Dementia diagnosis when someone has sensory loss

Sensory loss can ‘mask’ dementia

If a person has a sensory loss, it may make it harder to recognise the onset and progression of dementia and even ‘mask’ dementia. For example, a person with sight loss may be in the early stages of dementia, but family and friends assume that their relative’s problem with getting about is explained by their impaired vision. Staff or family may wrongly assume that confusion in a person with hearing loss is being caused by a malfunctioning hearing aid rather than dementia despite the as-yet unexplained association between deafness and dementia.

Assessment and diagnosis

Given that the key risk factor for dementia is age, anyone working with older people must be aware of the complications that are inherent when diagnosing dementia in a person with sensory loss and take clear steps to be able to separate the two conditions.

Why is a diagnosis of dementia important?
A person living with sensory loss may benefit from getting a diagnosis of dementia in the same way as anyone else. They may be prescribed disease-delaying treatments as well as have the opportunity to make plans about how to remain independent for as long as possible.

Person-centred testing

People with sensory loss should be tested and assessed by a practitioner who understands both sensory loss and dementia. It’s important to ascertain an individual’s preferred method of communication and ensure information is presented in an accessible format, taking into account things, for example, font size and colour contrasts. Tests which rely on visual interpretation of information or being able to hear questions may not be helpful.

A person who lives with sensory impairment or loss will have developed ways of coping with their condition that need to be noted. Every effort should be made to use and maintain the equipment they use. For example:

• is the person wearing their hearing aid and wearing it properly?
• is it being maintained as necessary?
• does the care home have a loop fitted? 
• are someone’s glasses within reach?
• are the glasses clean and of the correct strength?
• are glasses clearly labelled ‘for reading’ or ‘distance’ and being used for the right purpose?

It’s important to encourage all older people to have regular hearing and sight tests. Sensory losses change and deteriorate.

Once a diagnosis is made, accessible information and communication methods is critical for enabling a person with sensory loss and/or dementia to access suitable services. 

• Further reading Open

  Alzheimer's Society (2012) 'Am I at risk of developing dementia?', Factsheet 450. London: Alzheimer’s Society.

  Alzheimer's Society (2012) 'Genetics of dementia', Factsheet 405. London: Alzheimer's Society.

  Alzheimer's Society (2012) 'Younger people with dementia', Factsheet 440. London: Alzheimer's Society.

  Alzheimer's Society website 'Statistics', online information.

  BBC website 'Your guide to reducing the risk of dementia'.

  McCullagh, C.D., Craig, D., McIlroy, S.P. and Passmore, A.P. (2001) 'Risk factors for dementia', Advances in Psychiatric Treatment, vol 7, pp 24–31.

  NHS Choices website 'Can dementia be prevented?', online information.

• Useful links Open

  Alzheimer’s Society
  The Alzheimer’s Society produces over 80 factsheets on all sorts of topics related to dementia, including many that relate to early signs and diagnosis, including Risk factors for dementia (450), Assessment and diagnosis (426), After a diagnosis (471), and The progression of Alzheimer’s disease and other dementias (458).

  healthtalk
  The healthtalk website contains stories from 31 carers of people with dementia, some presented in videos, some in audio recordings. The stories cover a wide range of areas, including recognising the early signs of dementia and getting the diagnosis.

  NHS Choices
  NHS Choices describes itself as the ‘online front door to the NHS’. It is the UK’s biggest health website and includes an A–Z of health conditions, including dementia, as well as explaining about treatments and how the health system works. The Dementia Guide on this site includes a section on Getting a dementia diagnosis, Benefits of early dementia diagnosis, and What to do if you’ve just been diagnosed with dementia.

  Unlocking diagnosis: The key to improving the lives of people with dementia.
  This All-Party Parliamentary Group of Dementia publication reports on the APPG’s 2012 inquiry into differing diagnosis rates – and the barriers for lifting these – around the UK.

  World Alzheimer Report 2011: The benefits of early diagnosis and intervention
  The Alzheimer’s Disease International 2011 report investigated the benefits and disadvantages of early diagnosis and intervention for people with dementia, the implications of early diagnosis for health and social care costs, and best practice in early intervention around the world.

• Related pages from this section Open

  • Early signs and diagnosis of dementia
    • Early signs of dementia
    • Dementia risk factors
    • What else could it be?
    • Causes of dementia (video)
    • Why early diagnosis is important
    • Early diagnosis and drug treatment (video)
    • Getting a diagnosis
    • Diagnosis when someone has sensory loss