# Getting a Diagnosis of Dementia ## Dementia New Zealand **Source:** [https://dementia.nz/getting-a-diagnosis-of-dementia/](https://dementia.nz/getting-a-diagnosis-of-dementia/) **Capture Date:** 2026-06-07 --- ## Overview Getting a timely and accurate diagnosis of dementia is important — it opens the door to treatment, support, and time to plan for the future. Dementia NZ provides guidance on the steps involved, from recognising symptoms through to receiving a formal diagnosis. --- ## When to See a GP ### Signs That Warrant a GP Visit It is time to see a doctor if you or someone you know is experiencing: - Memory loss that is affecting daily life (forgetting recent events, appointments, conversations) - Difficulty with familiar tasks (cooking, managing money, using a phone) - Confusion about time, date, or place - Language problems (finding the right word, following a conversation) - Changes in mood, behaviour, or personality that are out of character - Poor judgement or decision-making - Withdrawal from social activities or hobbies ### Key Point Many conditions can cause dementia-like symptoms — including **depression**, **anxiety**, **vitamin B12 deficiency**, **thyroid disorders**, **infections** (especially in older people), **medication side effects**, **sleep apnoea**, and **alcohol misuse**. A thorough medical check can identify treatable causes. ### How to Prepare for the Appointment - **Make a list** of specific examples of memory or thinking problems — when they started, how often they happen. - **Bring a support person** — a family member or friend who has observed the changes can help explain things. - **List all medications** — prescription, over-the-counter, supplements, herbal remedies. - **Note any other health conditions** and recent illnesses, falls, or hospital stays. - **Write down questions** to ask the doctor. --- ## What to Expect at the GP Appointment ### 1. Medical History and Discussion - The GP will ask about the symptoms being experienced, when they started, and how they affect daily life. - They will also ask about medical history (including family history of dementia), lifestyle, and other health conditions. - Information from a family member or friend is very helpful — the person with symptoms may not be fully aware of the changes. ### 2. Cognitive Screening (e.g., Mini-ACE Test) - The GP will do a short cognitive test to assess memory, thinking, and problem-solving. - **Mini-Addenbrooke's Cognitive Examination (Mini-ACE)** is the most common test used in New Zealand. - The Mini-ACE takes about **5–10 minutes** and covers: - **Orientation:** time, date, place - **Registration and recall:** repeating and remembering a short list of words - **Verbal fluency:** naming as many animals or words starting with a letter as possible in one minute - **Clock drawing test:** drawing a clock face showing a specific time (tests planning, organisation, and visuospatial skills) - This test helps identify if further investigation is needed, but it is not a definitive diagnosis on its own. ### 3. Physical Examination - The GP may check: - **Blood pressure** and heart rate - **Neurological function** — reflexes, coordination, balance, eye movements - **Hearing and vision** — sensory impairments can mimic or worsen cognitive symptoms ### 4. Blood Tests Blood tests are done to rule out other causes of cognitive decline: - **Full blood count** — check for anaemia or infection - **Vitamin B12 and folate levels** — deficiency can cause memory problems - **Thyroid function** (TSH, T4) — hypothyroidism can mimic dementia - **Electrolytes and kidney function** — imbalances can affect cognition - **Liver function** — liver disease can affect brain function - **Blood glucose / HbA1c** — undiagnosed or poorly controlled diabetes - **Calcium levels** — abnormal calcium can cause confusion - **Syphilis screening** (rare but treatable cause) - **HIV screening** — in appropriate clinical context ### 5. Brain Imaging (CT Scan or MRI) If the GP suspects dementia, they will refer for a brain scan. - **CT scan (Computed Tomography):** Most commonly used — looks for stroke damage, tumours, bleeding, or significant brain shrinkage (atrophy) in regions associated with dementia. - **MRI (Magnetic Resonance Imaging):** More detailed than CT — better at showing small vessel disease, hippocampal atrophy (typical of Alzheimer's), and other structural changes. - Scans help rule out other causes (e.g., brain tumour, subdural haematoma, normal pressure hydrocephalus) and identify the type of dementia. --- ## After the Initial Assessment ### Referral to a Specialist If the GP findings suggest dementia, the person is usually referred to one of the following: - **Older People's Health Service / Geriatrician** — hospital-based specialist service for older adults with cognitive decline. - **Psychiatrist of Old Age / Mental Health Services for Older People (MHSOP)** — if there are significant behavioural or psychological symptoms. - **Neurologist** — especially for younger people, unusual presentations, or complex cases. - **Memory Clinic** — specialised multidisciplinary clinics (available in some regions) providing comprehensive assessment. ### Comprehensive Assessment At the specialist clinic, further testing may include: - **Detailed neuropsychological assessment** — 1–2 hours of tests measuring memory, language, attention, executive function, and visuospatial skills. This is the most accurate way to identify the type and severity of dementia. - **Further brain imaging** — MRI or PET scan (amyloid PET or FDG-PET in some cases). - **Lumbar puncture (spinal tap)** — in select cases, to measure Alzheimer's proteins (amyloid and tau) in cerebrospinal fluid. ### The Diagnosis - A diagnosis is made after reviewing all information: history, cognitive test results, blood tests, brain scans, and specialist assessments. - The doctor will explain the diagnosis, the type of dementia (Alzheimer's, vascular, Lewy body, frontotemporal, etc.), what to expect, and what support is available. - It is common to be given the diagnosis in a family meeting with a support person present. - A written summary and care plan should be provided. --- ## Why Early Diagnosis Matters | Benefit | Explanation | | ------------------------------ | ---------------------------------------------------------------------------------------------------------------------- | | **Treat reversible causes** | Up to 10% of "dementia" cases are caused by treatable conditions (depression, thyroid, vitamin deficiency, medication) | | **Access to medications** | Acetylcholinesterase inhibitors (donepezil, rivastigmine, galantamine) are most effective in early to moderate stages | | **Time to plan** | Legal planning (enduring power of attorney, advance care directive, will) can be done while the person has capacity | | **Access to support services** | Carer support, dementia advisory services, day programmes, support groups | | **Lifestyle changes** | Healthy eating, exercise, cognitive stimulation, social engagement can help maintain function | | **Safety planning** | Driving assessment, home safety modifications, falls prevention | | **Research participation** | Access to clinical trials and research studies | | **Emotional adjustment** | Time to come to terms with the diagnosis, seek counselling, and talk to family | --- ## What If You Are Concerned About Someone Else If you are worried about a family member, friend, or neighbour: 1. **Talk to them** — express your concerns gently and with specific examples (not vague "you're getting forgetful"). Use "I" statements: "I've noticed you seem to be having trouble with your memory lately, and I'm worried about you." 2. **Offer to go with them to the GP** — many people are anxious about memory problems; having a support person can help. 3. **Contact Dementia NZ or Alzheimer's NZ** — for advice on how to approach the conversation and what support is available. 4. **Do not ignore it** — if you notice changes, say something. Early diagnosis helps everyone. ### If the Person Refuses to See a Doctor - This is common — denial, fear, or lack of insight are all part of the condition. - You can write to their GP outlining your concerns (the GP cannot share information with you without consent, but they can receive it). - Try again later — sometimes a crisis (a fall, getting lost, an accident) helps motivate action. - Talk to Dementia NZ or Alzheimer's NZ for strategies. --- ## Summary of the Diagnosis Pathway | Step | What Happens | | -------------------------- | ------------------------------------------------------------------- | | **1. Recognise signs** | Memory loss, confusion, behaviour changes affecting daily life | | **2. See GP** | Discuss concerns, medical history, medications | | **3. GP assessment** | Mini-ACE cognitive test, physical exam, blood tests | | **4. Brain imaging** | CT or MRI scan to rule out other causes | | **5. Specialist referral** | Geriatrician, psychiatrist, neurologist, or memory clinic | | **6. Further testing** | Neuropsychological assessment, possibly PET scan or lumbar puncture | | **7. Diagnosis** | Review of all findings; diagnosis explained with family present | | **8. Care plan** | Treatment, support services, legal planning, follow-up | --- ## Key Contacts | Organisation | Contact | | ----------------------- | ---------------------------------- | | Dementia New Zealand | [dementia.nz](https://dementia.nz) | | Alzheimer's New Zealand | 0800 004 001 | | Dementia Helpline | 0800 004 001 (same number) | | Healthline | 0800 611 116 | --- ## Summary of Key Facts | Topic | Detail | | ------------------------------ | ---------------------------------------------------------------------------- | | **When to see GP** | Memory/cognitive changes affecting daily life; don't wait | | **At GP appointment** | Medical history, Mini-ACE cognitive test, physical exam, blood tests | | **Mini-ACE test** | 5–10 min test covering orientation, recall, verbal fluency, clock drawing | | **Blood tests** | Rule out anaemia, thyroid, B12, diabetes, infection, kidney/liver issues | | **Brain scan** | CT (commonly) or MRI to rule out tumours, stroke, other causes | | **Specialist referral** | Geriatrician, psychiatrist, neurologist, or memory clinic | | **Why early diagnosis** | Treat causes, access meds, plan legally, support services, lifestyle changes | | **If concerned about someone** | Talk gently, offer to go to GP, contact Dementia NZ for guidance |