Original Article: Evaluation of Suspected Dementia

"Evaluation of Suspected Dementia"

AFP

December 2025

E. Seth Kramer, DO, MPH; Melissa N. Johnson, MD; and Bradford Winslow, MD—Faculty members in the Department of Family Medicine at the University of Colorado Anschutz, authored the article, "Evaluation of Suspected Dementia,” published in the December issue of American Family Physician (AFP).

Their work highlights dementia, a serious neurocognitive disorder, that impairs and disrupts patients’ daily functioning. They discuss that while age is the strongest risk factor for developing dementia, other contributing factors include family history of the condition, cardiovascular disease, poorly managed diabetes, and lower levels of education.

From the article:

“The initial evaluation for dementia involves recognizing subtle signs that are often missed or mistaken for normal aging. Screening tools include the Mini-Cog, Memory Impairment Screen (MIS), and questionnaires that are completed by caregivers or friends. If cognitive impairment is suspected, a more detailed evaluation should be performed using tools such as the Montreal Cognitive Assessment (MoCA), Saint Louis University Mental Status (SLUMS), or Rowland Universal Dementia Assessment Scale (RUDAS). A thorough history should be taken and a medication review and physical examination should be performed for the assessment of vision; hearing; cardiovascular, nutritional, and functional status; neurologic function; and psychiatric status. Laboratory testing, such as vitamin B12 and folate levels, thyroid function, complete blood cell count, and comprehensive metabolic panel, may be necessary to rule out underlying conditions. Brain imaging with noncontrast magnetic resonance imaging (or non contrast computed tomography of the head if magnetic resonance imaging is unavailable or contraindicated) can rule out secondary causes. Differentiating dementia from potentially reversible conditions such as depression and delirium is essential. Referral to a neurologist is recommended for early-onset symptoms (before 60 years of age), for severe behavioral disturbances, or if the diagnosis is unclear.”

Read more of this article from the American Family Physicians December issue.