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Updated: Aug 24, 2026

The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease
Published on: October 13, 2016
[It is sad, but it is true: yes, your father has dementia...]
Guy Frenette1, Pierre Beauchemin
1Service de gériatrie ambulatoire du CHUQ-CHUL, Québec.
Abstract:
In the coming years, an increasing number of patients will be told by their family physician during a visit to his office that they are suffering from dementia. Since it is primarily a clinical diagnosis, and as doctors will have to manage the discomfort and uncertainty associated with it (possibility versus probability of dementia), the doctor-patient communication skills will be at the centre of the relationship. There is still no cure for dementia. When and how should we tell the patient and his family about it? What are the pros and cons of formally telling the patient? People expect to hear the truth, and get useful information at the right time. They also look for a regular and trustworthy follow-up through the full course of the disease. Giving information to the patient and the family is of the utmost importance: risk factors, diagnostic features, things to expect, prognosis, treatment, legal aspects, driving license. Natural caregivers play a major role in keeping the patient at home with an optimal quality of life: they have their own expectations and must be given appropriate support and information by the family physician.
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