When a loved one begins demonstrating signs of forgetfulness, repetitive stories, wandering and other memory-related symptoms, physicians will often note the term “dementia” in their medical charting. It may be due to insurance and Medicare billing codes for reimbursement. In any case, the diagnosis does not identify the cause.Dementia is not a disease; rather it is a group of symptoms including memory loss, changes in language and skills, and disorientation. When someone exhibits these symptoms, it is essential to have a thorough medical evaluation to determine the cause. Some of the conditions can be treated and even cured. Examples include: thyroid disorders, vitamin deficiencies, urinary tract infections, depression, dehydration, infection, alcohol or other substance abuse, and brain tumors.Other forms of dementia that are not curable include: Alzheimer’s disease, Lewy body dementia, vascular dementia, traumatic brain injury, fronto-temporal dementia and Parkinson’s disease.Evaluations should include a complete history to uncover the person’s lifestyle and past history for head injuries (even as a child), military service and health history.A thorough exam by a neurologist should include: physical and neurological evaluation, complete review of all medications, including prescribed, herbal and over-the-counter, neuropsychological testing to assess thinking and memory skills, complete blood count, screening metabolic panel, thyroid function test, vitamin B levels, urinalysis, electrocardiogram and a brain scan.A brain scan could include one of the following: Magnetic resonance imaging, computerized tomography, positron emission tomography, single proton emission computerized topography.Remember that dementia is not a complete diagnosis. Some drugs used to treat certain forms of dementia can actually cause extreme adverse reactions in other forms of dementia. Like every other challenge in life, you can’t play the game if you don’t know the rules.• Karen Perry is the executive director of The Lodge Assisted Living Facility in Carson City.