Wednesday, January 8, 2014

Common Diagnostic Criteria for Dementia

Over the last two decades, we’ve grown more aware of dementia, causes, and symptoms. Yet, families’ lives are turned upside down when a well-intentioned doctor hastily diagnoses a loved one’s condition as dementia.
Before we overview 15 diagnostic criteria used by medical professionals, some caveats are in order.
Over the years, I’ve witnessed families grow distraught after leaving the primary doctor’s office upon receiving a hasty diagnosis of dementia, Alzheimer’s, or Parkinson’s. Although, primary care physicians, emergency room personnel, and even physicians assistants have medical expertise and have seen a lot depending on the number of years of service, they are unlikely to specialize in dementia diagnosis and care.
Families, who suspect dementia, are advised to seek a proper diagnosis by geriatric assessment team. Such team members work together to arrive at a more accurate diagnosis than an internist will likely give. Team members include a geriatrician or geriatric doctor who specializes in geriatric medicine–diseases of the elderly (who often have multiple illnesses simultaneously). His/Her assessment is integrated with that of a geriatric social worker, therapist, psychologist or psychiatrist, speech pathologist to determine whether or not dementia is the cause of one’s symptoms such as bouts of forgetting, slight tremors, momentary imbalances, and disorientation.
The geriatric assessment team takes a medical history, and performs a physical, neurological exam, lab tests, and a mental acuity test. Below are 15 of the criteria they use to arrive at a diagnosis.

  1. Older age: At age 85, the probability of living with dementia approaches 50%.


  1. Head injury: Repeated concussions that include loss of consciousness (e.g., while playing football or engaged in other risky sports and occupations), can contribute to various forms of dementia including Alzheimer’s and Parkinson’s.

  1. Poor cardiovascular health will reduce blood flow and oxygen to the brain.

  1. Diabetes: Alzheimer’s – is it really type III Diabetes?

  1. Stroke caused by a blocked blood supply in the brain.

  1. High cholesterol: Clogged arteries reduce oxygen to the brain.

  1. High blood pressure increases risk for stroke.

  1. Obesity and lack of exercise: Studies show that exercise contributes to better brain function and better weight management.

  1. Lower educational level or a less actively challenged brain results in lower brain cell reserves hastening onset of dementia symptoms.

  1. Sleep apnea reduces oxygen to the brain and has been linked to cognitive deficits related to Alzheimer’s.

  1. Impaired vision or hearing causes one to withdraw from social situations, which contributes to dementia.

  1. Stride or gait a shuffling gait or small steps may be an early marker of Alzheimer’s or Parkinson’s.

  1. Infections may cause long-lasting inflammation linked to Alzheimer’s.

  1. Family history – genetic history contributes to up to 5% of the incidents of dementia diagnoses.

  1. Finally, just living causes dementia. ';-)' If you live long enough, see item 1.

CAVEAT: These fifteen diagnostic criteria must be evaluated together. One criterion, such as item 12, could be caused by arthritis with no connection to dementia. A geriatric assessment team or geriatrician evaluates a variety of life factors that enable a proper diagnosis.

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