Test for Dementia

Dementia is a common, very debilitating disease, and it can sometimes be difficult to diagnose. There is no surefire way to test it at home, and a doctor's visit is highly recommended if you suspect symptoms. A friend or family member can administer the Mini-Mental State Exam for a general idea of cognitive function, but a doctor can make best use of the results.

Steps

Preparing for a Doctor's Visit

1. Make an appointment with a doctor. The other sections on this page contain tests which you can take at home. These can give you a little information if you have no other options, but they are not a good replacement for a doctor's diagnosis, according to the Alzheimer's Association.
2. Prepare your medical history. Some drugs, medical conditions, and family history (indicating genetic problems) can put you at higher risk of dementia. Others mimic some symptoms of dementia, such as memory loss, but can be reversed if the doctor discovers the cause. Be ready to give your doctor the following information:
   • Your diet, alcohol use, and drug use. Bring the bottles of any medication you are taking.
   • Other known medical issues.
   • Changes in your behavior (especially related to social situations or eating habits).
   • Which of your biologically related family members have had dementia or dementia-like symptoms, if any.
3. Take a physical exam. Since dementia can be caused by reduced blood flow to the brain, the physical checkup should include a blood pressure reading, taking your pulse, and a temperature measurement. Your doctor may also test your balance, reflexes, and eye movement, or perform a variety of other tests depending on your exact symptoms.
4. Take a cognitive exam. There are many types of mental exams used to test for dementia, some of which are included in this article. Some common questions include:
   • State the day, month, and year.
   • Draw a clock face at twenty past eight.
   • Count backward from 100 by 7s.
5. Undergo lab tests if necessary. If your doctor does not request blood samples or other lab tests, you might want to ask about thyroid hormone tests and vitamin B12 tests, since these are common tests that can potentially narrow down the cause of your symptoms. There are many other tests that could be requested based on your specific medical history, but those are not necessary for every patient.
6. Ask about brain scans. If you are showing some symptoms but the cause is not clear, the doctor may recommend a brain scan to investigate possibilities besides dementia. CT scans, MRI scans, and EEG tests are the most common types of scans used to help diagnose dementia-like symptoms.
   • If your doctor is considering an MRI, let her know about any implants or alterations that cannot be removed, such as tattoos, replacement joints, pacemakers, or shrapnel fragments.
7. Ask about genetic testing. Genetic testing is controversial, as even a gene linked to increased risk of dementia does not necessarily mean you will be affected. Still, if there is a history of dementia in your family, especially early-onset dementia, a genetic test could be useful to you or your doctor.

Taking a Mini-Mental State Examination (MMSE)

1. Understand that this cannot be used as the only method of diagnosis. The Alzheimer's Association does not recommend using home tests instead of a doctor's visit. Use this quick, 10-minute test only if you do not have immediate access to a doctor, or if you cannot convince a family member or friend to visit a doctor.
   • Do not take this test if you are not fluent in the language it is being given in, or if you have a learning disability or dyslexia. Visit a doctor instead.
2. Understand how to take the test. The person who has possible dementia-like symptoms just needs to listen to instructions. A second person reads the steps below, and gives instructions or asks questions directed at the person being tested. Take note of how many points the test-taker earns for each section. At the end of the test, add up the scores in each section. Any score of 23 or below (out of 30 total) suggests possible cognitive impairment, which could indicate dementia or other health issues.
   • No calendars should be visible during the test.
   • Usually, 10 seconds are given to answer each question, with 30–60 seconds for questions involving spelling, writing or drawing.
3. Test orientation to time (5 points). Ask the person suspected of dementia the following questions, one at a time, in order. Score one point for each correct answer.
   • What year is it?
   • What season is it?
   • What month is it?
   • What is today's date?
   • What is the day of the week?
4. Test orientation to place (5 points). Ask where the person is currently located, in five separate questions. Score one point for each successful answer to the following:
   • What country are you in?
   • What state are you in? (Or "province," "territory," or similar term)
   • What city are you in? (Or "town")
   • What is the address of this house? (Or "What is the name of this building?")
   • What room are we in? (Or "What floor are we on?" for hospital patients.)
5. Test registration (3 points). Name three simple objects (for example, "table, car, house"), and ask the person to repeat them immediately after you. You must say them all together, with pauses in between, and the test-taker must also repeat them back to you all at once. Also, tell them that you will ask them to recall these words in a few minutes.
   • Score one point for each word successfully repeated on the first try.
   • Keep repeating the three objects until the test-taker succeeds. Do not score any points for successes after the first try, but write down the number of repetitions it takes for the test-taker to remember all three objects. (This is used in some expanded versions of the test.)
6. Test attention (5 points). Spell the word WORLD ("W-O-R-L-D"). Then ask the test-taker to spell the word WORLD backwards. Score 5 points if he succeeds within 30 seconds, and 0 points if he does not.
   • Some medical professionals find it helpful to write down the exact response the test-taker gives to this question.
   • This step should not be translated into another language directly. Try to find a version of the MMSE in that language to see what word is usually used.
7. Test recall (3 points). Ask the person to repeat the three words you told him to memorize earlier. Score one point per word remembered.
8. Test language (2 points). Point to a pencil, and ask "What is this called?" Point to a wristwatch, and repeat the question. Score one point per correct answer.
9. Test repetition (1 point). Ask the person to repeat the phrase "no ifs, ands, or buts." Score one point if he succeeds.
   • This is another step that cannot be translated directly to other languages.
10. Test ability to follow complex commands (3 points). Ask the person to follow a 3-step command (3 points). For example, tell the person to take a piece of paper in their right hand, fold it in half, and put it on the floor.
11. Test ability to follow written commands (1 point). On a piece of paper, write "close your eyes." Pass the paper to the test-taker, and ask him to follow this command. Score one point if he does within ten seconds.
12. Test ability to write a sentence (1 point). Ask the person to write any complete sentence. If it includes a noun and a verb, and makes sense, score 1 point. Spelling errors do not matter.
13. Test ability to copy a drawing (1 point). Sketch a geometric design on a piece of paper: one pentagon (five-sided figure), with a second pentagon overlapping on one corner. Ask the test-taker to copy this design on his own piece of paper. Score one point if he succeeds in matching the following characteristics:
    • Two shapes, both pentagons
    • An overlap that creates a four-sided shape (or however many sides your original figure had).
14. Check the results. If the test-taker scores 23 or below, visiting a doctor is recommended. Do not attempt to tell the test-taker what the results mean, if you do not have medical training in this area.
    • If the results are 24 or above, but symptoms are still concerning, try taking the MoCA test as well.

Tips

• You can also take the Montreal Cognitive Assessment test, which is a newer test which is more sensitive to early cognitive changes.
• If a doctor or home test suggests there is nothing to worry about, but your symptoms get worse, visit another doctor for a second opinion.
• Cognitive changes in the elderly can be an indication of a number of reversible conditions, including vitamin deficiencies, thyroid abnormalities, medication side effects, and depression. Take your loved one to the doctor to have them screened for these conditions if you notice any concerning signs or symptoms.

Related Articles

• Communicate With a Person With Dementia
• Care for Someone With Dementia
• Recognize the Early Symptoms of Alzheimer's Disease
• Find a Nursing Home for Someone With Alzheimer's Disease or Dementia
• Recognize Signs of Senile Dementia
• Deal With Alzheimer's as a Caregiver

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