Caregiver guide
How is dementia diagnosed? Getting a proper diagnosis
Dementia is diagnosed by ruling out other causes. A doctor, often working with a specialist, takes a medical history, tests memory and thinking, does a physical and neurological exam, orders lab tests, and may order brain scans. There's no single test, so a thorough evaluation matters.
Why a proper diagnosis matters
Diagnosing Alzheimer's disease is a process of ruling out other conditions that could be causing the symptoms, such as memory loss, confusion or personality changes. There is no single "test" that can diagnose Alzheimer's. Many other conditions can look like it, and some of them can be treated. That's why a thorough evaluation is so important.
It also matters because dementia isn't one disease. It's a group of symptoms with many possible causes, including Alzheimer's, vascular dementia and Lewy body dementia. If a doctor says "dementia," it's fair to ask, "Which type?" The answer can shape treatment and planning.
If you've noticed changes in your mom, dad or spouse and you're not sure what to do next, you're in the right place.
Who should we see first?
Start with the family doctor. Talk with them about the symptoms you've noticed, and ask for a basic check of physical and mental health.
We also recommend seeing a specialist who is trained and experienced in dementia and Alzheimer's disease, such as a geriatrician (a doctor for older adults) or a neurologist (a doctor for the brain and nervous system). A geriatric psychiatrist, a neuropsychologist or a memory disorder clinic can also help. The specialist will run a series of checks to rule out other conditions that may be causing early Alzheimer's-like symptoms.
Not sure where to find a specialist in Central Florida? Our Information & Referral service can point you to local physicians and memory clinics.
What happens during a dementia evaluation?
A proper evaluation includes, but isn't limited to, these steps. They may happen over more than one visit.
Medical history
The doctor interviews the person and close family members. They gather information about past and present health conditions, family history of illness, what the symptoms are, and when they first appeared.
Mental status evaluation
Short tests check whether the person knows the time and place, and look at thinking skills, short-term memory and the ability to do simple math. Learn more in our guide to cognitive assessment.
Physical exam
The doctor checks general health and nutrition, blood pressure and pulse. The exam helps rule out heart problems, hardening of the arteries, and kidney, thyroid or liver disease, all of which can cause dementia-like symptoms.
Lab tests
Blood and urine tests look for infections, anemia, liver or kidney problems, diabetes, low vitamin levels and abnormal hormone levels.
Brain activity and imaging
A CT scan or MRI can show brain shrinkage, tumors, strokes or blood clots. A PET or SPECT scan shows how well parts of the brain are working. An EEG records brain wave activity.
Neurological evaluation
The doctor tests the nervous system: coordination, the senses, speech, eye movement, muscle tone and strength. This helps rule out Parkinson's disease, stroke and brain tumors.
Will a brain scan show dementia?
A brain scan can show a lot, but it can't diagnose dementia on its own.
An MRI or CT scan can show shrinkage in certain parts of the brain, signs of past strokes, tumors or bleeding. That helps the doctor rule out other causes and can point toward a type of dementia, such as vascular dementia. Some people have a normal-looking scan in the early stages, so a normal result doesn't always rule dementia out.
Some specialists also use newer tests, such as special PET scans or blood or spinal fluid tests that look for proteins linked to Alzheimer's. These are one part of the evaluation, along with the history, memory tests and exam. Ask the doctor which tests they recommend and why.
How do I get a dementia diagnosis for a parent?
Many adult children notice the signs first. Mom repeats the same story, Dad has unpaid bills piling up, or a parent gets lost driving a familiar route. Here's how to move forward:
- Write down what you've seen. Note specific examples and when they started. Small details help the doctor.
- Share your concerns with the doctor before the visit. A short letter, a patient-portal message or a call to the office lets the doctor know what to look for. With your parent's permission, the doctor can talk with you directly.
- Go to the appointment. Your parent may not remember everything, or may say everything is fine. You can fill in the gaps and take notes.
- Bring a list of every medicine and supplement. Some medicines can cause memory problems.
- Ask for a referral to a specialist if the family doctor isn't experienced with dementia.
- Ask about the next steps before you leave: more tests, a follow-up date and who to call with questions.
What if your parent says nothing is wrong? Denial is very common, for the person and for the family. Try calling it a routine checkup or a medication review instead of a "memory test." Remind them that some causes of memory problems can be treated. If you're stuck, a free Care Navigation session with ADRC can help you plan the conversation.
Is it worth getting a dementia diagnosis?
Yes. Many families put it off because they're afraid of the answer. But a proper diagnosis helps in several ways:
- It may find something treatable. Thyroid problems, low vitamin B12, infections, medicine side effects, depression and sleep problems can all cause memory trouble, and they can often be treated.
- It opens the door to treatment. Some medicines may help with symptoms for a time. See our guide to medications and Alzheimer's.
- It gives time to plan. Your person can take part in legal, money and care decisions while they still can.
- It helps you understand. Knowing what's causing the changes can make the behavior easier to understand and less personal.
- It connects you to help. Support groups, education and research programs, like the State of Florida Brain Bank, often require a diagnosis.
Once you have a diagnosis, read our guide on what to do after a dementia diagnosis.
You don't have to figure this out alone
Getting a diagnosis can take weeks or months, and the waiting is hard. The Alzheimer's & Dementia Resource Center (ADRC) in Winter Park offers free help for families at every step:
- Care Navigation, free one-on-one sessions to talk through what you're seeing and what to do next.
- Information & Referral, help finding specialists, memory clinics and other local services.
- Caregiver support groups, free groups in person and online, where you'll meet people who've been through it.
For more answers about stages, types of dementia and memory screening, see our Alzheimer's and dementia FAQ.
Need someone to talk to right now, day or night? Call the Alzheimer's Association 24/7 Helpline at 800-272-3900. In an emergency, call 911.
Dementia diagnosis: common questions
How do doctors confirm dementia?
Doctors confirm dementia by putting several pieces together: a detailed medical history, memory and thinking tests, a physical and neurological exam, lab tests and often brain scans. They look for a decline in thinking that affects daily life and rule out other causes. Only an exam of the brain after death can confirm Alzheimer's with complete certainty.
What are the 5 early signs of dementia?
Common early signs include memory loss that affects daily life (like asking the same question again and again), trouble handling money or bills, getting lost in familiar places, trouble finding words, and changes in mood or personality. Having one of these doesn't mean someone has dementia, but it's a good reason to see a doctor.
How does your body warn you that dementia is starting?
The first signs are usually changes in thinking, not the body. People may forget recent events, struggle with plans or tasks they used to do easily, lose track of dates, misplace things more often or withdraw from activities. Family members often notice before the person does. Talk to a doctor if changes are new or getting worse.
What is the 30-question test for dementia?
It's usually a short memory and thinking test scored out of 30 points, such as the Mini-Mental State Exam. It asks about the date and place, memory, attention, language and copying a drawing. It's a screening tool, not a diagnosis. Read more in our guide to cognitive assessment.
What is the 2 finger test for dementia?
It's a simple task where the person watches someone make a shape with their fingers and tries to copy it. Trouble copying the gesture can be a sign of changes in the brain. Like other quick tests, it's a screening tool only and can't diagnose dementia.
How long does it take to get a dementia diagnosis?
It varies. Some people get answers in a few visits. Others wait weeks or months for specialist appointments, scans or follow-up tests. Ask the doctor what to expect and whether you can be put on a cancellation list.
How is vascular dementia diagnosed?
The same way as other dementias, with a history, memory tests, exams and lab work. Brain scans are especially important, because they can show strokes or damage to small blood vessels. The doctor will also look at blood pressure, heart health and diabetes.
Is there a blood test for dementia?
Some newer blood tests can look for signs of Alzheimer's changes in the brain. Doctors may use them as one part of a full evaluation for someone who already has symptoms. No blood test can diagnose dementia on its own. Ask your doctor whether a test would help before buying one online.
Can memory loss be caused by something treatable?
Yes. Thyroid problems, low vitamin B12, infections, medicine side effects, depression, sleep problems and some other conditions can cause memory problems. That's why a thorough evaluation is so important. Sudden confusion over hours or days needs a call to the doctor right away.
My person says nothing is wrong and won't go. What do I do?
You're not alone. Try calling it a routine checkup or a medication review, share what you've noticed with the doctor ahead of time, and go along to the visit. If you're stuck, call ADRC at (407) 436-7750 to book a free Care Navigation session.
Download ADRC's guide: Getting a Proper Diagnosis
Print our one-page checklist of what a thorough evaluation should include, and bring it to the appointment.
Free help for dementia caregivers in Central Florida
The Alzheimer's & Dementia Resource Center (ADRC) in Winter Park, Florida, offers free help for caregivers in Orange and Seminole counties. Call (407) 436-7750, Monday to Friday, 8:30 AM to 4:30 PM.