Overcoming the barriers to the diagnosis of dementia

Cognitive assessment is an important skill for health care providers, particularly when considering the increasing prevalence of dementia. Studies have shown that the current diagnostic criteria for dementia are inadequate, and dementia is missed in both outpatient and inpatient settings. Screening tests, such as the Mini-Mental State Examination, detect the presence of cognitive impairment but will not provide a diagnosis of dementia. The gold standard for diagnosing dementia is the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. Different causes of dementia are assessed by conducting a detailed history and physical examination of the patient. Differentiating mild cognitive impairment from dementia is very important in terms of medical management, particularly in relation to treatment with cholinesterase inhibitors.