Frontotemporal dementia - Diagnosing frontotemporal dementia

Confirming a diagnosis of dementia can be difficult, particularly when the condition is in its early stages. This is because many of the symptoms of dementia can be caused by other conditions.

When you visit your GP it can be helpful if you and a close relative or friend are seen together, because they can help you remember what is happening.

For frontotemporal dementia to be diagnosed correctly, you will have a number of tests and assessments, including:

an assessment of your symptoms – for example, how long you have had problems with thinking or language
a full assessment of your mental abilities
a physical examination
a review of the medication you are taking in relation to your symptoms
a range of tests, including blood tests, to rule out other possible causes of your symptoms, such as a vitamin B deficiency
brain scans such as a magnetic resonance imaging (MRI) scan can confirm a diagnosis of frontotemporal dementia by showing loss of brain cells in the frontal and temporal regions of the brain (behind the forehead and near the ears)

Some of these tests can be carried out by your GP. Some will be carried out by specialists, such as a neurologist (an expert in treating conditions that affect the brain and nervous system), an elderly care physician, or a psychiatrist with experience in treating dementia.

Assessing your mental abilities

Questionnaires are sometimes used to help test your mental abilities and how severe your symptoms are. One widely used questionnaire is the Mini Mental State Examination (MMSE).

The MMSE can be used to assess a number of different mental abilities, including:

short- and long-term memory
attention span
concentration
language and communication skills
ability to plan
ability to understand instructions

The MMSE is a series of questions, each carrying a score with a maximum of 30 points. Example questions include:

memorising a short list of objects and then repeating the list back
writing a short sentence that is grammatically correct, such as ‘the dog sat on the floor’
correctly identifying the current day of the week, followed by the date, the month, the season and the year

The MMSE is not a test to diagnose dementia. However, it is useful for assessing the level of mental impairment that a person with dementia may have.

Scores on these and other tests only help to assess the problem and must be taken into context. For example, someone who cannot read or write very well may score less than someone else, but they may not have dementia. Similarly, someone with a higher level of education may achieve a higher score but still have dementia.

More detailed psychological tests (including tests of frontal lobe function, language, memory and thinking) may also be used by a specialist psychologist.