Dementia - which type?

[BreatheAndFocus]

Please could someone explain how they diagnose which type of dementia a person has? Do they make an educated guess from specific symptoms and then confirm with a scan? Can all dementia types even be spotted on a scan? If not, are there other ways to tell?

I’ve been reading about the different types and some seem to have different or specific symptoms to others. Can symptoms alone suggest a type?

My mum is about to start the diagnostic process but there seems a long wait and I have no idea of what tests they’ll do, what scans, or if most people are just diagnosed by a consultant’s expertise.

Also, I’ve seen private dementia screens advertised - is that a good idea or a waste of money? Is a private referral to a hospital consultant more sensible? And, if so, what kind of figure are we talking about for a private scan?

A private scan ordered by a consultant, I mean. Sorry for the garbled questions. I hope they make sense.

My mum has recently been diagnosed with mixed dementia, Alzheimer’s and vascular, based on a brain CT scan and a “memory test” a sort of quiz carried out by a Nurse from the memory clinic (Addenbrooke’s Cognitive Assessment “. You can look this up online to get an idea.) I also filled in a brief questionnaire detailing how her behaviour had changed, and followed it up later, before our appointment, with a letter to the psychiatrist with a lot more detail.
It seems that usually the ACE is the first step followed by the scan if her score falls into the bracket for cognitive decline, then the psychiatrist reviews everything and delivers the diagnosis at the appointment. In our case, he was thorough, kind and gentle. We did have to wait many months for the scan, due to a shortage of scanners in this area.
i don’t know about private options, sorry.

Thank you for that @greenbeansnspinach Much appreciated. Do you know if the scan diagnosed the vascular dementia or the Alzheimers, or both?

Both I think, showing plaques, small vessel ischaemia, as well as shrinkage of the whole brain. I asked for a copy of the scan report which has been helpful subsequently. The diagnosis is based on the whole picture though.

I think that the type of dementia can't necessarily be definitively identified until post mortem, but a combination of scans plus symptoms can give a very good indication. My relative has Lewy Body Dementia, which was diagnosed by a private consultant following observations and questionnaire plus a private DAT scan. The consultant was basically certain about the type of dementia but still gave a diagnosis of 'likely' LBD, as there's no definitive proof. Previously, the NHS consultant had given a vaguer 'maybe Parkinsons but let's watch and wait' diagnosis, so I think the private appointment did speed things up considerably.

Yes, I apologise as my mum’s diagnosis was also prefaced by “likely “. Definitely dementia, probably mixed, and likely Alzheimer’s/vascular.

Thank you both 😊 You’ve been very helpful. I think we’ll probably try to get a private appointment. I think some of the stress is not knowing exactly what’s going on. Having a diagnosis would be a kind of anchoring point in all this.

A formal diagnosis does help both psychologically and in terms of opening some doors. What I’ve found unexpectedly rather sad is the fact you can’t discuss the diagnosis with the person themself. I hope things go as smoothly for you as possible.

Thank you very much @greenbeansnspinach Sending my best wishes to you and your mum too.