Dementia Screening and Diagnosis

The month of September is celebrated as Alzheimer’s Disease awareness month and 21st September is World Alzheimer’s Day. Dementia is increasing and by 2050 India is expecting 14.3 million people to deal with it. The COVID-19 pandemic has only worsened the scenario.

Dementia is a term used to describe a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with your daily life. It isn't a specific disease, but several diseases can cause dementia.

Importance of early detection

It has been shown in research that the average lifespan after the diagnosis of dementia is approximately 10 years, but it can be in the range of around 5 to 15 years. There is no complete cure for dementia. The three pillars of dementia care have been medication to slow down the disease, behavioural intervention and psychosocial support for the family/caregivers which enhances the quality of life of the patients and their caregivers.

Early detection is very important as it helps in earlier access to pharmacological, behavioural and psychosocial support. It allows the families to take plan for long term care. Handling legal matters and end of life support can also be dealt with earlier.

Role of Memory Screening Camps

A memory screening is an evaluation of memory and thinking skills. A memory screening is a simple and safe evaluation tool that checks memory and other thinking skills. It can indicate whether an additional check-up by a qualified healthcare professional is needed.

Early detection of dementia is very important to decrease the disease burden. This is where memory screening camps play a crucial role. It is important to understand the risk factors of dementia and do timely cognitive assessment.

Memory screening camps can be done with housing societies, senior citizen associations, hospitals, parks and community centres.

These camps include clinicians performing cognitive assessments in the form of scales. These can be done by a team of Geriatricians, Trained health care professionals, Psychiatrists, Neurologists and Clinical psychologists.

It should be done in government clinics as well as private healthcare clinics.

These camps are important as:

1. They help in assessing mental health of older adults and detect early signs of cognitive impairment
2. To raise awareness of risk factors and dementia
3. To develop an understanding of the difference between normal ageing and dementia
4. To identify cases of anxiety and depression
5. To encourage preventive action against developing cognitive impairment
6. To help older adults to live productively as they age
7. To provide a baseline cognitive assessment for future reference
8. To sensitize older adults regarding cognitive impairment

When to do a Memory screening?

Memory screenings make sense for anyone concerned about memory loss or experiencing warning signs of dementia; whose family and friends have noticed changes in them, and for those who believe they are at risk due to a family history of Alzheimer’s disease or a related illness. Screenings are also relevant for anyone who does not have a concern right now, but who wants to see how their memory is now and for future comparisons.

The following questions when in the affirmative will need a memory screening.

1. Am I becoming more forgetful?
2. Am I having trouble concentrating?
3. Do I have difficulty performing familiar tasks?
4. Do I have trouble recalling words or names in conversation?
5. Do I sometimes forget where I am or where I am going?
6. Am I misplacing things more often?
7. Have I been reminded by my family or friends that I often repeat questions or say the same thing repeatedly?
8. Do I get lost when walking or driving?
9. Have my family or friends noticed changes in my mood, behaviour, personality, or desire to do things?

Diagnosis

1. Cognitive and Neurological Tests - These tests are used to assess thinking and physical functioning

2. Blood Tests - To rule out Hypothyroidism, Vitamin Deficiencies (Vit B12/Folic Acid)

3. Brain Scans - These include CT Scan, MRI Scan and PET Scan

4. Mood Assessment - Depression cannot be missed!

Screening for Caregiver stress is also very important.

Sharing some strategies for prevention of dementia:

1. Regular exercise

2. Social engagement

3. Healthy diet

4. Mental stimulation

5. Quality sleep

6. Stress management

Memory screenings help in pointing in the right direction. Early detection helps in better care.

Let us remember those who forget.