Diagnosing Dementia

Explore opportunities such as the Medicare Wellness Visit to engage in evidence-based approaches to dementia diagnosis and management.

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The link below is is an interesting article that provides a tool to identify those at risk for dementia. This assessment tool

may be a useful adjunct to other cognitive assessment tools in determining who is at greatest risk for dementia.

This assessment tool might be useful in both outpatient and inpatient settings, and has the advantages of not taking long to

administer and is very low risk from a patient safety perspective.



Dr. Doraiswamy, of Duke University Medical Center, is the guest in an hour long discussion about the possible pathogenesis, diagnosis, and treatment of Alzheimer’s Disease. Strategies that may help prevent Alzheimer’s Disease are also discussed.

The podcast is available for free beginning Monday, September 30, 2013 and it should be available until October 21st, 2013.




The link below contains information on evaluating cognitive functioning:

  • Indicators for Cognitive Assessment
  • Methods of Cognitive Assessment
  • Appropriate Follow Up
  • Timeframe for Re-evaluation



Please note: This comes from the Alzheimer's Association


* No one tool is recognized as the best brief assessment to determine if a full dementia evaluation is

needed. Some providers repeat patient assessment with an alternate tool (e.g., SLUMS, or MoCA)

to confirm initial findings before referral or initiation of full dementia evaluation.

Cordell CB, Borson S, Boustani M, Chodosh J, Reuben D, Verghese J, et al. Alzheimer’s Association

recommendations for operationalizing the detection of cognitive impairment during the Medicare

The Alzheimer's Association has developed a diagnostic algorithm for dementia, based on the work of leading scholars in the field.

One very nice feature of the algorithm is that it features a set of standardized instruments recommended for use.  Feel free to try it out...and post a comment on whether you find it similarly helpful.



Does anyone have experience with a detailed comprehensive neuro cognitive assessment tool which focuses on varied domains of cognitive function and is reimbursed through Medicare.

We were using Neurotrack ™ which has been problematic with Medicare reimbursement.

The US Preventive Services Task Force is an authoritative group that issues evidence-based recommendations for clinical care.

They have recently updated their statement on Screening for Dementia and Cognitive Impairment.

Their recommendation remains that there is insufficient evidence to recommend for or against screening.

The guidance statement is the result of a very careful evidence summary and public comment period.

It also includes a very well done patient education brochure.

Both are included in the links below.

I have recently been appointed to a National Advisory Group on development of a Uniform Curriculum on Alzheimer's Disease.

Part of the work involves reviewing an existing set of materials developed by a group in Minnesota called "Act on Alzheimer's"

Note that all of the materials can be used by anyone for free - -you just can't sell them!

Please consider reviewing some of these materials, and giving me your feedback on how you might use them in your own work.

What other content would you like to see developed?

Nurses and students can learn to screen for ADL deficits using a modified “sock test." The modified sock test is simple – the nurse or student simply asks the patient to doff and don a shoe and a sock. This task taps a patient’s ability to do lower extremity dressing, which is the most demanding ADL task, as it requires lower extremity strength, axial flexibility, dynamic sitting balance, and manual dexterity.

As Kathleen Morrow mentioned in her blog posting, people with dementia have numerous unmet needs.

Especially, I feel that there is not enough information for early stage dementia people.

Dementia is progressive disease: the abilities to remember, understand, and communicate gradually declines.

Understanding dementia, making a plan for self-care (living arrangement), and sharing emotional distress with others with early stage dementia may help early stage dementia people to cope more easily.