What's So Important About a Diagnosis?

When I meet with an elder to conduct an assessment, I often learn that he or she has a memory problem. Unfortunately, many elders and their families do not have good information about memory loss, including what the term "dementia" means and the significance of a dementia diagnosis.

Dementia is an "umbrella" term that refers to an array of symptoms. A person with dementia exhibits problems with his or her memory as well as his or her ability to plan or think abstractly; to produce or understand language; to recognize or identify objects; or to perform motor activities such as walking or grooming. Having a memory problem by itself does not mean that the individual has dementia.

It is critically important for elders and their families to know whether the elder has Alzheimer's disease which accounts for approximately 2/3 of dementia cases, or one of the many other types of dementia such as those caused by head trauma, alcohol use or metabolic disorders.

Why is having a clear diagnosis so important?

• Some memory-impairing conditions are not considered to be dementia and should be handled differently. For example, a delirium is a change in cognition due to a medical cause such as a urinary tract infection which can be reversed when the condition is treated.


• The type of dementia determines the treatment options available. Someone with dementia related to Parkinson's disease will have different options available to them versus someone with a Alzheimer's diagnosis.


• If the elder has a clear dementia diagnosis, his or her physician may recommend psychotropic medications that may slow the progression of memory loss.


• The family has the opportunity to plan for the course of the illness as different types of dementia can have different symptoms and prognoses. It is important for families to be able to plan emotionally, we as make financial and legal arrangements.


• The elder may choose to enter into a clinical trial and possibly benefit from investigational medicines or treatments.

I encourage older adults and their families to talk with their physicians if the elder is experiencing memory problems, or symptoms such as paranoia or problems with language. Neurologists and psychiatrists are physicians with specialized training in diagnosing dementia and managing symptoms; in addition, there are diagnostic programs with teams of professionals who help to make the diagnosis and establish the plan of care.

While it is daunting for most people to consider the fact that they may have dementia, an early diagnosis can empower elders and their families to make informed choices about their care.