Dementia is frightening for many people and can be challenging to diagnose for providers. Since there is no single test that can definitively diagnose when symptoms initially present, doctors often rely on multiple tests to understand what is happening.
But what is dementia? Most people hear the term and automatically think Alzheimer’s; however, that’s only partially correct. Dementia, by itself, is not a true diagnosis. Rather, it means that someone is having a problem in thinking skills, memory for example, that makes completing daily tasks more challenging. While Alzheimer’s is the most common type of dementia, there are many other types.
While changes in thinking skills are sometimes a sign of a dementia process, these symptoms also occur for other reasons. For example, many people will experience changes in their thinking skills as a natural part of aging. Most notably, it is very common to walk into a room and momentarily forget what you walked in there for. It is also normal to occasionally forget a word while you are talking. If you become confused about where you are at, what you are doing, or you have a hard time following conversations, these are symptoms that shouldn’t be ignored. This is why it is so important to get a comprehensive work up, of which neuropsychology plays a significant role.
One of the evaluations included in the work up of dementia is neuropsychological testing. During this evaluation, the person concerned about their thinking skills (also known as cognition) talks with a neuropsychologist about his/her cognitive concerns. After, they complete paper and pencil testing to help providers know how different thinking skills work together. This is important since memory is most often the primary concern, but also a very complex thinking skill. That is, in order to make a memory, you have to be able to sense the information (hear/see, etc.), pay attention to it, think about it quickly enough, organize it, store it, and then be able to retrieve it at a later time. Disruption in any of these processes can cause a “breakdown” that looks like a memory problem, but is not. This “breakdown,” or pattern on neuropsychological testing, is one of the most sensitive ways to diagnose dementia.
If a diagnosis of dementia is made, there are treatment options you can discuss with your primary care provider or neurologist. However, it is important to remember that some of the medications used for dementia are not necessarily designed to improve a skill, but rather to slow progression. Other interventions include things like helping to reduce memory demands in day-to-day life, possible occupational or speech therapy, and ideas about starting conversations to plan for the future. However, as with most medical conditions, the right treatment starts with the right diagnosis.
Reducing Your Risk
At this time, there is not a way to fully prevent dementia and there is no cure; however, there are things you can do to help reduce risk. One good rule of thumb is: “what is good for my heart is good for my brain.” The brain, which weighs about 3 pounds, uses about 20 percent of the body’s blood and about 25 percent of its oxygen. That is really impressive for such a small organ! Knowing this, it becomes very important to manage things like high blood pressure, sleep apnea, diabetes, and atrial fibrillation (amongst other risk factors) as best you can. For most of these risk factors, taking medicine may not be enough. Getting regular exercise and eating healthy are also important. You can learn more about how to make some of these changes by talking with your primary care provider, primary care behaviorist, or speaking to a registered dietitian.
The other good rule of thumb in brain health is to remain socially and mentally active in your day. It is important to limit activities where you are sitting and not stimulated (e.g., watching television). Rather, engage in social events or take an adult education class on something you always wanted to learn (e.g., painting or photography). While “brain games” present an interesting new way of staying mentally active, there is no consistent research showing it prevents dementia or improves memory. As such, we usually recommend them only if they replace another sedentary activity; they should not be used in place of other social activities (e.g., visiting with family/friends).
If you suspect you or a loved one has dementia, consult a primary care provider and ask for a referral for neuropsychological testing.