The starting point for care, medicine and planning
Different types of dementia can look similar, but they often have different causes, progression patterns and treatment approaches.
Identifying the specific type of dementia helps guide the most appropriate care and future planning. A neurologist or neuropsychiatrist diagnoses the type of dementia by combining:
- a patient’s history
- examination
- cognitive testing
- blood tests
- brain imaging.
The pattern of results points to the most likely cause, which then determines which medicines, if any, might be recommended.
Below are some steps a specialist may take to diagnose an individual with dementia.
Understanding symptoms and medical history
The specialist will ask about:
- when symptoms started and how they have changed over time
- which areas are affected (memory, language, planning, mood, behaviour)
- how symptoms affect daily life (work, driving, finances, home tasks)
- medical history, medications, alcohol use and sleep
- family history of dementia or related conditions.
Input from a family member or someone who knows the patient well is often very helpful, as they may notice changes the individual has not.
Cognitive and neurological assessment
This typically includes:
- cognitive testing – structured tasks assessing memory, attention, language, visual-spatial skills, and problem-solving
- mental state assessment – particularly relevant if mood, behaviour or personality changes are present
- neurological examination – checking movement, coordination, reflexes and other nervous system function.
The pattern of difficulties (not just the presence of difficulties) helps distinguish between dementia types. For example, prominent early memory loss suggests a different cause than prominent early language or behavioural change.
Investigations
Tests help rule out reversible contributors and support diagnosis:
- blood tests – checking for thyroid problems, vitamin deficiencies, infection and other treatable causes
- brain imaging (MRI or CT) – looking at brain structure, patterns of shrinkage and ruling out other causes such as stroke or tumour
- additional imaging (in selected cases) – such as PET scans, which can show patterns of brain activity or specific proteins associated with certain dementias
- other tests (in selected cases) – such as cerebrospinal fluid testing or genetic testing, when the diagnosis is unclear or has specific implications.
The specialist will also discuss non-medicine supports, such as allied health input, safety planning, and follow-up review, as part of an overall care plan.
Why ongoing review matters
Dementia can change over time, and how someone responds to treatment can provide additional diagnostic information. Specialist follow-up allows the diagnosis and treatment plan to be adjusted as needed.
Common patient questions
Yes. As symptoms evolve, the specialist may refine the diagnosis, particularly in the early stages when features can overlap between dementia types.
No, not everyone needs every test. The specialist selects investigations based on your individual presentation.
Depending on your needs, this may include a neuropsychologist (detailed cognitive testing), GP and allied health professionals such as occupational therapists or speech pathologists.