What is dementia?

Dementia is a broad term for a condition that affects your brain. It's most common in older people and can slowly change how you think and behave.

When should I see my doctor?

You might notice that you or someone you care about have changes in mood, memory, thinking or behaviour. It's normal to feel worried if this happens. See your doctor for a check-up and to talk about what you have noticed.

There are lots of things you can do to help you live well with dementia. It's best to be diagnosed as soon as possible.

What tests are used to diagnose dementia?

There isn't one single test that tells you if you have dementia.

To diagnose dementia, your doctor will need to do a range of tests. The results of the tests help your doctor rule out other causes for your symptoms.

As well as asking about your medical history they may:

• do a physical examination
• do a neurological (nervous system) examination
• order blood or urine pathology tests
• ask you to do cognitive (thinking) tests
• send you for a CT scan, MRI or other scan

The testing process can take time. Your doctor may need to repeat some tests in a few months or a year before you can get a firm diagnosis.

It's fine to ask your doctor what they are looking for and what each test is for.

Personal medical history

Your doctor will ask about:

• your medical history
• what medicines you take
• your family medical history
• any changes in your memory and thinking
• what you eat, and if you smoke

Dementia tends to get worse over time. If you are having tests for dementia, it's a good idea to bring a family member or close friend with you. They can help explain your personal history and what has changed.

Physical examination

Your doctor may examine you to check for any physical causes of your symptoms.

Neurological examination

In a neurological examination, your doctor checks your nerves by testing your:

• reflexes (automatic reactions)
• coordination
• eye movement
• muscle tone and strength
• speech
• sensation (how things feel on your skin)

Pathology tests

Your doctor may send you for blood tests and urine tests.

Pathology tests are used to check for:

• an infection
• anaemia
• electrolyte imbalance or kidney problems
• liver function problems
• thyroid function problems
• vitamin deficiency

These can cause similar symptoms to dementia.

Cognitive testing

Doctors use cognitive tests to check your thinking, such as your:

• memory
• problem solving ability
• counting
• language skills
• spatial awareness
• concentration

First, you might do a short screening test, such as a mini-mental state examination (MMSE). Depending on the result, your doctor might refer you to other specialist doctors, such as a:

• neurologist (specialist in the brain and nervous system)
• geriatrician (specialist in conditions affecting older people)
• psychiatrist (specialist in mental health)
• neuropsychologist (specialist in how brain conditions affect behaviour, mood and thinking)

Another cognitive test is the Alzheimer's Disease Assessment Scale — Cognitive (ADAS-Cog). This test can be used for people with mild symptoms. It takes around 30 minutes and is usually done by a specialist or a psychologist.

Neuropsychological testing

Neuropsychological tests measure your thinking, memory and other skills to help identify specific problem areas. This is a longer test, and it can be quite expensive.

Psychiatric testing

A psychiatrist may check if you have another condition with similar symptoms to dementia. If you have depression, anxiety, hallucinations or delusions, these will need to be treated. Psychiatrists also do specialised dementia assessments.

X-rays and scans

Your doctor may want a scan to look at your brain, such as:

• a CT scan
• an MRI scan
• a PET scan

Brain scans can rule out conditions such as a tumour, stroke or hydrocephalus (fluid on the brain). They can also help diagnose some types of dementia.

Test results and diagnosis

Your doctor or specialist who has your test results can diagnose dementia. To start, it may be a 'preliminary diagnosis'. That means you can start planning what care and treatment you may need. Being diagnosed early can give you more choice about what to do next.

If you are diagnosed with dementia, you may feel a mix of relief, shock and worry about what comes next.

If you are the person being tested, you might not want to know your diagnosis. In this case, you may want to choose to have your doctor speak with a family member or loved one instead.

Learn about the different ways you can manage your life if you are diagnosed with dementia.

Prepare for your medical appointment by creating a list of questions to ask your doctor.

Resources and support

Visit the Dementia Australia website to find out more about testing for dementia or call the National Dementia Helpline on 1800 100 500.

Dementia Australia has developed a free BrainTrack app to help you monitor and understand changes in your memory and thinking ability.

Learn more about dementia from the Sydney University Cognitive Decline Partnership Centre. They have a flow chart showing the steps to diagnosis.

Visit My Aged Care for information about the Support at Home program, which can help you access services, equipment, products and home modifications so you can live at home for longer.

Languages other than English

Dementia Australia has information in many languages other than English.

The National Ageing Research Institute (NARI) provides dementia information in 9 languages: Arabic, Cantonese, Mandarin, Hindi, Tamil, Greek, Vietnamese, Spanish and Italian.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.