Who gives a diagnosis of dementia? [3 most common]

Welcome back, Careblazer. Today I want to spend some time talking about the different types of healthcare providers that are involved in the diagnosis of dementia. It can be pretty confusing to figure out what type of providers specialize in dementia and what ones your loved one may benefit from seeing. So in today’s post, I’m going to cover the most common types of dementia providers and how they can be helpful to you and your loved one. Because there are SO many different types of providers that can play a role in good dementia care, I’m going to focus on those most important for assessing dementia. And in a future post, I’ll talk about those that are really important for giving treatments for dementia and the symptoms of dementia. 

If you would rather watch a video on this topic, click here.

Let’s start first with the PCP. This is where most of you will start the process of getting a dementia diagnosis and it’s a really great place to start because there are many different conditions that can look like dementia and the PCP can help rule some of those conditions out by running different tests. It’s likely the PCP will also order some lab results here to make sure things are looking normal and there’s not some other underlying reason causing thinking problems. As I’ve mentioned before, dementia is a last resort diagnosis. We call it a diagnosis of exclusion because it’s important to exclude all other possible causes for the thinking problems before coming to a diagnosis of dementia. 

Okay, so based on the lab tests and evaluations the PCP runs, they may diagnose the dementia - this is usually done at this level if the dementia is pretty moderate to severe. It’s when the disease is so apparent, the PCP determines there doesn’t need to be any further assessment. And if there is any memory testing done at all at this level, it’s usually a very brief screening measure that can be done in about 10 minutes. Again, the diagnosis of dementia is usually not going to come from the PCP unless the dementia severity has progressed so far to the point that it is apparent and there were no other suspicious reasons for the problems. More likely, they will refer. 

For most people, the PCP will likely refer them to another provider. Now, at this point the PCP can refer to several different types of providers. To see my video on how dementia is diagnosed, you can click here. One of the providers they may refer to will be a neurologist. 

Neurologist. At this point the neurologist will do a physical exam, perhaps do more blood work, and even order brain scans to get a better idea of what’s going on. They are a specialist in the brain and how it works. At this point, the neurologist may give a diagnosis of dementia and maybe even prescribe medications for the dementia. In some cases, the neurologist may want additional information to be sure. This is where they will refer to a neuropsychologist.

Neuropsychologist. The neuropsychologist is an expert in brain body behavior. This is where the person will go through a series of pencil and paper testing. They will be asked various questions and do various different tasks like count backwards or put some blocks together. There are a lot of different tests to give here. The main point I want to make here is that the neuropsychologist is usually doing in-depth testing. This is way more than any 10 or 15 minute measure that your loved one may have received in a PCP office. The in-depth testing helps identify your loved one’s strengths and weaknesses and from that information very specific information about how your loved one learns best and best approaches to take can be made. Any good neuropsychological assessment will also include mood evaluation because things like depression can look like dementia. 

Now those are the 3 main providers that would be involved in the assessment of dementia. But I want to share 2 other types of providers that are very important when it comes to the assessment of dementia.

Audiologist/Optometrist

I’d say the other 2 providers that are really important and should likely be consulted at the beginning of any suspected cognitive decline are audiologists and optometrists. Especially audiologists. So much of what appears to be memory problems can really be caused by hearing or vision problems and by making sure both of those things are functioning as good as possible, you can get a more accurate understanding of your loved one’s abilities. It may be that your loved one still get diagnosed with dementia, but after cleaning the ears or giving hearing aids if needed, the level of impairment may not be as bad as it first seems.

I’m going to stop there. There are so many other professionals that are helpful in this disease process. I’ll do a video next week on the different types of providers important for the treatment of dementia and dementia symptoms. 

If you have any follow-up questions you’d like me to answer, leave them below in a comment and I can do a future video on them. 

Have a great week Careblazers!