If you’re worried your forgetfulness might be a sign of something more serious, it may be time to talk to your doctor about cognitive tests.
Misplaced your keys again? Blanked on the name of your neighbor’s dog? Don’t panic: Occasional forgetfulness is a normal part of aging.
But if you have a sneaking suspicion that your memory lapses might be an early sign of dementia, it’s important to trust your gut and see your doctor. “Often, people don’t want to acknowledge there might be a problem. They worry that talking about it might make it real,” says Laura D. Baker, Ph.D. She’s a professor of gerontology and geriatric medicine at Wake Forest University.
The truth, Baker says, is that seeking out medical care as soon as possible “improves your quality of life and gives you a better trajectory over time.” And while healthy lifestyle changes like stress management can delay the onset of cognitive impairment, they work best when started early.
Plus, you may not be dealing with dementia at all: Many other conditions can trigger cognitive symptoms, including sleep apnea and a vitamin deficiency. Cognitive screening tests can help determine what you’re dealing with and how best to treat it.
So, how can you tell if you’re experiencing early signs of dementia? And is there a way of testing for it? Here’s what you need to know.
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What warning signs of dementia shouldn’t I ignore?
It’s not unusual to experience memory lapses as you age, but it’s a red flag when memory changes disrupt your daily life. According to the Centers for Disease Control and Prevention (CDC), the following symptoms warrant a call to your doctor:
- Problems paying bills after years of managing your finances successfully
- Confusion about the time or date
- Personality changes, like getting upset easily or feeling fearful or suspicious
- Withdrawing socially and isolating yourself
That can also include challenges with expressing yourself, including repeating yourself and getting upset when the wrong word comes out. “I remember my grandfather calling me his daughter when he didn’t have a daughter,” says Karlene Ball, Ph.D., an experimental psychologist specializing in gerontology and a psychology professor at the University of Alabama at Birmingham.
And if you’re having increased difficulty driving, that may also be a red flag. “People will sometimes follow another car as a coping technique — they want to look like they’re driving normally,” says Ball. “But then they get lost.”
Can my doctor test me for dementia?
Not exactly. Your primary care doctor (PCP) can check for physical symptoms, such as changes to your balance or reflexes, that could indicate cognitive impairment, says Ball. They’ll also ask you questions about what you’ve been experiencing. Baker notes that these questions might be:
- Have you started forgetting things recently, or more often?
- What have you been forgetting?
- Has anyone else noticed that you’re forgetting things?
- Are you worried about what you’re forgetting?
Your PCP might also ask you questions about your home life:
- Do you feel comfortable alone?
- Do you forget to turn off the stove?
- Have you missed bill payments?
Your doctor may order blood tests to rule out other conditions, such as hormonal imbalances and nutrient deficiencies, that can cause cognitive symptoms, says Ball. “Another issue that causes some of these symptoms is depression,” she says. “Or it could be something as simple as a prescription drug interaction,” she adds. “That can be easily corrected, and then you could be back to normal.”
At your Medicare annual wellness visit, you may start to be screened for cognitive function, even if you don’t have any memory complaints. For example, you may be given a quick timed test to evaluate your executive function and short-term memory, says Baker. “A nurse might administer it, or you might sit in the waiting room and do it on an iPad,” she says. “It can detect moderate memory impairment, but it usually won’t pick up on the beginning stages of impairment,” she says.
Would getting evaluated by a specialist be helpful?
If your doctor thinks you need further cognitive evaluation, they will likely refer you to a neurologist, geriatrician, or neuropsychologist, Ball says. “It’s also your right to ask for it,” says Baker. “If your doctor isn’t concerned but you are, push for it.”
At your appointment, which is typically about an hour long, you’ll be observed while you take a series of cognitive tests designed to evaluate skills such as:
- Focus
- Language comprehension
- List learning
- Problem solving
“You might be asked to count backward from seven or list as many types of fruit as possible in 90 seconds,” Ball says. “A lot of the tests are timed,” Baker adds. “They want to see how quickly you can work, whether you’re able to stay on task, and how many errors you make.”
The tests have all been standardized in terms of how they’re administered, scored, and interpreted. “This allows us to compare you to other people your age and determine what’s normal cognitive aging and what isn’t,” notes Baker.
What other cognitive tests might be helpful?
Although they aren’t routinely used, you could also get these additional cognitive tests:
- Brain scan. A positron emission tomography (PET) scan can look for a buildup of beta- amyloid proteins in the brain, which is a hallmark of Alzheimer’s disease. “Amyloid in the brain can accumulate before obvious cognitive symptoms appear,” says Baker. But PET scans are expensive and are often not covered by insurance or Medicare, she notes.
- Genetic testing. The apolipoprotein E (APOE) genotype is a risk factor for dementia and Alzheimer’s disease, Baker says. This type of testing is becoming more commonplace, and you can pay for it out of pocket through a service like 23andMe, she says.
Bottom line: While there may not be a “dementia test” your doctor can give you, cognitive screening tests are the next best thing. They can help your doctor determine whether your symptoms are normal or not. And if it turns out that you are in fact dealing with the early stages of dementia, getting an assessment now gives you the best chance to prevent or slow the progression of more serious memory problems later.
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Additional sources:
Sleep apnea and vitamin deficiencies causing cognitive symptoms: Cleveland Clinic
Alzheimer’s warning signs you shouldn’t ignore: Centers for Disease Control and Prevention
