The prevalence of dementia is on a rising trend with the rapidly ageing population in Singapore. Hence, early diagnosis of dementia is important as early therapeutic interventions may palliate substantially, if not reverse, the significant emotional and economic costs of the illness. This is especially important in view of potential disease-modifying therapies in the pipeline, where treatment can then be initiated for those in the earliest stages of cognitive impairment, hence reducing the resultant morbidity and complications of the disease. In this paper, we present a 4-step approach to dementia evaluation, incorporating local data, where possible. The first step requires the exclusion of delirium as the cause of the forgetfulness or confusion. The second step involves establishing the diagnosis of dementia. The third step assesses for the behavioural, functional and social problems associated with dementia. The final step, with the use of a focused history, physical examination, investigations and selected use of neuroimaging, attempts to establish the aetiological diagnosis of the dementia.