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The difficulty in getting a diagnosis

Elderly man in blue sweater with family on sofa

You know that feeling when something isn’t quite right within yourself? It’s human nature to imagine the worst case scenario, first. Chronic, persistent pain or a lump under the skin? It must be cancer! Just ask Dr Google and you will be rewarded with your worst fears.

Well, it’s not always cancer.

And memory loss does not always mean it’s dementia either, but if it is, getting a diagnosis is important.

The brain is the most complicated and complex part of the human body. It is because of this complexity that doctors and scientists don’t completely understand how it works.

The average brain contains one hundred billion neurons, and information can pass between those neurons at speeds of up to 400 kilometres per hour. Symptoms of dementia can result from those neurons not communicating properly. But like so many other issues related to the brain, it’s not always easy to diagnose.

Dementia cannot be diagnosed with a blood test. Getting a diagnosis of dementia is a complicated process of elimination and can take anywhere from a few weeks to many, many months.

Diagnosis can be particularly difficult early in the condition. It is during this time that a period of monitoring (up to 12 months) may be needed before a diagnosis can be made. This can result in a stressful and uncertain wait for the person involved, and their family.

The reality is that some people miss out on a diagnosis because their symptoms are mistaken by family and friends as normal signs of ageing.

So, what are the steps and why does it take so long to diagnose?

Step one sounds fairly obvious but can often be the hardest. A visit to your doctor.

Your GP or healthcare professional will start with an assessment, taking into consideration your medical history, whether dementia runs in the family and any current medications. The aim is to try to rule out other possible causes for your symptoms. Perhaps you have an underlying yet treatable condition: a vitamin deficiency, infection, metabolic disorder, hormonal imbalance or a side effect from your existing medication.

With possible causes ruled out, the next step is to determine the cause of the symptoms and this will usually involve referral to a specialist: a geriatrician, a neurologist or a psychiatrist.

Your GP may use a series of short cognitive screening tests or refer you for more detailed testing. Depression can cause some symptoms of dementia and it is important to check this is not a contributing factor.

It is vital to determine the type of dementia as each different form, and there are over 100 of them, can present different symptoms and may require different treatments. This is where brain scans, such as magnetic resonance imaging (MRI) or positron emission tomography (PET), may be used. Scans will also rule out the possibility of stroke or fluid on the brain. Or cancer.

Developing better and more accurate ways to diagnose dementia earlier is a critical factor in the race to create new treatments that may slow or even halt its progression. We can but hope that it happens in our lifetime.

As for Dr Google, it’s probably best to ignore advice from a search engine. If you are concerned with memory loss, start with a phone call to your GP.

If you are concerned about dementia, contact Alzheimer’s WA on 1300 66 77 88.

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