When it comes to dementia, many families suspect their loved one has developed the condition long before a formal diagnosis. In fact, it's likely families have been noticing symptoms several years before a diagnosis is made.
Still, despite having suspicions for years, going through the process of getting a formal dementia diagnosis can be a worrying and uncertain time for all involved - particularly since there may be no certainty at all.
How is dementia diagnosed?
Currently, diagnosing dementia is often a difficult, lengthy and intensive process. Because there is no definitive test, doctors need to use a variety of tools to reach a diagnosis. These may include taking a detailed medical history, running memory and thinking tests (known as neuropsychological or cognitive tests), laboratory tests and brain scans.
Frustratingly, even after extensive testing, there may not be a definitive diagnosis. Instead, the eventual diagnosis may be 'possible' or 'probable' dementia (although diagnosis accuracy even in these situations is around 90 per cent).
What does the future of dementia diagnosis hold?
While receiving a diagnosis of dementia can be difficult to deal with, early diagnosis benefits both the person affected and their family. The earlier the condition is diagnosed, the quicker everyone involved can come to terms with it, and begin to make plans for the future.
While there is no one test that accurately diagnoses dementia, the good news is that much research is being done to develop better tools for a more accurate and early diagnosis.
In particular, scientists are currently working towards the ability to make a pre-clinical diagnosis of dementia. This means, that instead of waiting for symptoms to develop, medical practitioners will be able to predict who is likely to develop the condition. This will enable people to undertake lifestyle prevention strategies in order to delay dementia onset, and to begin earlier treatment in order to slow or halt disease progression.
Currently, there are three major areas of diagnosis research:
1. Biomarker analysis:
Researchers are currently searching for biomarkers (biological markers) for dementia that indicate the presence of disease. While several possible biomarkers for Alzheimer's disease have already been identified, testing for them involves a spinal tap - collection of fluid from around the spinal column. Researchers are currently investigating whether similar biomarkers can be found in blood, and if so, will aim to develop a simple blood test to check for them.
This involves looking at the brain through a range of computerised screening tools called tomography. Currently several brain imaging tests are used to aid dementia diagnosis. Researchers are further refining these tests to make them more widely available.
In addition, international researchers are working on standardising the scanning and analysis techniques used in magnetic resonance imaging (MRI) to develop a database of scans of people with dementia. The hope is that scans of people from around the world could be compared with those in the database to help establish whether the scan is normal, or it suggests signs of dementia.
3. Neuropsychological testing:
Memory and thinking tests form an important part of the diagnosis process. However, current tests have flaws - they can be hard to administer and interpret, and may show bias regarding cultural background or education levels. Researchers are currently developing tests that provide better accuracy, as well as tests targeted to those from different cultural backgrounds.
Researchers are also developing tests designed to detect very early changes in cognitive function, meaning a pre-clinical diagnosis is more likely.
Currently there is no cure for dementia. However, scientists hope that ongoing research will lead to medical practitioners being able to accurately diagnose different types of dementia at pre-clinical stages.
This would be an important breakthrough, allowing early treatment of dementia and eventually prevention of this condition, once effective therapies have been identified and developed.
You may wish to read more about dementia, including dealing with dementia in the family. Or, to search for a care option to support someone with dementia, start a care summary.
Statistics, last updated June 2015; accessed 17 January 2016 https://fightdementia.org.au/about-dementia/statistics
Research into better ways of diagnosing dementia, accessed 17 January 2016 https://fightdementia.org.au/research-publications/research/areas-of-dementia-research/research-into-better-ways-of-diagnosing-dementia
Early diagnosis of dementia, accessed 17 January 2016 https://fightdementia.org.au/about-dementia-and-memory-loss/am-i-at-risk/diagnosing-dementia/early-diagnosis-of-dementia