What Is Vascular Dementia
Vascular dementia is the second most common form of dementia after Alzheimer’s disease. It’s caused when decreased blood flow damages brain tissue. Blood flow to brain tissue may be reduced by a partial blockage or completely blocked by a blood clot.
Symptoms of vascular dementia may develop gradually, or may become apparent after a stroke or major surgery, such as heart bypass surgery or abdominal surgery.
Dementia and other related diseases and conditions are hard to tell apart because they share similar signs and symptoms. Although vascular dementia is caused by problems with blood flow to the brain, this blood flow problem can develop in different ways. Examples of vascular dementia include:
- Mixed dementia. This type occurs when symptoms of both vascular dementia and Alzheimer’s exist.
- Multi-infarct dementia. This occurs after repeated small, often “silent,” blockages affect blood flow to a certain part of the brain. The changes that occur after each blockage may not be apparent, but over time, the combined effect starts to cause symptoms of impairment. Multi-infarct dementia is also called vascular cognitive impairment.
Researchers think that vascular dementia will become more common in the next few decades because:
Managing Movement Problems In Ftd
Medications and physical and occupational therapy may provide modest relief for the movement symptoms of FTD. A doctor who specializes in these disorders can guide treatment.
For people with corticobasal syndrome, Parkinsons disease medicines may offer some temporary improvement. Physical and occupational therapy may help the person move more easily. Speech therapy can help them manage language symptoms.
For people with progressive supranuclear palsy, sometimes Parkinsons disease drugs provide temporary relief for slowness, stiffness, and balance problems. Exercises can keep the joints limber, and weighted walking aids such as a walker with sandbags over the lower front rung can help maintain balance. Speech, vision, and swallowing difficulties usually do not respond to any drug treatment. Antidepressants have shown modest success. For people with abnormal eye movements, bifocals or special glasses called prisms are sometimes prescribed.
People with FTD-ALS typically decline quickly over two to three years. During this time, physical therapy can help treat muscle symptoms, and a walker or wheelchair may be useful. Speech therapy may help a person speak more clearly at first. Later on, other ways of communicating, such as a speech synthesizer, can be used. The ALS symptoms of the disorder ultimately make it impossible to stand, walk, eat, and breathe on ones own.
What Are The Causes Of Lewy Body Dementia
The precise cause of LBD is unknown, but scientists are learning more about its biology and genetics. For example, we know that an accumulation of Lewy bodies is associated with a loss of certain neurons in the brain that produce two important chemicals that act as messengers between brain cells . One of these messengers, acetylcholine, is important for memory and learning. The other, dopamine, plays an important role in behavior, cognition, movement, motivation, sleep, and mood.
Scientists are also learning about risk factors for LBD. A risk factor is something that may increase the chance of developing a disease. Some risk factors can be controlled while others cannot. Age is considered the greatest risk factor. No specific lifestyle factor has been proven to increase one’s risk for LBD.
Other known risk factors for LBD include certain diseases and health conditions, particularly Parkinson’s disease and REM sleep behavior disorder, which have been linked to a higher risk of LBD.
Having a family member with LBD also may increase a person’s risk, though LBD is not considered a genetic disease. Variants in three genes APOE, SNCA, and GBA have been associated with an increased risk, but in most cases, the cause is unknown.
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Causes And Risk Factors
PD is idiopathic, meaning that a doctor does not know why a person has the condition. However, according to Johns Hopkins Medicine, early-onset Parkinsons disease has links to genetic inheritance from a parent.
Researchers have identified several risk factors that may make a person with Parkinsons disease more likely to experience dementia.
These risk factors include:
- advanced age at time of diagnosis
- experiencing excessive daytime sleepiness
- hallucinations before the onset of other dementia symptoms
- having a specific Parkinsons symptom that causes a person to have difficulty starting to take a step or to halt mid-step while walking
- a history of mild thought impairment
- more severe movement impairment symptoms than most people with Parkinsons disease
However, researchers do not know why some people with Parkinsons disease develop cognitive difficulties as well as movement problems.
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Depression May Be An Early Symptom Of Parkinsons
Depression is one of the most common, and most disabling, non-motor symptoms of Parkinsons disease. As many as 50 per cent of people with Parkinsons experience the symptoms of clinical depression at some stage of the disease. Some people experience depression up to a decade or more before experiencing any motor symptoms of Parkinsons.
Clinical depression and anxiety are underdiagnosed symptoms of Parkinsons. Researchers believe that depression and anxiety in Parkinsons disease may be due to chemical and physical changes in the area of the brain that affect mood as well as movement. These changes are caused by the disease itself.
Here are some suggestions to help identify depression in Parkinsons:
- Mention changes in mood to your physician if they do not ask you about these conditions.
- Complete our Geriatric Depression Scale-15 to record your feelings so you can discuss symptoms with your doctor. Download the answer key and compare your responses.
- delusions and impulse control disorders
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What Are The Symptoms Of Vascular Dementia
People with vascular dementia may experience:
- Difficulty performing tasks that used to be easy, such as paying bills
- Trouble following instructions or learning new information and routines
- Forgetting current or past events
- Misplacing items
- Loss of interest in things or people
- Changes in personality, behavior, and mood, such as depression, agitation, and anger
- Hallucinations or delusions
- Poor judgment and loss of ability to perceive danger
Recognition And Coordination Difficulties
A person showing early signs of dementia may put everyday things in unusual places . They may have difficulty recognising familiar items such as a chair, soap, toothbrush, cutlery, kettle, coffee jar, cooker or fridge.
Signs of a loss of coordination skills can include struggling to undo or do up buttons, to tie or untie shoes and neckties, and to use a hair brush or razor. They may be more subtle, such as putting down a cup of tea too close to the edge of a table or having difficulties lifting a teapot or kettle or using a knife to cut vegetables or fruit.
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What Is The Treatment For Dementia
Treatment options for Alzheimer’s disease and other dementia are limited. While there are medications available to try to improve the symptoms of Alzheimer’s disease, the effect of these medications is limited. Physical exercise has been shown to be of some benefit in helping to maintain cognition. Staying engaged and participating in social events may also be of some help. To date, no treatment which can reverse the process of Alzheimer’s disease has been identified.
How Is Dementia Diagnosed
To diagnose dementia, doctors first assess whether a person has an underlying, potentially treatable, condition that may relate to cognitive difficulties. A physical exam to measure blood pressure and other vital signs, as well as laboratory tests of blood and other fluids to check levels of various chemicals, hormones, and vitamins, can help uncover or rule out possible causes of symptoms.
A review of a persons medical and family history can provide important clues about risk for dementia. Typical questions might include asking about whether dementia runs in the family, how and when symptoms began, changes in behavior and personality, and if the person is taking certain medications that might cause or worsen symptoms.
The following procedures also may be used to diagnose dementia:
Early detection of symptoms is important, as some causes can be treated. However, in many cases, the cause of dementia is unknown and cannot be treated. Still, obtaining an early diagnosis can help with managing the condition and planning ahead.
Going For An Assessment
The list of conditions and problems above isnt everything. Theres a whole range of things that can occasionally cause dementia-like symptoms for some people.
Diagnosis For These Four Types Of Dementia
Symptoms can be similar among different types of dementia, and some people have more than one form of dementia, which can make an accurate diagnosis difficult. Symptoms can also vary from person to person. Doctors may ask for a medical history, complete a physical exam, and order neurological and laboratory tests to help diagnose dementia.
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Statistics Of Dementia In Men
Approximately 14 percent of Americans 71 years and older have some form of dementia, with the prevalence being slightly higher in women. Sixteen percent of women 71 years and older suffer from dementia, compared to only 11 percent of men. These results were found during the Aging, Demographics, and Memory Study .
Researchers and scientist are still unclear why this gender difference exists, but theorize that the longer life expectancies of women may play a factor. Other possible reasons may be hormonal differences between men and women, genetic differences , and even historical differences in education, as in the past, educated women were a rarity and it is known that low education is a risk factor for the development of Alzheimers.
Treatment And Care For Lewy Body Dementia
While LBD currently cannot be prevented or cured, some symptoms may respond to treatment for a period of time. An LBD treatment plan may involve medications, physical and other types of therapy, and counseling. A plan to make any home safety updates and identify any equipment can make everyday tasks easier.
A skilled care team often can suggest ways to improve quality of life for both people with LBD and their caregivers.
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Common Symptoms That Occur In The Early Stages Of Dementia
As people get older, theyre likely to notice changes in the way their brain works especially what they are able to remember. The symptoms that occur in the early stages of dementia are similar to normal, age-related changes but with a few differences. These differences can help you know if you should be concerned about Alzheimers or dementia.
Here are ten early signs of Alzheimers and other types of dementia.
Early Signs Of Parkinsons Disease Dementia
In the beginning, PDD can be subtle. Early on, there may be memory loss and difficulties with daily activities, says Michael S. Okun, M.D., executive director of the Norman Fixel Institute for Neurological Diseases at University of Florida Health in Gainesville. Delusions or hallucinations may also start to happen. Dr. Petrossian points out that there can be an overlap between the early signs of dementia and mild cognitive impairment due to Parkinsons disease, which can make it difficult to learn new skills and recall information or conversations.
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What Are The Early And Later Signs And Symptoms Of Dementia
Early signs of dementia may include:
- Simple forgetfulness
- Problems performing tasks or activities that were previously done without effort.
- Difficulty with learning new material is frequently one of the earliest signs of dementia.
Many patients with early Alzheimer’s disease or other types of dementia are unaware that they have any problem. As the disease progresses, behavioral changes can become evident.
- Patients have difficulty performing basic tasks, such as getting dressed or using the bathroom.
- Some patients begin to forget pieces of information about themselves, including their address or telephone number, or even their date of birth.
- They may have difficulty understanding what is occurring around them.
- Some patients have problems remembering to eat and may develop pronounced weight loss.
- In the late stages of dementia, patients often cannot recognize family members and their ability to communicate effectively is markedly impaired.
- They are no longer able to effectively care for themselves and require assistance for all activities of daily living.
- Over time, patients can forget how to walk or even how to sit up.
The stages of dementia are loosely grouped into mild, moderate, and severe categories by some doctors. However, there is another system of staging for dementia.
How Is Parkinson Disease Treated
Parkinson disease cant be cured. But there are different therapies that can help control symptoms. Many of the medicines used to treat Parkinson disease help to offset the loss of the chemical dopamine in the brain. Most of these medicines help manage symptoms quite successfully.
A procedure called deep brain stimulation may also be used to treat Parkinson disease. It sends electrical impulses into the brain to help control tremors and twitching movements. Some people may need surgery to manage Parkinson disease symptoms. Surgery may involve destroying small areas of brain tissue responsible for the symptoms. However, these surgeries are rarely done since deep brain stimulation is now available.
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What To Do If A Loved One Is Suspicious Of Having Dementia
- Discuss with loved one. Talk about seeing a medical provider about the observed changes soon. Talk about the issue of driving and always carrying an ID.
- Medical assessment. Be with a provider that you are comfortable with. Ask about the Medicare Annual Wellness exam.
- Family Meeting. Start planning, and gather documents like the Health Care Directive, Durable Power of Attorney for Health Care, Estate Plan.
What Is Needed For A Parkinsons Disease Dementia Diagnosis
There is no definitive medical test that confirms cognitive decline or dementia in Parkinsons disease. The most accurate way to measure cognitive decline is through neuropsychological testing.
- The testing involves answering questions and performing tasks that have been carefully designed for this purpose. It is carried out by a specialist in this kind of testing.
- Neuropsychological testing addresses the individuals appearance, mood, anxiety level, and experience of delusions or hallucinations.
- It assesses cognitive abilities such as memory, attention, orientation to time and place, use of language, and abilities to carry out various tasks and follow instructions.
- Reasoning, abstract thinking, and problem-solving are tested.
- Neuropsychological testing gives a more accurate diagnosis of the problems and thus can help in treatment planning.
- The tests are repeated periodically to see how well treatment is working and check for new problems.
Imaging studies: Generally, brain scans such as CT scans and MRIs are of little use in diagnosing dementia in people with Parkinsons disease. Positron emission tomographic scan may help distinguish dementia from depression and similar conditions in Parkinsons disease.
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How Is Vascular Dementia Treated
Because many different disease processes can result in different forms of vascular dementia, there may not be one treatment for all. However, vascular dementia is often managed with medications to prevent strokes and reduce the risk of additional brain damage. Some studies suggest that medications that are used to treat Alzheimer’s might benefit some people with an early form of vascular dementia. Treating modifiable risk factors like high blood pressure, diabetes, high cholesterol, and problems with the rhythm of the heartbeat can help prevent additional stroke. Living a healthy lifestyle is important to help reduce the risk factorsof vascular dementia.
What To Watch For
Here are some of the warning signs identified by dementia experts and mental health organizations:
Difficulty with everyday tasks. Everyone makes mistakes, but people with dementia may find it increasingly difficult to do things like keep track of monthly bills or follow a recipe while cooking, the Alzheimers Association says. They also may find it hard to concentrate on tasks, take much longer to do them or have trouble finishing them.
Repetition. Asking a question over and over or telling the same story about a recent event multiple times are common indicators of mild or moderate Alzheimer’s, according to the Cleveland Clinic.
Communication problems. Observe if a loved one has trouble joining in conversations or following along with them, stops abruptly in the middle of a thought or struggles to think of words or the name of objects.
Getting lost. People with dementia may have difficulty with visual and spatial abilities. That can manifest itself in problems like getting lost while driving, according to the Mayo Clinic.
Personality changes. A loved one who begins acting unusually anxious, confused, fearful or suspicious becomes upset easily or loses interest in activities and seems depressed is cause for concern.
Troubling behavior. If your family member seems to have increasingly poor judgment when handling money or neglects grooming and cleanliness, pay attention.
People with mild cognitive impairment are at an increased risk of developing dementia.
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Managing Sleep Disorders In Lewy Body Dementia
Sleep problems may increase confusion and behavioral problems in people with LBD and add to a caregiver’s burden. A physician can order a sleep study to identify any underlying sleep disorders such as sleep apnea, restless leg syndrome, and REM sleep behavior disorder.
REM sleep behavior disorder, a common LBD symptom, involves acting out one’s dreams, leading to lost sleep and even injuries to individuals and their sleep partners. Clonazepam, a drug used to control seizures and relieve panic attacks, is often effective for the disorder at very low dosages. However, it can have side effects such as dizziness, unsteadiness, and problems with thinking. Melatonin, a naturally occurring hormone used to treat insomnia, may also offer some benefit when taken alone or with clonazepam.
Excessive daytime sleepiness is also common in LBD. If it is severe, a sleep specialist may prescribe a stimulant to help the person stay awake during the day.
Some people with LBD have difficulty falling asleep. If trouble sleeping at night persists, a physician may recommend a prescription medication. It is important to note that treating insomnia and other sleep problems in people with LBD has not been extensively studied, and that treatments may worsen daytime sleepiness and should be used with caution. Sleep problems can also be addressed by avoiding lengthy naps, increasing daytime exercise, and avoiding caffeine, alcohol, and chocolate late in the day.