As a psychologist doing neuropsychological testing with older adults, I often speak to patients and families about dementia. There are many misconceptions about what dementia is and is not, and I find that it’s not always well understood by people outside the medical profession. Hopefully, this information will help clarify what dementia is, how it is different than other conditions, and how dementia testing can help.
WHAT IS DEMENTIA?
Dementia is a general term for loss of cognitive function — memory, thinking, problem-solving, and language — that gets in the way of daily life. It can be caused by several different types of changes to the brain. Here are the most common:
Alzheimer’s disease: The most common type of dementia, which causes gradual cognitive decline, often over about a decade.
Lewy body dementia: The second most common type of dementia, caused by abnormal deposits in the brain, and with symptoms similar to the cognitive decline that can occur in Parkinson’s disease.
Vascular dementia: Caused by cardiovascular problems that harm the brain, sometimes gradually over time (for example, high blood pressure), and sometimes suddenly (for example, a stroke).
Frontotemporal dementia: This type of dementia impacts the frontal lobes of the brain first (the part behind our foreheads), and can cause personality change, and eventually other cognitive problems.
What Is Not Dementia?
Because dementia is a general term, I often hear it misused or misunderstood. There are various reasons for cognitive changes, and they are not all dementia. Dementia is different than:
Delerium:
A temporary change in cognition that often involves confusion, disorientation, and poor memory. Delirium can happen in response to a medical emergency, a reaction to a medication, a vitamin deficiency, or other immediate medical causes. Delerium is a medical emergency and must be treated as soon as possible. Fortunately, delirium is usually treatable, and the person can return to normal brain function once the cause is addressed.
Depression:
This common mental health condition can cause symptoms such as sadness, fatigue, and difficulty concentrating. These symptoms can sometimes look like dementia. When a person is depressed, they may not pay attention to what is happening around them, which can impact memory. Depression is also treatable with therapy and medication, and once depression is treated, people often see an improvement in their cognition as well.
Hearing loss:
Hearing loss can make it difficult to understand speech, which can lead to problems with memory and communication. Many times, people assume that because someone has a hearing impairment, they have a cognitive impairment, but of course, they are two totally different conditions.
Vision loss:
Vision loss can also make it difficult to understand and remember things. Again, just because someone has impaired vision does not mean anything about their cognitive function.
Vitamin B12 deficiency:
Vitamin B12 is essential for brain health. A deficiency in vitamin B12 can cause symptoms such as fatigue, memory problems, and confusion.
Thyroid problems:
The thyroid gland produces hormones that help regulate metabolism. Thyroid problems can cause a variety of symptoms, including fatigue, weight gain, and cognitive changes.
Speech problems:
Speech problems such as a stutter or slowed speech after a stroke do not have any bearing on cognitive function, and do not, by themselves, indicate dementia.
Neuropsychological Testing in Dementia
Dementia is not a normal part of aging. Although age is the biggest risk factor for dementia, most older people don’t have dementia.
There’s no cure for dementia, but there are treatments that can help manage symptoms and improve quality of life. As you can see, there are many potential causes of cognitive change that can look like dementia. Neurological tests and brain imaging can give some information that helps with a clear diagnosis in cases of cognitive change, but many brain changes are similar across conditions, and not visible on brain imaging until very late into the disease. This is where neuropsychological testing comes in.
Neuropsychological testing is a type of assessment that evaluates a person's cognitive abilities. It is used to diagnose dementia and other brain disorders, as well as to measure the severity of cognitive impairment and track changes over time.
Neuropsychological tests can measure a variety of cognitive abilities, including:
Memory
Attention
Language
Problem-solving
Visual-spatial skills
Executive functions (planning, organizing, and decision-making)
Neuropsychological testing is typically conducted by a psychologist or neuropsychologist; these are doctors who specialize in the assessment and treatment of brain and behavior disorders.
A NEUROPSYCHOLOGICAL ASSESSMENT CAN HELP WITH DIAGNOSING DEMENTIA
Neuropsych testing can be a valuable tool for diagnosing dementia. We can identify patterns of impairment that give information about the cause of brain and behavior changes, including what type of dementia a person may have, or whether there is another explanation for their cognitive change.
For example, people with Alzheimer's disease typically have difficulty with memory and executive functions. People with vascular dementia may have difficulty with attention and processing speed. People with Lewy body dementia may have difficulty with visual-spatial skills and executive functions.
Neuropsychological testing can also help to rule out other medical conditions that can cause cognitive impairment, such as depression, vitamin deficiencies, and thyroid problems.
NEUROPSYCH TESTING CAN HELP WITH MANAGING DEMENTIA
Neuropsych assessment with a psychologist is also helpful for managing dementia. When we know the areas of cognitive decline (for example, memory), we can recommend specific strategies to support the person in need (for example, using reminders and cues in ways that will work best to support that person’s memory).
Neuropsych testing can also be used to track dementia over time. We can monitor cognitive change, which can inform things like managing money, living independently, and what type of assistance could help someone remain independent for as long as possible.
THE BENEFITS OF DEMENTIA TESTING
Neuropsychological assessment offers a number of benefits for people with dementia and their loved ones:
Accurate diagnosis: Neuropsychological testing can help to accurately diagnose dementia and rule out other medical conditions. Remember, there are some treatable causes of dementia; an accurate diagnosis could be life-changing!
Individualized treatment: By identifying the specific cognitive deficits that a person is experiencing, neuropsychological tests can help to guide treatment and support services.
Tracking progression: Neuropsychological testing can be used track changes over time, and help adjust treatment and support as things change.
Education and support: Neuropsychologists know a lot about dementia, and can help patients and families understand what is happening, what to expect in the future, and how to plan and support one another.
Begin Dementia Testing in Los Angeles, CA
If you are concerned that you or someone you know may have dementia, it is important to talk to your doctor, and potentially consider neuropsych testing for dementia. Dr. Reger is happy to offer dementia testing and other support from her Los Angeles, CA-based practice. You can schedule an appointment by following these steps:
Reach out for a free consultation.
Schedule neuropsychological testing with Dr. Reger.
Start receiving the support you deserve!
OTHER THERAPY AND TESTING SERVICES OFFERED IN LOS ANGELES, CA
I know that you may need more support in addition to neuropsychological testing. This is why I’m happy to offer several types of assessments and services around Southern California. Other services I offer include psychological evaluations for workers’ comp, preoperative assessments, individual therapy, and therapy for older adults. Visit my blog for more helpful information today!