Dementia is a growing concern as our population ages, and early detection is more crucial than ever. In this blog post, we'll explore how therapists can develop a toolkit for recognizing dementia in clients and discuss some practical interventions to support them. This information is especially valuable for therapists who may not have specialized training in neuropsychology but still play a key role in early detection and ongoing care.   

Understanding Dementia: More Than Just Memory Loss 

Dementia is a broad term for a decline in cognitive function severe enough to interfere with daily life. While Alzheimer's disease is the most well-known form, there are several types of dementia, each with unique characteristics. 

Dr. Nicholas Schollars emphasizes the importance of accurate assessment: "We do run the risk of misdiagnosing our clients and giving them the wrong treatment if we misuse this information." 

Types of Dementia 

Alzheimer's Disease:

• Characteristics: Slow, insidious onset with initial memory and learning impairments. 
• Stats: 60-90% of dementia cases. 
• Early Signs: Difficulty learning new information, forgetting recent events or familiar names. 

Vascular Dementia: 

• Characteristics: Often follows cardiovascular events like strokes. 
• Stats: 20-30% of stroke victims develop vascular dementia. 
• Early Signs: Sudden cognitive decline following a stroke, stepwise progression of symptoms. 

Frontotemporal Dementia (FTD):

• Characteristics: Affects behavior or language due to frontal or temporal lobe atrophy. 
• Early Signs: Apathy, behavioral disinhibition, language difficulties.   

Lewy Body Dementia:

• Characteristics: Fluctuating cognition, detailed visual hallucinations, Parkinsonism. 
• Early Signs: Periods of confusion, vivid hallucinations, motor symptoms like tremors. 

Early Detection of Dementia: Why It Matters 

Detecting dementia early can significantly alter the disease's progression. "We can extend that period of time by about two to three years, which can be extremely meaningful for our clients," notes Dr. Schollars. Early detection allows for: 

• More effective use of new medications. 
• Extended independence and quality of life. 
• Better preparation for caregivers. 

Screening Tools for Dementia 

Using reliable screening tools can help identify dementia early. Dr. Schollars recommends three common tools: 

Montreal Cognitive Assessment (MoCA): 

• Description: A widely used cognitive screening test. 
• Administration: Can be done on paper, iPad, or via telehealth. 
• Scoring: A score above 26 is normal; scores below 26 may indicate cognitive impairment. 

Mini-Mental State Examination (MMSE): 

• Description: Another common screening tool focusing on different cognitive domains. 
• Scoring: Scores of 25 or above indicate normal cognitive function.   

Ascertain Dementia 8 (AD8): 

• Description: A self-report and informant-report tool that uses a symptom checklist. 
• Scoring: Scores of 2 or higher suggest further testing is needed. 

Practical Interventions and Support for Dementia

Once dementia is detected, therapists can play a vital role in supporting clients and their caregivers. Dr. Schollars highlights several strategies: 

Mindfulness and Meditation: 

• Benefits include reduced stress, improved quality of life, and maintained brain connectivity. 
• "Mindfulness can significantly slow the rate of cognitive decline," says Dr. Schollars. 

Music Therapy: 

• Enhances quality of life and reduces depression. 
• Can be enjoyed by clients across all stages of dementia. 

Group Therapy: 

• Provides social support and helps process grief related to the diagnosis. 
• Alleviates caregiver stress by offering a community of shared experiences. 

Therapists are uniquely positioned to recognize and support dementia in their clients. By understanding the different types of dementia, utilizing effective screening tools, and implementing practical interventions, therapists can make a significant impact on the lives of those affected.  

As Dr. Schollars points out, "Being able to discern dementia and then get them into the pipeline of dementia care as quickly as possible is very important." Let's use our skills and knowledge to offer hope and support to our clients and their families. 

If you're a mental health provider wanting to learn more about demetia, you can take our home-study course for CE credit: Beyond the Surface: A Clinician's Toolkit for Dementia Recognition and Intervention

Alternatively, you can watch the content from the home-study course for free without CE credit: