Early diagnosis of dementia: pros and cons


Expert reviewer Professor Graham Stokes, Bupa Global Director of Dementia Care
Next review due September 2020

Not everyone agrees about the best time to go the doctor with possible signs of dementia. Some people think it’s best to find out as soon as possible. Others feel they would rather not know.

There’s no right or wrong answer. Every person has to do what they think is the right thing for them. We’ve set out some pros and cons to help you think about the issues and decide what’s best for you and your family.

Early diagnosis: the pros and cons

The pros

There are many benefits of an early diagnosis of dementia. You may want to talk these over with other members of your family or your GP.

Early assessment of symptoms

Sometimes, a person may have symptoms that are similar to dementia but which are actually caused by another medical condition that could be treated. Getting a proper diagnosis can make sure everything possible is done to treat the symptoms.

Some symptoms that are caused by dementia are also treatable. For example, many people with dementia have depression. This can make coping more difficult because they are more withdrawn and less interested in things. Dementia symptoms such as depression and agitation can be treated more successfully if they’re picked up early. Other common problems in older age, such as deafness, may make symptoms like confusion worse.

Access to dementia medicines

Treatment is available for some types of dementia, including Alzheimer’s disease and dementia with Lewy bodies. Medicines for Alzheimer’s disease should be started when the condition is in its early stages. These medicines can help to slow the development of the condition, reduce symptoms and improve quality of life. In dementia with Lewy bodies, the same medicines can improve both mental function and behaviour.

These are prescription medicines, so if someone doesn’t have a diagnosis, they won’t have access to them. This is another reason why early diagnosis is important.

Getting advice and support

With a positive diagnosis, you’ll be able to access information and support services that are there to help people with dementia and their families. Charities like Alzheimer’s Society have a lot of information about dementia and coping with it. There may be local support groups you can contact. Some areas have Admiral Nurses who support people with dementia and their carers. They can tell you about other local services, such as memory clinics.

Making plans

Early diagnosis gives people with dementia and their relatives the opportunity to plan for the future. This will make things easier in the long run. The person with dementia can participate more in the decision-making, as they will have the capacity to do this earlier in the condition. An early diagnosis also gives you all more time to discuss treatment and care options, as well as practical and financial arrangements.

Explaining what’s happening

Having a diagnosis can give you an explanation for early symptoms. Behaviour changes or unusual decisions the person with dementia has made may make a bit more sense in light of the diagnosis. When there is an explanation for symptoms, it can make them easier to cope with. It also means you have more idea what to expect in the future.

Time to adjust

A person with dementia is often first assessed after a crisis has occurred, like an accident or forgetting to pay bills. Getting an early diagnosis gives everyone time to adjust before things become critical.

It’s common for families to feel sad, frustrated, angry and irritable. You need time to come to terms with the diagnosis and the feelings it stirs up. Early diagnosis can help carers to feel more supported and cope better. It can also enable the person with dementia to stay in their own home for longer.

Not surprisingly, some people have quite negative feelings about dementia. They may prefer not to know. It’s almost as if putting a label on the symptoms makes it real. Not knowing also means that you can avoid some difficult and upsetting conversations.

For some types of dementia, there is a lack of available treatment. You may feel that if nothing can be done, there’s no point in having all the stress and upset that assessment and diagnosis will inevitably cause.

The arguments for early diagnosis are not really scientific. They are largely common sense. There isn’t the conventional research evidence that can persuade people that it’s something they should do.

The cons

Not surprisingly, some people have quite negative feelings about dementia. They may prefer not to know. It’s almost as if putting a label on the symptoms makes it real. Not knowing also means that you can avoid some difficult and upsetting conversations.

For some types of dementia, there is a lack of available treatment. You may feel that if nothing can be done, there’s no point in having all the stress and upset that assessment and diagnosis will inevitably cause.

The arguments for early diagnosis are not really scientific. They are largely common sense. There isn’t the conventional research evidence that can persuade people that it’s something they should do.

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Personal quotes

Here are two real-life quotes showing some of the different feelings that people have about early diagnosis.

"My father-in-law knows what he has and since his diagnosis it's meant his behaviour has improved. He’s not frustrated by his behaviour because he knows why he’s like that. His mood has improved."

"We are at the learning stage. Not everybody wants to know that they may have dementia and my husband is really stubborn."

Our view

Professor Graham Stokes, Bupa Global Director of Dementia Care:

‘At Bupa, we think that early diagnosis for dementia is helpful. As we hope we’ve shown, it can help to avoid a family crisis by getting practical and emotional support in place as quickly as possible. It will also help to:

  • get treatment started when it’s most effective
  • plan for the future and come to terms with what to expect
  • get important arrangements in place, such as Lasting Power of Attorney and plans for future care
  • access information and support services

Just as importantly, early diagnosis of dementia allows you to take some control over the situation. Feeling out of control can be very disheartening. Being able to get some plans in place for finances and care can reassure you that you and your family are coping with the situation as well as you can. Professionals and others living with dementia and their carers can give tips on making life easier; for example, practical ways to establish a comforting routine. This can do wonders for confidence and mood.

Finally, and probably most importantly, getting a diagnosis early on means that the person with dementia can take part in all of these conversations. Dementia nearly always comes on gradually. Early diagnosis is likely to mean that a person with dementia can understand their options and explain how they feel and what they would like. Knowing a loved one’s wishes may later be a source of support and comfort, when the person is unable to make decisions for themselves.’

Tests for dementia

There are a number of different tests doctors use to help diagnose dementia. Some of the names of these tests include the General Practitioner Assessment of Cognition (GPCOG), the Memory Impairment Screen and the Mini-Cog, but they’re all similar. They’re designed to pick up issues around memory, language, understanding and attention.

Some tests are designed to be carried out as an initial assessment by your GP. Others are more in-depth, and will be carried out following referral to a memory clinic or specialist. The person being tested may be asked to do a number of things, including:

  • repeat certain words or phrases, or recall these at the end of the test
  • identify different pictures, or name as many of something as they can (animals, for example)
  • do some simple maths
  • follow simple commands
  • do some simple drawing, such as copying shapes or drawing a clock

The doctor will also ask questions to find out whether the person knows where they are, is aware of recent events, and the time and date.

If your loved one is being tested, it’s important not to jump in to help. The purpose is to see if they can answer the questions themselves. The doctor will be looking at certain things, such as if the person being tested remembers the right words to use and how fluently they can speak. The doctor may talk to you informally about symptoms you’ve noticed in your loved one, or they may ask you to carry out a more structured questionnaire.

Diagnosing dementia is difficult, particularly in the early stages. No single test can provide a definite diagnosis. If a clear diagnosis can’t be made, your doctor might suggest returning in a few months to see whether there is any change in the person’s symptoms.

Can I do an online test for dementia?

You may find quizzes and tools online that claim to be able to spot dementia symptoms. Some may be based around the tests that clinicians use, but it’s important to remember that these don’t work as stand-alone tools. They always need to be delivered and interpreted by a medical professional.

While it’s understandable that many people look for information on how to diagnose dementia, it isn’t possible to diagnose dementia yourself. It’s really important to see a doctor if you’re concerned about yourself or a loved one.

Memory and mental state tests aren’t foolproof. How you perform in them can be affected by many things, including how you feel that day, your language, and other health problems and your education. A doctor will take all this into account. And while tests can help with a diagnosis, they’re not the only thing your doctor will look at. They will also do a physical examination and tests, assess other dementia symptoms, and take into account your past medical history, general mood and appearance. Your doctor will bring all of this information together when making a diagnosis.

If the diagnosis isn’t clear, your doctor can also look at how things are changing over time, rather than at one point in time – as with an online test. Your doctor may also be able to pick up on more subtle changes in your memory, which might be a sign of mild cognitive impairment.


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Related information

    • Bupa focus group on dementia, 30 June 2016.
    • Evaluation and formulation of dementia. Practical Dementia Care (online). Oxford Medicine Online. oxfordmedicine.com, published May 2016
    • Depression in adults. BMJ Best Practice. bestpractice.bmj.com, last updated December 2016
    • Mental Health. Oxford Handbook of General Practice (online). Oxford Medicine Online. oxfordmedicine.com, published March 2014
    • Dementia. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised August 2016
    • Dementia with Lewy bodies. BMJ Best Practice. bestpractice.bmj.com, last updated September 2016
    • Alzheimer’s Dementia. BMJ Best Practice. bestpractice.bmj.com, last updated February 2016
    • Frontotemporal Dementia. BMJ Best Practice, bestpractice.bmj.com, last updated February 2016
    • Vascular dementia. PatientPlus. patient.info/patientplus, last checked October 2014
    • Vascular dementia. BMJ Best Practice. bestpractice.bmj.com, last updated January 2016
    • Carers of people with dementia. Health Talk Online. www.healthtalk.org, last updated March 2015
    • Get Support. Alzheimer's Society. www.alzheimers.org.uk, accessed February 2017
    • Admiral Nursing: what is an Admiral Nurse? Dementia UK. www.dementiauk.org, accessed February 2017
    • Support for the Family and Care Providers. Practical Dementia Care (online). Oxford Medicine Online. oxfordmedicine.com, published May 2016
  • Reviewed by Graham Pembrey, Lead Health Editor, Bupa Health Content Team, September 2017
    Expert reviewer Professor Graham Stokes, Bupa Global Director of Dementia Care
    Next review due September 2020



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