If you notice changes in memory and orientation that affect day-to-day activities in yourself or someone close to you, it is important to be assessed by a healthcare professional.
First step: The family doctor at the Health Centre
How to prepare: Bring a written list of the symptoms you have observed, with practical examples of forgetfulness or disorientation, as well as a list of medications and recent blood tests.
If it concerns your family member, and if there is refusal: It is common for the person not to recognise the symptoms or to feel afraid of the appointment. Try to reassure them by explaining the need to understand the situation and the best way to help.
The doctor may carry out:
cognitive screening tests - Brief questions to assess memory and orientation.
exclusion of reversible causes - Blood tests may be requested to rule out vitamin deficiencies, such as B12 and B9, thyroid problems, such as hypothyroidism, infections, metabolic imbalances, among others.
Specialist consultation
If the suspicion remains, the person will be referred to a specialist consultation. In Portugal, the diagnosis is made by neurologists or psychiatrists.
The diagnosis may involve:
clinical history - a detailed interview with the person and, preferably, with a family member or caregiver.
neuropsychological assessment
exams - computed tomography (CT scan) or magnetic resonance imaging (MRI), as well as other specific exams, such as a lumbar puncture to search for characteristic biomarkers.
After the diagnosis, the doctor will adjust the medication and carry out periodic assessments.
In the event of a sudden worsening of symptoms, often caused by infections, particularly urinary infections, or dehydration, and not necessarily by the progression of dementia itself, medical assessment is also essential.
This process follows the Standard of the Portuguese Directorate-General of Health (DGS) for the diagnostic and therapeutic approach to people with Cognitive Impairment or Dementia, Standard No. 053/2011, updated on 21 April 2023.
Bibliographic references
Direção-Geral da Saúde. (2023). Clinical Standard: 053/2011 - Update - Diagnostic and therapeutic approach to patients with cognitive decline or dementia.
https://normas.dgs.min-saude.pt/wp-content/uploads/2011/12/norma_053_2011_abordagem-diagnostica-e-terapeutica-do-doente_04_2023.pdf