Cell Models Of Stroke
Various cell culture models have been developed to understand the underlying mechanistic features of cerebral ischemia. Primary neuronal and glial cultures from cortex, hippocampus, cerebellum, and hypothalamus of embryo or perinatal rats and mice have been used widely to study anoxic or ischemic damage. The overall objective of in vitro research on ischemia was to understand the changes specific to each cell population and how they are similar in vivo. These cell models aid the progress and testing of potential therapeutic agents designed to prevent and/or counteract specific steps in the ischemic cascade of neurodegeneration .
Using cell culture model, Allen et al. conducted research to explore the function of small GTPase RhoA and its effector Rho kinase in permeability changes mediated by OGD. They concluded that OGD concessions the structural and functional capacities of an in vitro model of human cerebral barrier through activation of RhoA/Rho kinase pathway.
A research group from Canada attempted to study the effect of neutrophils on the increase in BBB permeability associated with ischemic reperfusion injury in vitro . Human brain endothelial cell line hCMEC/D3 was exposed to OGD with reoxygenation, and permeability was measured for a range of OGD exposure times . This study found that OGD induces reversible increases in permeability linked to nitric oxide synthesis in a human culture model of the BBB and shows that neutrophils mitigate permeability increases .
Helping Someone With Vascular Dementia
Caring for a person with vascular dementia can be very stressful for both you and your loved one. You can make the situation easier by providing a stable and supportive environment.
- Modify the caregiving environment to reduce potential stressors that can create agitation and disorientation in a dementia patient.
- Avoid loud or unidentifiable noises, shadowy lighting, mirrors or other reflecting surfaces, garish or highly contrasting colors, and patterned wallpaper.
- Use calming music or play the persons favorite type of music as a way to relax the patient when agitated.
How Can I Prevent Stroke
In many cases, vascular dementia is preventable. Risk factors for stroke and vascular dementia include
- high blood pressure,
- smoking, and
For many people, risk can be reduced by adopting a healthy lifestyle. People who have had a stroke may be able to reduce their risk of further strokes by drug treatment or surgery in addition to adopting a healthy lifestyle.
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Prevention Of Vascular Dementia
Studies show that the health of blood vessels is linked to your heart health. As you keep your heart healthy, you may reduce the risk of Vascular Dementia. To reduce your risk of Vascular Dementia, you may want to do the following.
- Healthy Blood Pressure. Be sure to monitor your blood pressure and keep it in a normal range. If you are experiencing high blood pressure, consult your doctor to manage it.
- Control Diabetes. Try to avoid developing type 2 diabetes by maintaining a healthy diet and exercise routine. This will help decrease the risk of Dementia. If you have Diabetes, be sure to control your glucose levels to protect your blood vessels from damage.
- Quit Smoking. If you smoke, now is the time to quit. Smoking causes damage to your blood vessels throughout your body.
- Be active. Create a workout routine to help you stay physically active. By doing this, you may avoid Vascular Dementia.
- Check your Cholesterol. Be sure to maintain healthy cholesterol levels. If you have high cholesterol, be sure to get the proper medical care to help maintain it. Having your levels in check may reduce the risk of heart attacks and strokes, leading to vascular Dementia.
Links Between Stroke And Vascular Dementia And Alzheimers Disease
After a few minutes or even a few seconds following IS, the IS cascade begins and can continue for hours until the disease ceases. The IS cascade involves biochemical reactions in the brain and other aerobic tissues. Dementia syndromes established after stroke were typically considered to be vascular in origin and post stroke dementia might be the significance of the effects of stroke and degenerative changes . Research linking stroke and dementia has focused on shared vascular risk factors, ameliorated by lifestyle activities or medication. Aging is the most important risk factor for stroke and dementia. Dementia occurs in up to one-third of elderly patients with stroke, a subset of whom have AD rather than a pure VaD. A mixed etiology of dementia and cerebrovascular disease was thought to become more common with increasing age, although no clinical criteria for the diagnosis of dementia with cerebrovascular diseases are currently available . Stroke doubles the risk for dementia , and approximately 30% of stroke patients go on to develop cognitive dysfunction within 3 years . The association between stroke and dementia was also observed in patients younger than 50 years, up to 50% of whom exhibit cognitive deficits after a decade .
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Recognise And Meet Spiritual And Cultural Needs
Care providers also need to be attentive to meeting a persons spiritual or cultural needs at the end of life. For one person, this may involve making sure they have contact with a religious leader in the last days or hours of their life, while another may want their favourite composers music to be played quietly but continuously throughout the period. This information should be recorded clearly, and should not come as a surprise to care staff who will know the person their life history, preferences and nature well. You should also discuss these aspects with the persons family or friends.
Support Family And Loved Ones
It is vital that the persons family and loved ones are aware that the person may be in the last few days or hours of life. Share information in a gentle and sensitive manner, drawing on those staff who have the strongest relationships with the person and their family. Giving family members space to explore their feelings and concerns is a critical part of good end-of-life care.
Often, family and loved ones want to be present when the person dies. They should know that changes can happen suddenly and the person may die, for example, when they have just popped out of the room to use the bathroom.
Sometimes, family members may not want to be present at the death. Family and relatives should never feel that they should stay, but always give them the opportunity to stay and to be involved in care as they wish.
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Caring For Someone With Dementia
Caring for a person with dementia can be physically and emotionally demanding. Anger, guilt, frustration, discouragement, worry, grief and social isolation are common.
Learn as much about vascular dementia as you can. Ask the primary care doctor or neurologist about good sources of information. Your local librarian also can help you find good resources.
Take care of yourself. See your doctors on schedule, eat healthy and exercise.
Seek support. People with dementia and their families benefit from counseling or local support services. Contact your Alzheimers Association local affiliate to connect with support groups, resources, referrals, home care agencies, residential care facilities, telephone help lines and educational seminars.
Encourage. You can help a person cope with vascular dementia by listening, reassuring them that life can be enjoyed and helping them retain dignity and self-respect.
Provide a calm environment. It can reduce worry and agitation. Establish a daily routine that includes comfortable activities for the person with vascular dementia.
New situations, excess noise, large groups of people, being rushed to remember or being asked to do complicated tasks can cause anxiety. As a person with dementia becomes upset, the ability to think clearly declines even more.
Paying attention to your needs and well-being is one of the most important things you can do for yourself and the person in your care.
Vascular Dementia Signs And Symptoms
Vascular dementia affects different people in different ways and the speed of the progression also varies from person to person. Some symptoms may be similar to those of other types of dementia and usually reflect increasing difficulty to perform everyday activities like eating, dressing, or shopping.
Behavioral and physical symptoms can come on dramatically or very gradually, although it appears that a prolonged period of TIAsthe mini-strokes discussed aboveleads to a gradual decline in memory, whereas a bigger stroke can produce profound symptoms immediately. Regardless of the rate of appearance, vascular dementia typically progresses in a stepwise fashion, where lapses in memory and reasoning abilities are followed by periods of stability, only to give way to further decline.
|Common Signs and Symptoms of Vascular Dementia|
|Mental and Emotional Signs and Symptoms|
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Life Expectancy And Dementia With Lewy Bodies
Dementia with Lewy bodies accounts for around 7% of cases of dementia. Lewy bodies are tiny protein deposits that affect thought, memory and movement and are linked to both dementia and Parkinsons disease.
Hallucinations, sleep disturbance, and movement problems can be an early feature in dementia with Lewy bodies, so that diagnosis may be made at an earlier stage. Some research suggests that survival can be significantly shorter with this challenging condition, however, the Alzheimerâs Society says:
What Is The Follow
If you have had a stroke or have vascular dementia, you should see your health care provider regularly. These visits allow him or her to evaluate your symptoms and adjust treatments if necessary.
You may eventually become unable to care for yourself, or even to make decisions about your care.
- It is best to discuss future care arrangements with family members as early as possible so that your wishes can be clarified and documented for the future.
- Your health care provider can advise you about legal documents that you should complete to ensure that these wishes are observed.
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Symptoms Of Vascular Dementia
Symptoms of vascular dementia depend on what part of the brain is affected and to what extent. Like Alzheimer’s disease, the symptoms of vascular dementia are often mild for a long time. They may include:
- Problems with short-term memory
- Hallucinations or delusions
Symptoms that suddenly get worse often signal a stroke. Doctors look for symptoms that progress in noticeable stages to diagnose vascular dementia. Alzheimer’s, by comparison, progresses at a slow, steady pace. Another clue is impaired coordination or balance. In vascular dementia, problems walking or balancing can happen early. With Alzheimer’s, these symptoms usually occur late in the disease.
What Other Things Help
In addition to medications, there are various ways to help a person with vascular dementia. Research has shown that physical exercise and maintaining a healthy weight help to enhance brain health and reduce the risk of heart problems, stroke and other diseases that affect blood vessels. A balanced diet, enough sleep and limited alcohol intake are other important ways to promote good brain health and reduce the risk for heart disease. Other illnesses that affect the brain, such as diabetes, high blood pressure and high cholesterol, should also be treated if present.
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How Long Can Person With Vascular Dementia Care For Themselves
A person with vascular dementia will need help with at least some aspects of daily function, such as managing medications, paying bills or preparing food. You or your family member with vascular dementia may be able to do many things for themselves although, it may not be safe for them to live alone, depending on what abilities are affected. For some people with vascular dementia, more specialized care may be required from facilities that care specifically for people with dementia.
Do Strokes Cause Dementia
While strokes do not officially cause Vascular Dementia, oftentimes, Vascular Dementia does follow a stroke or several mini-strokes. There is a growing number of people who have had strokes and now have Dementia. This is more common in older ages but can be diagnosed in those who are younger as well but not typically seen.
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Towards The End Of Life
It can be very difficult for family and carers to prepare for the end, but by thinking about it and making some plans, it may be a little easier. When someone reaches the final stages of life one of the main concerns is to ensure that they are comfortable and as pain free as possible. If you are concerned that the person with dementia may be in some pain or discomfort, discuss this with the doctor and nursing staff.
Why Is It Challenging To Diagnose Vascular Dementia
It is often challenging to diagnose Vascular Dementia, because it depends on the size of the blockage or the area that is affected in the brain. Suppose a small portion is involved in the area that controls your memory. In that case, you may just become a little bit more forgetful, but you can still function as expected in your life. In part, it goes unnoticed. But, if larger areas are affected, this may affect bigger things like solving problems or extensive memory impairments. This will be more noticeable but may be classified as a different type of Dementia.
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What Happens In Vascular Dementia
Vascular dementia can cause different symptoms depending on where the blood vessels are damaged in the brain. For example, a person who had a stroke may have sudden problems with memory, balance, or speech. However, a person can have several strokes that may be unnoticeably small, but the damage can add up over time.
Many people with vascular dementia have trouble with memory. Others may have difficulty with organization and solving complex problems, slowed thinking, or being easily distracted. People with vascular dementia may also have changes in mood or behavior, such as irritability, loss of interest, or depression.
Sometimes, people with vascular dementia have trouble with balance and movement. This might include weakness on one side of the body, and the symptoms may get worse over time.
What Is The Prognosis If You Are Living With Vascular Dementia
Regardless of the type of Dementia that you are living with, it is a progressive disease that worsens over time. Dementia affects individuals differently. While some living with Vascular Dementia may see a prolonged decline, others may decline at a much more rapid pace.
Currently, there is no cure for Vascular Dementia. You can do things that may reduce your risk factors or help slow its progression.
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Are There Medicines To Treat Vascular Dementia
Though there is no cure for vascular dementia yet, there are medications that can help manage the symptoms. Sometimes medications used to treat memory problems in Alzheimers disease may be helpful for vascular dementia. Sometimes, people with vascular dementia can have mood changes, such as depression or irritability. These can be managed by medications like the ones used for depression or anxiety.
How Vascular Dementia Develops
Symptoms of vascular dementia can appear suddenly if they are caused by a single stroke, or if they are caused by silent strokes they may appear gradually over time. Vascular dementia sometimes develops in steps, so that symptoms will stay the same for a while and then suddenly get worse. These steps are usually due to new strokes.
You can read more about treatments to slow down the progression of dementia.
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A Tia Is A Warning Of Two Serious Health Conditions
1. Its a sign of major stroke in the near futureMini strokes usually dont cause permanent brain damage, but theyre a serious warning sign that a major stroke will happen in the future.
In fact, a TIA occurs before about 12% of all strokes.
2. They cause vascular dementiaVascular dementia is the second most common form of dementia and is caused by reduced blood flow to the brain usually from a stroke or a series of strokes.
This type of dementia usually affects people aged 60 to 75 and is more common in men than women.
Even though TIAs can be unnoticeably small, the damage to the brain adds up over time.
When the blood flow to the brain is blocked, brain cells dont get oxygen and nutrients. That causes damage to areas of the brain associated with learning, memory, and language.
This leads to memory loss, confusion, and other signs of dementia.
Stage : Middle Stage Vascular Dementia
With vascular dementia, the disease usually becomes worse after some time, particularly with the lack of proper treatment.
After finding out the possible vascular dementia prognosis and going through the initial stages of the disease, a person then moves on to the next phase of the illness.
At this stage, the symptoms that you experienced during the initial malady start to become more intense.
You might even find that you need more assistance with your day to day life because your level of independence starts to decline.
With most people, getting help from family and friends is still sufficient at this point without the need for professional home care. For some, it may be time to step down from responsible duties at the workplace.
Help is necessary for more daily tasks
Problems with communication, disorientation, confusion, reasoning, and memory loss escalate in a way that a person is not able to be as productive as they are supposed to be.
Many can handle a few house chores here and there, but may still need some support with a few areas in their lives.
Most of the time, individuals at this stage cannot fully complete jobs. You may find that something as simple as counting from one to ten becomes an uphill task for most.
Most individuals with vascular dementia will start pulling away from social life, knowing that the symptoms are becoming more visible at this stage.
This is known as the stepwise or step-like progression pattern.
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