General Practice

Dementia | Assessment and diagnosis

Dementia is the term used when a person experiences a gradual loss of brain function due to physical changes in the structure of their brain. It is not a normal part of the ageing process, however, it is more common for people over the age of 65, but can affect people as young as 45.


People with dementia and Alzheimer’s disease can become very forgetful and easily confused – they can sometimes forget what day it is or what they did yesterday. As a result people with dementia may display behavioural and emotional problems.

People with dementia don’t all have the same experience, as symptoms can occur in different combinations and the rate of deterioration varies. Over time most functions of the brain are affected. Eventually, people with dementia may need help with daily activities like dressing, toileting, showering and eating.

Ten warning signs of dementia

1. Recent memory loss that affects daily life

It’s normal to forget meetings, names or telephone numbers occasionally and then remember them later. A person with dementia might have trouble remembering recent events.

2. Difficulty performing regular tasks

It’s normal to make a wrong turn occasionally while driving. Someone with dementia might have regular difficulty driving a familiar route.

3. Problems with language

Many people have trouble finding the right words sometimes. But someone with dementia might have difficulty following, or initiating a conversation.

4. Disorientation of time and place

It is normal to occasionally forget what day it is or where you are going. A person with dementia may be confused about the time of day, and what is appropriate for that time.

5. Decreased or poor judgment

Making a bad decision once in a while is normal.  A person with dementia might make bad decisions more frequently and start paying less attention to their physical appearance.

6. Problems with abstract thinking

It’s normal to have difficulty balancing a budget. A person with dementia might completely forget what the numbers are and what needs to be done with them.

7. Misplacing things

Anyone can misplace their wallet or keys. A person with dementia might repeatedly put things in inappropriate places.

8. Changes in mood and behaviour

Everyone becomes sad or moody from time to time. A person with dementia can have rapid mood swings, from calm to tears to anger, for no apparent reason.

9. Changes in personality

People’s personalities can change a little with age. A person with dementia might have problems in social situations they have previously been comfortable with.

10. Loss of initiative

It is normal for people to tire of housework, business activities or social obligations. A person with dementia may no longer initiate things that they once enjoyed.

Based on Ten Warning Signs, Dementia Australia

Getting a diagnosis

If you think you or someone you care about may have dementia, it is important to see a GP for an assessment as soon as possible.

The benefits of an early diagnosis include some peace of mind in knowing what is going on, the opportunity to find out more about the condition, access to services and support and the ability to plan for the future. For some people, medication which might delay the progression of cognitive problems is available.

The GP will do a complete medical assessment. They may decide the symptoms are a result of a treatable condition, or they may confirm dementia.

An assessment may include:

  • Discussing medical history
  • Talking to family/whānau (with appropriate permission)
  • Undergoing a physical examination
  • Laboratory tests, which may include a blood and urine tests
  • Cognitive testing, which assesses how the brain is working – in particular memory, language, attention span and problem solving
  • Brain imaging, which looks at the brain’s structure and is used to rule out other medical conditions or diagnose the particular type of dementia
  • Mental health assessment, which may identify treatable conditions such as depression, and to manage some symptoms experienced as part of the dementia.