Diagnosis of dementia and Alzheimer's disease

- [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.