Diagnosing dementia can feel like navigating a maze—especially in the early stages, when signs of cognitive decline may be subtle or easily mistaken for normal aging. Fortunately, clinical guidelines have evolved to offer greater clarity, and tools like Neurotrack’s cognitive screening system are helping streamline the process for clinicians. In this post, we’ll walk you through how dementia is typically diagnosed with the help of new technology, from initial screening to clinical workup, using the DSM-5 diagnostic criteria as a framework.
Why start here?
Early detection is key. Neurotrack’s technology allows clinicians to screen patients quickly and effectively—either at home or in the office. It begins with a 3-minute test and unlocks additional tasks only where concern is warranted. These exams can completed on any device and are designed to align with DSM-5 criteria for neurocognitive disorders.
What’s included in the report?
Once testing is complete, the tool generates a report summarizing the results in pertinent cognitive domains, in accordance with DSM-5 guidelines.
Each report features:
A summary of cognitive performance compared to peers of similar age, sex, and educational background
Possible clinical indications
Recommended next steps
This report serves as a powerful jumping-off point for further evaluation when cognitive impairment is detected.
If the screening raises concerns, the next step is a clinical workup. According to guidelines from the DSM-5, Medicare, the Alzheimer’s Association, and the American Academy of Neurology, the goals of this workup are to:
Rule out other possible causes of cognitive symptoms (such as depression, overmedication, infection, or sleep apnea)
Determine the severity and functional impact of any cognitive decline
Key steps include:
Reviewing medical records and patient history
Screening for psychiatric symptoms and assessing functional impairment with a reliable informant (such as a caregiver)
Evaluating substance use and medication side effects
Administering additional questionnaires and tests
Ordering labs or brain imaging when appropriate
The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) categorizes cognitive impairment into two major types:
Modest cognitive decline in one or more cognitive domains
Daily functioning mostly preserved (especially instrumental activities of daily living)
Not attributable to delirium or another mental disorder
Significant decline in one or more cognitive domains
Interference with basic activities of daily living
Also not due to delirium or another mental disorder
Diagnosis must be supported by:
Cognitive testing (e.g., Neurotrack)
Observations from a trusted informant
Clinical judgment regarding changes in function and cognition over time
If you were trained under DSM-IV, you might notice several important updates in DSM-5:
Mild Neurocognitive Disorder was introduced to better recognize early-stage disease
Memory loss is no longer the defining symptom—this recognizes that other domains, for example, complex attention or executive function, are often affected first
Objective cognitive assessment tools are now emphasized in making a diagnosis (so FDA-registered digital tests like Neurotrack that provide clinically-trusted, instant results without the variability of subjective scoring are ideal)
The DSM-5 offers greater specificity in identifying behaviors and syndromes to support differential diagnosis
With digital tools like Neurotrack and the structured guidance of the DSM-5, clinicians now have a clearer, more objective way to assess cognitive function. This approach supports earlier detection and timely diagnosis, getting patients the care and support they require, which in turn improves outcomes.
Want to learn more about how digital cognitive assessments can support your practice? Contact us to explore Neurotrack’s Cognitive Screening System today.