Starting the Diagnosis Journey with Your GP
The diagnostic process for dementia in New Zealand begins with a visit to your General Practitioner (GP). If there are concerns about changes in memory, behaviour, or daily function, the GP is the initial point of contact. A crucial part of this first appointment is to eliminate other treatable conditions that can resemble dementia symptoms, such as depression or vitamin deficiencies. Bringing a family member or friend is recommended to provide a broader view of observed changes.
During the GP visit, several assessments are conducted, including a thorough medical history covering symptoms and their impact on daily life, and a physical examination to check for other health issues. Informant questionnaires may also be used to gather insights from someone familiar with the patient.
Comprehensive Assessment Tools and Tests
Cognitive Screening
A cognitive screening tool is used to evaluate abilities like memory, language, and attention. The Mini-Addenbrooke's Cognitive Examination (Mini-ACE), a brief five-minute test, is the recommended tool in primary care since September 2020. For those of Māori descent, the Māori Assessment of Neuropsychological Abilities (MANA) is under development.
Laboratory and Imaging Tests
To exclude other potential causes of cognitive decline, laboratory tests are ordered, such as blood tests for Vitamin B12 and folate levels, thyroid and renal function, and other metabolic issues. Urinalysis can check for infections like UTIs. Brain imaging, through a CT or MRI scan, helps visualise the brain's structure to rule out conditions like strokes or tumours and may indicate the type of dementia.
Specialist Referrals and Assessments
If a clear diagnosis isn't reached through initial assessments or the case is complex, the GP will make a referral to a specialist. These specialists in New Zealand can include neurologists, geriatricians, geriatric psychiatrists, or multi-disciplinary memory clinics. Specialists might conduct more detailed neuropsychological testing.
Making the Final Diagnosis and Planning Ahead
Upon completion of all assessments, the diagnosing clinician will communicate the findings using clear terms like "dementia" or "mate wareware" to ensure access to appropriate support. A diagnosis facilitates several important steps:
- Accessing support services from organisations like Alzheimers New Zealand.
- Discussing potential treatment options, including medications and non-pharmacological interventions to manage symptoms.
- Making future plans, such as establishing an enduring power of attorney and updating legal documents.
- Undergoing a Needs Assessment to determine eligibility for funded support services.
| Assessment Stage | Description | Purpose |
|---|---|---|
| Initial GP Visit | Comprehensive medical history, physical exam, and discussion with family/whānau. | To gather preliminary information and rule out basic, treatable conditions. |
| Cognitive Screening (Mini-ACE) | A brief, 5-minute test assessing memory, language, and attention. | To provide a quantifiable measure of cognitive impairment. |
| Laboratory Tests | Blood and urine tests, checking for vitamin deficiencies, infections, etc.. | To exclude other medical causes of cognitive symptoms. |
| Brain Imaging (CT/MRI) | A scan of the brain's structure. | To rule out structural issues like tumours or strokes, and identify signs of dementia type. |
| Specialist Referral | Consultation with a neurologist, geriatrician, or memory clinic. | For complex cases or diagnostic uncertainty. |
Conclusion
The process for how is dementia diagnosed in New Zealand is a thorough and multi-stage one. It involves working with a GP and potentially specialists to ensure an accurate diagnosis and rule out other treatable conditions. An early diagnosis is key to accessing available support and planning for the future. For more information, visit Dementia New Zealand.
