How is dementia diagnosed, and will it become Alzheimer's?
Is a diagnosis of dementia, based only on mini-mental tests and seven blood tests, a death sentence from Alzheimer's in the future?
I am also curious why doctor did not order CT scans/MRI's of the brain? I was under stress and had not eaten in 12 hours before the mini-mental was administered. Would that affect my performance, which was poor?
Expert Answer
Many people ask about the steps involved in diagnosing dementia and wonder about the accuracy of the process. To answer the question meaningfully, I think it best to clarify the term "dementia".
Dementia is not actually a diagnosis; it's a state of impaired thinking caused by some underlying medical condition. For example, Alzheimer's disease is a medical condition that can lead to dementia, a stroke can cause dementia, and so can a head injury. Alzheimer's disease is the leading cause of dementia but there are about a dozen other common causes (and many other less common causes).
While the mini-mental state exam (MMSE) can give a doctor a measure of how well your brain is working, it won't explain what medical condition might be impairing your thought process. In this regard, it is one early step in a diagnostic process to find the underlying problem that must be treated. Blood tests are a common second step as they can identify conditions such as thyroid disease and vitamin deficiencies that can also affect clear thinking.
According to published diagnostic guidelines, an MRI is a logical next step when no obvious problems are identified from the blood work. The MRI will show structural problems in the brain such as tumors or strokes and will help with an accurate diagnosis.
To be very direct in response to your specific question, Alzheimer's can not be accurately diagnosed solely with an MMSE and blood work. And yes, anxiety and fatigue may have negatively affected your score on the MMSE.
Finally, please be aware that an Alzheimer's diagnosis is not necessarily a death sentence. While approved treatments have only modest effects on average, some patients respond better than others, particularly when the disease is diagnosed at an early stage and timely intervention is prescribed. Patients who stay active (physically and mentally), eat well, take their medications, and control their blood pressure and cholesterol tend to do the best.