Carers of people with dementia

Tests for dementia

A GP often carries out initial tests, which should include taking a history of symptoms, a physical health chek, blood tests and congnitive tests. Cognitive test may include questions about the date, the location and a short term memory test. Many carers witnessing these tests reported being amazed to discover just how much memory loss there was. A GP may make a diagnosis or refer the person for further tests. Usually further tests are carried out in a specialist department. The decision as to whether the ongoing referral is to memory assessment service, a neurologist, psychiatrist, geriatrician or psycho-geriatrician will depend on the nature of the symptoms, especially in younger people where dementia is rare and neurological or psychiatric problems may need to be excluded first. For a lot of the people we talked with, in 2003/4, it was not uncommon that the diagnostic process including waiting for a specialist referral took at least a year; this has hopefully improved since iniatives such as the National Dementia Strategy for England (Department of Health 2009) and others were introduced.

A complete assessment will include taking a thorough history of the symptoms, talking to friends/relatives where possible, and carrying out investigations for any conditions that might have caused the symptoms described, this may include blood tests and X-rays, a physical examination, and a medicine review to check for any medicines that may impair cognitive functioning. Specific tests for dementia always include cognitive tests. A doctor usually suggests that the patient has a brain scan, usually a CT scan, and sometimes an MRI scan. A CT scan takes only a few minutes and does not require the patient to actually go inside the scanner, so is acceptable to most people. Some carers are anxious that a scan may be frightening, however, so in some cases a diagnosis may be made without supporting evidence of a scan.

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The diagnostic process should involve taking a thorough history from the carer as well as the person with dementia. In some cases, particularly where an elderly couple are living independently, another family member may be needed to give a clear picture of the situation. Several carers expressed concern that they were not included in the process of taking a history. Doctors did not ask for the carer's account of their day to day existence and their abilities and accepted the patient's account of things, which the carers felt bore no relation to reality. Some specialists appeared to forget that once they had made their diagnosis the problems of the person with dementia and of their carer had not necessarily been resolved.

Since the National Dementia Strategy for England was launched in 2009-2014, the process of diagnosing dementia seems to be quicker for many than it was for the people we interviewed in 2003/4, but services do differ across the country. 
 


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Last reviewed July 2018.

Last updated July 2018.

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