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Early diagnosis of dementia: pros and cons
Expert reviewer Professor Graham Stokes, Bupa Global Director of Dementia Care
Next review due September 2020
Not everyone agrees about the best time to go the doctor with possible signs of dementia. Some people think it's best to find out as soon as possible. Others feel they would rather not know.
There's no right or wrong answer. Every person has to do what they think is the right thing for them. We've set out some pros and cons to help you think about the issues and decide what's best for you and your family.
What's the difference between Alzheimer's and dementia?
This video answers your questions, including symptoms, treatment and risk factors
Early diagnosis: the pros and cons
There are many benefits of an early diagnosis of dementia. You may want to talk these over with other members of your family or your GP.
Early assessment of symptoms
Sometimes, a person may have symptoms that are similar to dementia but which are actually caused by another medical condition that could be treated. Getting a proper diagnosis can make sure everything possible is done to treat the symptoms.
Some symptoms that are caused by dementia are also treatable. For example, many people with dementia have depression. This can make coping more difficult because they are more withdrawn and less interested in things. Dementia symptoms such as depression and agitation can be treated more successfully if they're picked up early. Other common problems in older age, such as deafness, may make symptoms like confusion worse.
Access to dementia medicines
Treatment is available for some types of dementia, including Alzheimer's disease and dementia with Lewy bodies. Medicines for Alzheimer's disease should be started when the condition is in its early stages. These medicines can help to slow the development of the condition, reduce symptoms and improve quality of life. In dementia with Lewy bodies, the same medicines can improve both mental function and behaviour.
These are prescription medicines, so if someone doesn't have a diagnosis, they won't have access to them. This is another reason why early diagnosis is important.
Getting advice and support
With a positive diagnosis, you'll be able to access information and support services that are there to help people with dementia and their families. Charities like Alzheimer's Society have a lot of information about dementia and coping with it. There may be local support groups you can contact. Some areas have Admiral Nurses who support people with dementia and their carers. They can tell you about other local services, such as memory clinics.
Making plans
Early diagnosis gives people with dementia and their relatives the opportunity to plan for the future. This will make things easier in the long run. The person with dementia can participate more in the decision-making, as they will have the capacity to do this earlier in the condition. An early diagnosis also gives you all more time to discuss treatment and care options, as well as practical and financial arrangements.
Explaining what's happening
Having a diagnosis can give you an explanation for early symptoms. Behaviour changes or unusual decisions the person with dementia has made may make a bit more sense in light of the diagnosis. When there is an explanation for symptoms, it can make them easier to cope with. It also means you have more idea what to expect in the future.
Time to adjust
A person with dementia is often first assessed after a crisis has occurred, like an accident or forgetting to pay bills. Getting an early diagnosis gives everyone time to adjust before things become critical.
It's common for families to feel sad, frustrated, angry and irritable. You need time to come to terms with the diagnosis and the feelings it stirs up. Early diagnosis can help carers to feel more supported and cope better. It can also enable the person with dementia to stay in their own home for longer.
Not surprisingly, some people have quite negative feelings about dementia. They may prefer not to know. It's almost as if putting a label on the symptoms makes it real. Not knowing also means that you can avoid some difficult and upsetting conversations.
For some types of dementia, there is a lack of available treatment. You may feel that if nothing can be done, there's no point in having all the stress and upset that assessment and diagnosis will inevitably cause.
The arguments for early diagnosis are not really scientific. They are largely common sense. There isn't the conventional research evidence that can persuade people that it's something they should do.
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Here are two real-life quotes showing some of the different feelings that people have about early diagnosis.
"My father-in-law knows what he has and since his diagnosis it's meant his behaviour has improved. He's not frustrated by his behaviour because he knows why he's like that. His mood has improved."
"We are at the learning stage. Not everybody wants to know that they may have dementia and my husband is really stubborn."
Professor Graham Stokes, Bupa Global Director of Dementia Care:
'At Bupa, we think that early diagnosis for dementia is helpful. As we hope we've shown, it can help to avoid a family crisis by getting practical and emotional support in place as quickly as possible. It will also help to:
get treatment started when it's most effective
plan for the future and come to terms with what to expect
get important arrangements in place, such as Lasting Power of Attorney and plans for future care
access information and support services
Just as importantly, early diagnosis of dementia allows you to take some control over the situation. Feeling out of control can be very disheartening. Being able to get some plans in place for finances and care can reassure you that you and your family are coping with the situation as well as you can. Professionals and others living with dementia and their carers can give tips on making life easier; for example, practical ways to establish a comforting routine. This can do wonders for confidence and mood.
Finally, and probably most importantly, getting a diagnosis early on means that the person with dementia can take part in all of these conversations. Dementia nearly always comes on gradually. Early diagnosis is likely to mean that a person with dementia can understand their options and explain how they feel and what they would like. Knowing a loved one's wishes may later be a source of support and comfort, when the person is unable to make decisions for themselves.'
What tests are there for dementia?
The most widely used test for dementia is called the Mini-Mental State Examination, or MMSE. There are others, called the GPCog, Memory Impairment Screen and Mini-Cog, but they're all similar. They are designed to pick up issues in a number of areas known to be a problem in dementia, such as memory, concentration and attention.
A range of health professionals often work together to carry out this testing. This can include a psychiatric nurse and a psychologist. As part of the test, they may ask the person being tested to:
repeat words back to them
name as many of something as they can (animals, for example)
do some simple maths
follow simple commands
do some simple drawing, such as copying shapes or drawing a clock
They will also ask questions to find out whether the person knows where they are, what is happening and the time and date.
If your loved one is being tested, it's important not to jump in to help. You'll be able to answer most of the questions, but the purpose is to see if your loved one can remember for themselves. The way they answer the questions can also reveal more about their condition. For instance, they may or may not remember the right words to use, or speak fluently or hesitantly. You may be asked for any missing information later.
Diagnosing dementia is difficult, particularly in the early stages. No single test can provide a definite diagnosis. In some cases, mental examination tests might be repeated a few months later to see if the results have changed.
While it's understandable that many people look for information on how to diagnosed dementia, it isn't possible to diagnose dementia yourself. It's really important to see a doctor if you're concerned about yourself or a loved one. This is because you can then access available treatment. The doctor will take the results of the mental state exam into account when coming to a diagnosis. But they'll put it together with the results of a physical examination, any physical test results, any dementia symptoms, past medical history, and general mood and appearance.
You may find quizzes and tools online that claim to be able to spot dementia symptoms. Some may be based around the tests that clinicians use, but it's important to remember that these don't work as stand-alone tools. They always need to be delivered and interpreted by a medical professional.
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Author information Author information
Reviewed by Graham Pembrey, Lead Health Editor, Bupa Health Content Team, September 2017
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