Early diagnosis opens the door to treatment, planning, and support — before significant damage has occurred.
Recognizing the early signs of dementia and pursuing a timely diagnosis can open the door to treatment, planning, and support. Here's what you need to know.
Early diagnosis opens the door to treatment, planning, and support — before significant damage has occurred.
These signs go beyond normal age-related forgetfulness. If you or a loved one experience several of these, it's time to consult a doctor. Early detection significantly improves outcomes.
Forgetting recently learned information, important dates, or events — and increasingly relying on memory aids or family members to recall things you used to handle independently.
Difficulty following a familiar recipe, keeping track of monthly bills, or concentrating on tasks that involve numbers. Making more errors than usual in things you've done for years.
Trouble driving to a familiar location, managing finances, or remembering the rules of a favorite game. Needing repeated guidance for tasks that were once routine.
Losing track of dates, seasons, and the passage of time. Sometimes forgetting where you are or how you got there. Difficulty understanding something if it isn't happening immediately.
Problems with balance, difficulty reading, trouble judging distance, and problems distinguishing contrast. These can also be signs of cataracts — see a doctor to rule out other causes.
Stopping in the middle of a conversation and having no idea how to continue. Struggling to find the right word, calling things by the wrong name ("that thing for the hand" instead of "watch").
Putting things in unusual places (iron in the refrigerator, wallet in the freezer). Unable to go back over steps to find a lost item. May accuse others of stealing.
Changes in judgment or decision-making. Paying less attention to personal grooming. Falling for scams or giving large amounts of money to telemarketers.
Removing oneself from hobbies, social activities, or other engagements. Trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby.
Becoming confused, suspicious, depressed, fearful, or anxious. Easily upset when outside their comfort zone. Mood swings that seem out of character for the individual.
Alzheimer's disease accounts for the majority of dementia cases, but there are several distinct types — each with different underlying causes, progression patterns, and treatment approaches.
The most common form. Characterized by amyloid plaques and tau tangles in the brain. Symptoms typically begin with short-term memory loss and progress to affect language, reasoning, and daily function. The only form currently with FDA-approved disease-modifying therapies.
Caused by reduced blood flow to the brain, which may result from a stroke, a series of mini-strokes, or chronic small vessel disease — a stroke history is not required. Symptoms may appear suddenly after a vascular event or develop gradually over time. Risk factors overlap heavily with heart disease. Especially prevalent in Louisiana given the state's high rates of hypertension and diabetes.
Caused by abnormal deposits of alpha-synuclein protein in the brain. Distinct features include vivid hallucinations, significant fluctuations in alertness, REM sleep behavior disorder, and Parkinson's-like movement symptoms. Often misdiagnosed as Alzheimer's or Parkinson's disease.
Affects the frontal and temporal lobes, causing changes in personality, behavior, and language rather than memory loss. The most common variant, Behavioral Variant FTD (bvFTD), presents with dramatic changes in personality, social conduct, and impulse control. More commonly strikes people in their 50s and 60s, and is often initially misdiagnosed as a psychiatric condition. Other variants include Primary Progressive Aphasia (PPA).
Many patients show pathological features of more than one type of dementia simultaneously. The most common combination is Alzheimer's disease with vascular dementia (AD + VaD), which is particularly prevalent in Louisiana given the state's high rates of cardiovascular disease, hypertension, and diabetes. Mixed dementia often progresses more rapidly than either condition alone and underscores the importance of managing vascular risk factors even after an Alzheimer's diagnosis. A comprehensive workup is essential for accurate diagnosis and appropriate treatment planning.
⚑ Especially prevalent in Louisiana due to high rates of vascular diseaseDiagnosing dementia involves ruling out other causes and identifying the specific type. There is no single test — a comprehensive evaluation is required.
Find a SpecialistYour doctor will ask about your symptoms, when they began, and how they've changed over time. Input from a family member or close friend is often invaluable, as patients may not be aware of the full extent of changes.
Standardized tests assess memory, problem-solving, attention, counting, and language. Common screening tools include the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Mini-Cog. More detailed neuropsychological testing may follow.
A neurological exam assesses reflexes, coordination, balance, sensory function, and eye movements to identify signs that may indicate other neurological conditions contributing to symptoms.
Blood tests rule out reversible causes of cognitive decline such as thyroid disorders, vitamin B12 deficiency, infections, or medication interactions — all of which can mimic dementia symptoms.
✓ Important: some cognitive changes identified at this stage may be treatable or reversibleCT or MRI scans can reveal strokes, tumors, or shrinkage of brain regions associated with specific dementias. PET scans can detect amyloid plaques or glucose metabolism patterns characteristic of Alzheimer's disease.
Cerebrospinal fluid (CSF) analysis or specialized blood tests (e.g., plasma p-tau217) can detect Alzheimer's biomarkers with high accuracy. These tests are increasingly being used in clinical practice to confirm diagnosis before initiating anti-amyloid therapy.
Following a confirmed diagnosis — particularly for early-stage Alzheimer's or MCI — your clinician should discuss whether participation in a clinical trial is appropriate. Louisiana has active research programs at LSUHSC, Tulane, and other academic centers. Early-stage patients are often the best candidates for emerging disease-modifying therapies under investigation.
Find Louisiana Research Programs →Screening tools are quick, office-based tests used to detect potential cognitive impairment. A positive screen should be followed by comprehensive neuropsychological evaluation — screening alone is not a diagnosis.
A brief, widely-used screen combining a 3-item word recall and a clock-drawing test. Designed for primary care settings. Sensitive for detecting dementia but limited in detecting mild cognitive impairment. Available in multiple languages.
More sensitive than the MMSE for detecting mild cognitive impairment. Assesses attention, concentration, executive functions, memory, language, visuoconstructional skills, and orientation. Score of 26+ out of 30 is considered normal.
One of the most widely used cognitive screening tools. Assesses orientation, registration, attention, recall, language, and visuospatial ability. Scores range from 0–30; below 24 suggests possible impairment. May miss early or mild cases.
Your primary care physician can perform initial screening and rule out other causes. However, a definitive diagnosis — especially for less common dementias or atypical presentations — typically requires evaluation by a neurologist, geriatrician, or neuropsychologist. If anti-amyloid therapy is being considered, specialist involvement is essential.
No. Normal age-related changes include occasionally forgetting a name but remembering it later, making the occasional error when managing finances, and needing a bit more time to learn new things. Dementia involves significant, progressive changes that interfere with daily life — not occasional lapses that correct themselves.
MCI is an intermediate stage between normal cognitive aging and dementia. People with MCI have noticeable cognitive changes that go beyond normal aging but don't yet significantly interfere with daily life. About 10–15% of people with MCI progress to dementia each year, though some remain stable or even improve. MCI is now recognized as an important intervention window for emerging disease-modifying therapies.
There is increasing data to support the use of blood-based biomarkers — particularly plasma phospho-tau 217 (p-tau217) and amyloid beta ratios — for identifying Alzheimer's-related brain changes. However, these tests are not yet widely used as standard of care in clinical practice and are not currently considered the gold standard for diagnosis. They are most appropriately used in the context of specialist evaluation, and results should always be interpreted alongside clinical history, cognitive testing, and imaging. Their role in routine primary care continues to evolve rapidly.
Alzheimer's brain changes begin 15–20 years before symptoms appear. With biomarker testing (PET scans or blood tests for amyloid/tau), it is now possible to detect these changes in the preclinical stage. Early detection opens the window for disease-modifying therapies like lecanemab and donanemab, which are most effective before significant neuronal damage has occurred.