Getting a Dementia Diagnosis: What the Process Actually Looks Like

For many families navigating dementia, the stretch of time between suspicion and diagnosis is one of the hardest. Most people don’t know what the diagnostic process actually involves, and that lack of knowledge can contribute to a delay in diagnosis.

Dr. Reza Hosseini Ghomi, a neuropsychiatrist and health technology entrepreneur who specializes in neurodegenerative disorders, walked through the full picture in a recent episode of ComForConnections. Here’s what he shared about how a diagnosis actually comes together.

The first step is a visit with a primary care doctor

A visit with a primary care physician is more productive than many people expect. If concerns come up, most primary care providers will administer a brief cognitive assessment on the spot: recalling a short word list, solving a simple math problem, drawing a clock. Combined with the history a family member or caregiver provides, that’s often enough to determine whether a referral is warranted.

The referral typically goes to a neurologist, psychiatrist, or geriatric specialist. From there, additional evaluation may include brain imaging — ideally an MRI — and increasingly, a blood test. A blood-based test for Alzheimer’s-related proteins became widely available in recent years, making early diagnosis significantly more accessible. Previously, confirming Alzheimer’s required a spinal tap or specialized imaging that most patients couldn’t readily access. That’s changed, and primary care providers are now better positioned to move the process forward without waiting for a specialist.

The honest caveat is that wait times for specialist appointments can be long, and the path isn’t always linear. Dr. Hosseini Ghomi describes it as being where cancer care was several decades ago — the process is improving, but it still asks a lot of families.

Why a formal diagnosis matters

One of the most common hesitations families bring to this process is the worry that a diagnosis will create problems with things like insurance, employment, or driving. Dr. Hosseini Ghomi has heard this concern throughout his career, and his experience has proven time and again: the benefits of a formal diagnosis far outweigh the risks.

A specific diagnosis in the chart is what unlocks practical support. Insurance plans, including Medicare, begin covering caregiver services and other care resources once a qualifying diagnosis is documented. Treatment options, including medications that work best when started early, become available. 

Most importantly, the clarity a diagnosis brings to the family matters more than some anticipate. As Dr. Hosseini Ghomi put it in the episode, a diagnosis brings resolution to a worry families may have been struggling to articulate for years.

Cognitive health is connected to overall health

The case for moving through the diagnostic process without delay isn’t only about accessing care sooner. Several health conditions that are common and treatable — among them sleep apnea, high blood pressure, elevated cholesterol, thyroid irregularities, and some medications — are known to worsen cognitive symptoms or accelerate decline. Identifying and addressing those factors early can meaningfully affect the course of the disease.

Certain medications deserve particular attention. A class of drugs called anticholinergics, which includes older antihistamines, some bladder medications, and certain sleep aids, can cloud thinking and memory — especially in someone who already has an underlying dementia process. Reviewing the full medication list with a provider is often one of the first and most productive steps a family can take.

Early action opens doors

When approached proactively, a diagnosis can lead to interventions that ease symptoms and make the journey less stressful for everyone involved. As Dr. Hosseini Ghomi told Tiffany Robison in the episode: “A diagnosis doesn’t end someone’s story. It changes how you build the care around them — and the earlier the better, the more time you will have and the more time they will be independent.”

Listen to Dr. Hosseini Ghomi’s full conversation with Tiffany Robison on ComForConnections, and learn more about ComForCare’s in-home dementia care services.