What is dementia?
Dementias are medical disorders caused by impairment of brain function that affect everyday function – especially memory, planning, understanding, decision-making, social and self-awareness.
Dementia is caused by brain disease or injury, and is the most disabling condition of older adults. It is often a “silent partner” in health care and community settings, and can be present for several years before it’s recognized.
- Trouble with short-term memory
- Trouble communicating or finding words
- Getting confused or disoriented
- Making poor decisions
- Becoming more easily upset
- Behaving unpredictably
To learn more about dementia, please refer to our Dementia 101 infographic series:
What is early detection of dementia?
Early detection of dementia means identifying the problem when it is affecting a person’s life – before a crisis occurs. Not everyone is aware or will say they are having problems. Because many people living with dementia never report symptoms (e.g., changes in memory, thinking or ability to get things done), early detection strategies use a number of different but complementary approaches.
This usually starts with a conversation. First, ask about memory concerns or other symptoms, and also talk with someone who knows the person well (i.e., a family member or friend). Cognitive assessment methods can help: these include screening tools that use mental tasks to identify cognitive impairment (performance-based screeners) or changes in everyday functioning observed by others (informant-based screeners).
What is dementia?
Dementia can be detected wherever affected people are – in the kitchen at home, in the supermarket, at the bank, on the bus, at the park, at the food bank, in the senior center, during a blood draw for lab tests. Once detected, a clinician needs to know about it in order to assess and diagnose the problem.
We do want individuals experiencing cognitive changes (symptoms) and their family or friends who observe the effects of cognitive changes (signs) to pay attention, and bring those concerns and observations to a professional equipped to evaluate the situation. Don’t ignore these symptoms and signs! Everyone can play a part in detecting dementia.
Health care professionals – usually a physician, nurse practitioner, or physician assistant – are responsible for diagnosing dementia in their own patients, but this process works better when an individual or family member raises the concern. Providers are more likely to detect dementia when that happens! Some providers use routine screening approaches as part of a general exam, such as the Medicare Annual Wellness visit (AWV). The AWV requires detecting cognitive impairment as an essential component, but putting that into practice requires a strategy for how to do it. The simplest method is to ask about symptoms first (see “Prescreening Conversation” document and/or the KAER toolkit), and then to use a screening tool (performance- or informant-based). There is no consensus about whether or not to use screening tools with people who do not raise concerns, although we already know that doing so can increase recognition of dementia.
We do not expect strangers who see possible signs of dementia to report them to anyone, and it might be considered an invasion of privacy to do so unless there are obvious signs of danger. However, there are exceptions. Staff at community-based aging and service organizations often develop trusted relationships with community members and can observe signs of dementia and assist people with communicating with a health care professional. Some organizations, including Area Agencies on Aging (AAA) have developed training programs for staff on how to recognize dementia. AAAs exist in most communities. Click here to locate your local AAA. Additionally, people engage on a regular basis with community spaces such as local libraries, grocery stores, bakeries, faith-based organizations, parks, banks, and pharmacies and may have longstanding and relationships with staff and others who frequent those spaces. By taking a “whole-of-community” approach towards dementia detection, we envision building and sustaining entire communities that are age- and dementia friendly.