulness and Memory Decline

 

1.3 Physical Examination

     Patients undergo neurological examinations, including tests for balance, gait, vision, and muscle function. Additionally, physicians assess other physical conditions that may contribute to symptoms, such as dehydration, infections, or nutritional deficiencies.

 

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The preliminary assessment of dementia emphasizes screening, medical history evaluation, depression screening, and a detailed physical checkup to determine the cause and develop an appropriate treatment plan.

 

 

 

 

 

2. Laboratory Testing

2.1 Blood Tests

     Blood tests help identify treatable conditions such as vitamin B12 deficiency and thyroid disorders. Advanced diagnostic techniques, such as genetic testing related to Alzheimer’s disease, are also available. Modern technology allows differentiation between Alzheimer’s and other types of dementia by analyzing Beta-amyloid (Aβ42) levels in cerebrospinal fluid and P-Tau (Phospho-tau) levels in blood.

 

 

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A decreased Aβ42:Aβ40 ratio indicates protein accumulation in the brain, aiding in diagnosis.

 

 

 

 

3. Neuroimaging (Brain Imaging)

3.1 Magnetic Resonance Imaging (MRI)

     MRI scans help detect brain atrophy, particularly in the hippocampus and temporal lobes. This imaging technique also differentiates dementia from other causes such as stroke, tumors, or brain injuries.

 

3.2 Positron Emission Tomography (PET Scan)

     PET scans use tracers to detect beta-amyloid accumulation in the brain, making them effective for early-stage dementia diagnosis and distinguishing dementia types.

 

3.3 SPECT Scan

     SPECT scans (Single Photon Emission Computed Tomography) assess blood flow in the brain, identifying abnormalities in specific brain regions.

 

Precautions Before Imaging Tests

• Avoid high-carbohydrate and sugary foods.
• Refrain from smoking, alcohol, and caffeine consumption (e.g., coffee).
• Avoid intense physical exercise before the test.
• Inform physicians and nurses about any pre-existing medical conditions and medications taken.

 

 

 

 

4. Additional Tests

• Genetic Testing Recommended for patients with early-onset symptoms or a family history of dementia, including mutations in PSEN1, PSEN2, or APP genes.
• APOE ε4 Gene Testing Since this gene variant is linked to an increased risk of Alzheimer’s disease, testing may be conducted to assess genetic predisposition.

 

Dedicated Brain Care for You and Your Loved Ones

     The Brain and Neurology Center at Ramkhamhaeng Hospital is committed to helping patients overcome challenges posed by dementia. Our team of specialized physicians, combined with modern medical advancements, ensures a warm and secure environment, allowing patients to regain quality of life with confidence.

 

Read More: 7 Ways to Slow Down and Prevent Dementia