Diagnosing dementia

What if you think someone you know well is suffering from dementia? Who should you go to then? It is very important that this is investigated. In some cases this is not dementia, but a brain tumor, for example. There are so many diseases that have the same symptoms, so an investigation is definitely necessary.

Research of great importance.

When it comes to dementia, making a diagnosis is very important. It is also very important that a diagnosis is made quickly. When it comes to a memory problem that needs to be resolved, it is important that something is done quickly before the memory is permanently affected. Just think of someone who has a B12 deficiency (this will be explained further in the text). Detecting dementia is also of great importance for covering the costs of further treatment.

The GP’s examination.

If someone thinks they have dementia, they should go to the doctor. The GP then asks all kinds of questions to bystanders of his patient (heteronamnesis) and the patient himself (anamnesis). This is to assess whether someone really has dementia or whether it is due to something else. The assessment is made by requesting medical history, but the use of medicines, diet, behavioral characteristics and difficulties with daily activities are also important information that contributes to the assessment.

When taking the anamnesis, the GP mainly looks at:

  • How the person follows the conversation.
  • Whether the person can express her words well.
  • Or that person mixes things up.
  • Whether the person in question can still do daily things, such as cooking, dressing or even how the person eats with the cutlery.
  • Whether the person has difficulty recognizing objects.
  • Whether that person still oversees daily things.
  • Whether the person is also slower to understand.
  • Whether the person in question also needs to be motivated to do something.


Examinations in the hospital

The GP almost always refers the patient to a neurologist, because dementia takes place in the brain. This is to rule out tumors or other possibilities or to determine the treatment of the incipient demented person. The treatment is not the same for every form of dementia. Different medications are prescribed for each different form of dementia.

The most important studies

  • During a neurological examination they can rule out tumors, intoxication (poisoning) or a stroke. A stroke is caused by a clogged artery in the brain or blood clots in the brain that can block the blood supply. This blockage in the brain can result in a cerebral infarction, TIA, or a cerebral hemorrhage
  • mini-mental State examination is an international test that provides a good idea within ten minutes of whether the person in question has dementia at all. This research consists of all questions regarding orientation in time and place, but also arithmetic functions, memory functions, language functions, etc.
  • The EEG examination consists of a test in which brain activity is measured on the surface of the skull. Doctors can demonstrate or rule out vascular disorders, consciousness disorders, epilepsy or other cerebral abnormalities. Cerebral abnormalities are abnormalities in the central nervous system. Vascular disorders are blockages in the blood vessels in your body as a result of which organs (including your brain) no longer receive enough oxygen and will eventually die little by little. By disorders of consciousness we mean that the person in question responds too much, too little or no longer responds to stimuli at all. Vascular disorders in particular have symptoms that also correspond to the symptoms associated with dementia. The oxygen supply to the brain can also be affected by vascular disorders.
  • An extensive blood test can show whether there is something wrong with the thyroid, liver or kidneys. This blood test can also see whether HIV is involved and whether there is a vitamin B12 deficiency. This is an important vitamin that ensures that enough red blood cells are produced. Red blood cells contain a substance called hemoglobin that absorbs oxygen. A shortage of red blood cells therefore means a shortage of oxygen absorption. A vitamin B12 deficiency also causes mood swings, fatigue, memory problems, and problems with speaking and walking. In short, the symptoms of a vitamin B12 deficiency resemble the symptoms of dementia. If you are deficient in this vitamin for too long, you can even develop dementia.

At the end of this study it can be clearly determined whether the person in question indeed suffers from dementia. The treatment can be determined and, if necessary, the person in question must go to a care institution, because you should not underestimate caring for a person with dementia.

Medication for people with dementia

The medicine against dementia has not yet been invented, but there are medicines that can slow down the process of dementia. Two things are paramount: treating symptoms and slowing down the process.

  1. Medication to treat the symptoms is often common medication, for example; behavioral disorders, sleep deprivation. This means medications such as antidepressants, sleeping pills or tranquilizers.
  2. Medication to slow the disease consists of three types of medications that together are called acetylcholinesterase inhibitors. This term consists of the medications rivastigmine, galantamine and memantine.

Rivastigmine is able to delay physical decline by approximately six months. Language use, arithmetic skills and orientation skills also improve after using the medicine. Rivastigmine has more side effects than galantamine, such as; fever, sweating, trembling, listlessness, drowsiness, fainting, hypersensitivity, liver disorders, palpitations and cardiac arrhythmias, loss of appetite and therefore weight loss, nausea. These symptoms do not apply to every user of the drug. Driving is therefore not possible in this case. Rivastigmine is mainly used in the early stages of dementia.
Galantamine improves language use, arithmetic skills and orientation, but not only has advantages. Driving is no longer allowed while taking galantamine. Nausea, vomiting, drowsiness and dizziness, and cardiac arrhythmia may also occur as side effects and it is also intended for use by beginners.
Memantine ensures that there is a normal amount of glutamate in the brain. Glutamate is a substance in the brain that stimulates the neurotransmitters (substance that transmits signals) in the brain. However, too much glutamate in the brain can cause a disruption (sometimes permanent) and then the signals no longer arrive properly, or not at all. Some side effects when using memantine drug can be; fatigue, shortness of breath, constipation. In some cases, fungal infections, thrombosis or epilepsy may also occur as side effects and is suitable for a further phase in the dementia process.
So it is very important to see a doctor. People with early onset dementia in particular benefit greatly from this use of medication.

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