After changes in the patient’s cognitive function have been suspected with a positive initial brief cognitive evaluation/screening, it becomes imperative that the primary care physician seeks to rule out other potential causes in establishing a diagnosis of dementia. This would include a dementia workup including labs, structural head imaging such as an MRI.
The physician would evaluate the workup and could include further cognitive assessments through use of tools such as a mini–mental status examination (MMSE), Montreal Cognitive Assessment (MoCA), or other tools as preferred or a referral to a specialist. Based on the workup and assessments, the physician would communicate the cognitive impairment may be a dementia. At this point, MD weighs all the evidence and decides what type of dementia this may be and what stage they are likely in. Staging and type of dementia will help guide appropriate treatment and management strategies.
Once the diagnosis of dementia is confirmed, the patients need to be notified and the expected prognosis, what to expect from the disease, need for supervision, how to handle driving, legal and financial matters (or whom to refer to) and how to get social support for caregivers (day care, support groups, referrals for in home help or good assisted living or ECFs, etc.) need to be addressed.
Diagnosis and Disclosure Tools
The following is a list of tools and resources that you may find helpful:
Algorithm Guiding the Differential Diagnosis of Dementia
AD Medications Fact Sheet
Driving Information and Contract
Family or Caregiver Questionnaire
Patient Questionnaire
GP Management Plan /Team Care Arrangement – Dementia
Sample Dementia Care Plan
Clinical Dementia Rating (CDR)
Diagnosis and Disclosure Resources
Family Conversations About Alzheimer’s Disease, Dementia & Driving
AD Resources
After a Diagnosis
Disclosing a Diagnosis of Dementia
Disclosure of an Alzheimer's disease diagnosis
I Have Alzheimer's Disease
AA: LIVING WELL
TAKING ACTION
Communicating a diagnosis of dementia