Juliet Holt Klinger, MA, Expert on Dementia Care

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20 February 2017

When you are having issues with your stomach, you make an appointment to see a gastroenterologist. When you can’t stop sniffling and sneezing in the spring, you call an allergist. But when the early symptoms of dementia arise, knowing what doctor to see may not be as clear. In fact, several different types of practitioners may get involved before reaching a diagnosis.



The journey typically starts with your primary care physician. If you or your loved one is over the age of 65, I recommend you see a board certified geriatrician for your primary care. Even if your family doctor is not a geriatrician, they will likely be the one who diagnoses the cognitive changes. This process generally includes getting a thorough medical history, testing mental status, physical and neurological exams, blood tests and brain imaging. It should also involve a discussion with the patient and their close family, to see what symptoms are the most troubling.

It’s important to remember that memory problems are not always caused by dementia and dementia is not only about memory problems. Depression, urinary tract infections, thyroid problems and heavy alcohol consumption are just some of the possible causes for increased confusion in older adults and most of these can often be resolved. Because of the thoroughness of the diagnostic process, the Alzheimer’s Association estimates that physicians accurately identify dementia in about 90 percent of cases.

If you or your loved one is having issues with cognition or was diagnosed with dementia, I recommend seeing a neurologist that specializes in Alzheimer’s and related dementias. If your primary care doctor doesn’t suggest this, go ahead and ask them to refer you to one. You can check with your local Alzheimer’s Association chapter for a list of neurologists who focus on dementia or you can call the neurologists’ offices to ask.

A neurologist should be able to identify whether it is Alzheimer’s or another form of dementia. This is crucial information because different types of dementia have different progression rates, ways that symptoms manifest themselves and care partnering considerations, and to some extent different treatments. Understanding and anticipating these can make a major difference for the person living with the diagnosis. While there is no cure for dementia, some of the available medications can temporarily slow the progression of symptoms and may help people living with the disease have a higher quality of life for longer.

The neurologist will also decide if it’s appropriate to partner with other professionals, such as a gero-psychiatrist or a neuropsychologist. For example, this is helpful if your loved one is living with depression or if further neuropsychological testing is needed.

An important component throughout this process is feeling comfortable with each physician. A dementia diagnoses can be a life-changing upheaval for individuals and families. It’s crucial to work with doctors who know how to communicate well and offer empathy and respect as the disease process progresses.

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