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NEUROLOGY SERVICES

Diagnosis & Treatment

Dementia

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How is Dementia Diagnosed?

Diagnosis

There is no specific test to diagnose dementia. Instead, the health professional will ask about the patient’s history and perform a physical examination, cognitive testing, and possibly other tests.

Tests that can help diagnose the type of dementia include:

  • Cognitive and psychological tests. Doctors will evaluate the patient’s thinking ability, memory, language skills, orientation, reasoning, and attention.
  • Neurological evaluation. Doctors evaluate memory, language, visual perception, attention, movement, senses, balance, walking, reflexes, and other areas.
  • Psychiatric evaluation. Doctors evaluate the patient’s mental health, including depression, anxiety, or other conditions.
  • Brain scans
    • CT or MRI scans can detect stroke, hemorrhage, subdural hematoma after a fall, and brain tumors, which may help diagnose vascular dementia and rule out causes of dementia symptoms.
    • PET scans are not routinely used to confirm an Alzheimer’s diagnosis associated with  Alzheimer’s. This test is most meaningful when amyloid is not present since the presence of amyloid may be in the blood vessels and not indicate Alzheimer's disease.
    • Lumbar punctures are increasingly used to look for amyloid and tau and phosphor-tau in the spinal fluid.

How is Dementia Treated?

Treatment

Most forms of this condition, including Alzheimer’s disease, have no cure, and research for suitable dementia treatment is ongoing. Some medications can help manage symptoms, and specific therapies can help a person with dementia feel better.

Medications

The following dementia medications are used to manage symptoms. Cholinesterase inhibitors are medications that decrease the breakdown of neurotransmitters (chemicals in the brain) called acetylcholine. Their most common use is in treating diseases such as Alzheimer’s disease (all stages)  and Parkinson’s disease dementia. Cholinesterase inhibitors are not approved for Lewy body dementia.

  • Other medications such as antidepressants, antipsychotics, and anxiolytics can help with behavior symptoms, including irritability, anxiety, depression, sleep disturbances, hallucinations, and symptoms found in Parkinson’s disease (slowness, stiffness, tremor, and imbalance) or agitation.

Therapies

In the early stage of dementia, nondrug approaches, such as supportive care, physical exercise programs, and appropriate social activitie s, may help with symptom management. These may include:

  • Counseling. Patients and their families should be counseled about the disease and its progression. They should be encouraged to seek social service consultations and to register with relevant support groups and societies.
  • Occupational therapy. An occupational therapistcan work with a person with dementia to identify difficulties and help with day-to-day activities. The occupational therapist can recommend ways to arrange the home in a way that will help the patient.
  • Physical therapy for gait and balance
  • Other therapies and activities may benefit people with dementia, bring joy, and help reduce depression and agitation. These include:
    • Music therapy
    • Art therapy
    • Pet therapy
    • Massage therapy
    • Exercise and yoga

FAQs

FAQs

The risk of developing dementia rises with age, especially after age 65. Early onset of Alzheimer’s disease can occur at a younger age.

Certain diseases, including Alzheimer’s disease, cause dementia in about 60% of cases. These diseases are associated with an abnormal buildup of certain proteins that damage or change brain function. In most cases, the exact causes of the underlying diseases are unknown.

Sundowning is a state of confusion that may affect people with Alzheimer’s disease and other types of dementia in the late afternoon and evening. Sundowning can cause anxiety, agitation, and aggression. The cause of this behavior is unknown.

It is hard to say how quickly dementia will progress. Some people with dementia will need support soon after their diagnosis, while others will stay independent for several years. It depends on the type of dementia, the person’s age at diagnosis, and what other health issues the patient might have.

On average, a person will live around ten years after a diagnosis of Alzheimer’s disease, the most common type of dementia. Some people live longer, 15 or 20 years. Those diagnosed in their 80s or 90s may not live that long.

Get Care

Trust NewYork-Presbyterian for Dementia Treatment

Our team at NewYork-Presbyterian has expertise in evaluating and treating Alzheimer’s and related disorders. Learn more about diagnosing Alzheimer’s disease and about other neurological services provided by NewYork-Presbyterian. Contact us to make an appointment.