Symptoms:

Dementia symptoms include difficulty with many areas of mental function, including:

• Language
• Memory
• Perception
• Emotional behavior or personality
• Cognitive skills (such as calculation, abstract thinking, or judgment)

Dementia usually first appears as forgetfulness.

Mild cognitive impairment is the stage between normal forgetfulness due to aging and the development of dementia. People with MCI have mild problems with thinking and memory that do not interfere with everyday activities. They are often aware of the forgetfulness. Not everyone with MCI develops dementia.

Symptoms of MCI include:

• Forgetting recent events or conversations
• Difficulty performing more than one task at a time
• Difficulty solving problems
• Taking longer to perform more difficult mental activities

The early symptoms of dementia can include:

• Language problems, such as trouble finding the name of familiar objects
• Misplacing items
• Getting lost on familiar routes
• Personality changes and loss of social skills
• Losing interest in things you previously enjoyed, flat mood
• Difficulty performing tasks that take some thought, but that used to come easily, such as balancing a checkbook, playing games (such as bridge), and learning new information or routines

As the dementia becomes worse, symptoms are more obvious and interfere with the ability to take care of yourself. The symptoms may include:

• Forgetting details about current events
• Forgetting events in your own life history, losing awareness of who you are
• Change in sleep patterns, often waking up at night
• More difficulty reading or writing
• Poor judgment and loss of ability to recognize danger
• Using the wrong word, not pronouncing words correctly, speaking in confusing sentences
• Withdrawing from social contact
• Having hallucinations, arguments, striking out, and violent behavior
• Having delusions, depression, agitation
• Difficulty doing basic tasks, such as preparing meals, choosing proper clothing, or driving

People with severe dementia can no longer:

• Understand language
• Recognize family members
• Perform basic activities of daily living, such as eating, dressing, and bathing

Other symptoms that may occur with dementia:

• Incontinence
• Swallowing problems

Signs and tests:

Dementia can often be diagnosed with a history and physical exam by a skilled doctor or nurse. A health care provider will take a history, do a physical exam (including a neurological exam), and perform some tests of mental function called a mental status examination.

The health care provider may order tests to help determine whether other problems could be causing dementia or making it worse. These conditions include:

• Thyroid disease
• Vitamin deficiency
• Brain tumor
• Intoxication from medications
• Chronic infection
• Anemia
• Severe depression

The following tests and procedures may be done:

• B12 level
• Blood ammonia levels
• Blood chemistry (chem-20)
• Blood gas analysis
• Cerebrospinal fluid (CSF) analysis
• Drug or alcohol levels (toxicology screen)
• Tests for exposure to metals such as lead or arsenic
• Electroencephalograph (EEG)
• Glucose test
• Head CT
• Liver function tests
• Mental status test
• MRI of head
• Serum calcium
• Serum electrolytes
• Thyroid function tests
• Thyroid stimulating hormone level
• Urinalysis