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What Happens When Someone With Dementia Has A Stroke

What Are The Medications For Stroke

When stroke becomes dementia. Dr. Amy Brodtmann Lecture

The agents most frequently used to treat stroke or vascular dementia and its complications include the following:

  • Antiplatelet agents – Aspirin, ticlopidine , clopidogrel bisulfate , and extended-release dipyridamole with aspirin
  • Antidepressants – Several different classes of drugs and many different agents
  • Antihypertensive agents – Several different classes of drugs and many different agents

Is It Possible To Have A Stroke And Not Know It

Yes. You can have a silent stroke, or one youre completely unaware of or cant remember.

When we think of strokes, we often think of symptoms like slurred speech, numbness, or loss of movement in the face or body. But silent strokes dont show symptoms like these. In fact, silent strokes usually display no symptoms at all.

Like ischemic strokes, silent strokes happen when blood supply to a part of your brain is suddenly cut off, depriving your brain of oxygen and damaging brain cells.

But a silent stroke is, by nature, hard to recognize. Thats because a silent stroke disrupts blood supply to a part of your brain that doesnt control any visible functions like speaking or moving, so you might never know a stroke occurred.

The way most people find out they had a silent stroke is when they have an MRI or CT scan for another condition and doctors notice that small areas of the brain have been damaged.

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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Can You Reverse The Damage

Theres no way to reverse permanent damage done to brain cells from the lack of oxygen.

However, in some cases, healthy parts of your brain may take over the functions that used to be performed by the areas that have been damaged. Eventually, if the silent strokes continue, your brains ability to compensate will decrease.

According to the National Institute of Neurological Disorders and Stroke, rehabilitative therapy can help people who have had lost some of their abilities because of stroke. Professionals that can help you regain function include:

  • physical therapists
  • sociologists
  • psychologists

Some doctors prescribe Alzheimers medications to people with vascular dementia, but theres no proof yet that the drugs work for these patients.

There are many small, practical things you can do to help your memory if silent strokes have impaired your cognitive abilities. Try these steps:

  • Practice routines for completing certain tasks at certain times of the day.
  • Create habits for putting things you need, like medication and keys, in the same spot every day.
  • Make to-do lists and instruction lists to help you remember the steps to complicated tasks.
  • Use a pill box to help you keep track of medications.
  • Set up direct payments of your bills so you dont have to memorize due dates.
  • Play memory games to sharpen your skills.

Here are some preventive things you can start today:

  • Get blood pressure under control.

How Is Vascular Dementia Linked To Stroke

stroke symptoms dementia 11 Common Misconceptions About

When you have a stroke, the blood supply to part of your brain is cut off, killing brain cells. The damage from a stroke can cause problems with memory and thinking. For many people, these problems improve over time. If the problems dont improve or get worse this may be a sign of vascular dementia.

Vascular dementia can also be caused by a series of small strokes. These result in lots of small areas of damage in your brain. Often, these strokes can be so small that you don’t know you are having them. These are known as silent strokes.

Sometimes symptoms of vascular dementia can be confused with the effects of stroke. Both stroke and vascular dementia can cause problems with memory, thinking and mood. Strokes happen suddenly while the symptoms of vascular dementia often get worse over time. The difference is that vascular dementia gets worse over time. If youre unsure, go to see your GP.

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Provide Support For Family And Friends

Keep any family or friends informed about what is happening in a gentle, sensitive and supportive way. This will help reassure them that the person is getting the care they need. You could consider signposting them to appropriate services, such as an Admiral Nurse or local Alzheimers Society. It can also help to give them an opportunity to talk about what is happening.

Is There Surgery For Stroke

The goal of surgery is to improve the flow of blood in the blood vessels of the brain. An example is carotid endarterectomy, an operation to remove a blockage from a carotid artery, one of a pair that comprises the main arteries leading to the brain. Not everyone is a candidate for these operations.

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Induction Of Focal Ischemia

The induction of transient and permanent focal ischemia in animal models has been the most frequently used method to study mechanisms of IS. Most human ISs are caused by the occlusion of a middle cerebral artery , so animal models were developed to induce ischemia in this arterial territory . In the induction of transient focal ischemia, blood vessels in the brain are blocked for up to 3 hours, followed by prolonged reperfusion. In permanent focal ischemia, arterial blockage continues, usually for one or more days. In both types of induced ischemia, blockage is achieved via mechanical, thermal, embolic, or chemical methods . In mechanical ischemia, proximal occlusion is achieved through the intraluminal suture technique. This technique is the most frequently used method to occlude cerebral arteries in rat models of stroke since it was relatively easy to execute and it was noninvasive . This method involves a poly-L-lysinecoated intraluminal suture that, yields reliably large infarcts and greatly reduced inter-animal changeability in rats . Another research group aimed compare the effectiveness and reproducibility of MCA filament occlusion model in rats and mice, demonstrated that the microsurgical filament occlusion of the MCA can be more successfully performed in mice .

Findings from these studies are useful and improved basic understanding of focal ischemia. Further research is needed to identify precise causal factors of focal ischemia.

Driving After A Stroke

What is Vascular Dementia?

If you have had a stroke or TIA, you can not drive for 1 month. Whether you can return to driving depends on what long-term disabilities you may have and the type of vehicle you drive.

It’s often not physical problems that can make driving dangerous, but problems with concentration, vision, reaction time and awareness that can develop after a stroke.

Your GP can advise you on whether you can start driving again 1 month after your stroke, or whether you need further assessment at a mobility centre.

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Caring For Someone With Dementia Towards The End Of Life

Please be aware – this;information is for healthcare professionals.;We also have;information for the public.;

You can use our My Learning form ; to reflect on how this page has helped with your continuing professional development.

People with dementia may experience problems with thinking, memory, behaviour and mobility. It can be difficult to recognise when someone with dementia is nearing the end of their life. You can support the person by communicating with them and helping them with any symptoms they have. If possible, its a good idea to plan the persons care in advance to help understand what they want from their care.

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Care In The Last Days Of Life With Dementia

We use the words dying or terminal to describe when a person is in the last few days or hours of life. Sometimes a death is sudden and unexpected. More often, though, a person shows signs that they are dying: it is important to recognise these and plan ahead. This section will help you to anticipate and manage symptoms, as well as provide some tips to help prepare family and loved ones through what is a highly emotional and uncertain time.

I dont want my mother to die alone. I want her to be comfortable and to die with dignity.

A daughter of a person with dementia.

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Stroke And Dementia: Whats The Link

15th April 2021.

Both dementia and a stroke can significantly impact a persons life, from the physical effects to the strain on your emotional wellbeing. Quite often, people are unfamiliar with the causes and impacts of dementia and strokes until they, or a loved one, have experienced them. There are numerous online resources which explain the link between a stroke and dementia, but we understand that this information can be difficult to understand, which is why we have put together a simple guide on how stroke and dementia are connected.

A Tia Is A Warning Of Two Serious Health Conditions

Stroke significantly increases the risk of dementia

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.

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Prognosis For People With Vascular Dementia

If the conditions that cause vascular dementia go untreated, the prognosis is not good. A person with vascular dementia may seem to improve for periods of time until another stroke takes away more brain function, memory, and independence. Eventually, untreated vascular dementia usually ends in death from stroke, heart disease, or infection.

Although vascular dementia is a serious condition, catching it early and preventing further damage are the best medicine. People with vascular dementia can work with their doctors and families to detect and manage the condition.

Diagnosis Of Vascular Dementia

A diagnosis of dementia is based on the following:

  • Symptoms, which are identified by asking the person and family members or other caregivers questions

  • Results of a physical examination

  • Results of mental status testing

  • Results of additional tests, such as computed tomography or magnetic resonance imaging

Mental status testing, consisting of simple questions and tasks, helps doctors determine whether people have dementia.

Neuropsychologic testing, which is more detailed, is sometimes needed. This testing covers all the main areas of mental function, including mood, and usually takes 1 to 3 hours. This testing helps doctors distinguish dementia from other conditions that can cause similar symptoms, such as age-associated memory impairment, mild cognitive impairment, and depression.

Information from the above sources helps doctors usually rule out delirium as the cause of symptoms . Doing so is essential because delirium, unlike dementia, can often be reversed if promptly treated.

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What Is The Outlook For Stroke

At this time, there is no known cure for vascular dementia. While treatment can stop or slow the worsening of symptoms, or even improve them in some cases, the damage done to the brain by a stroke cannot be reversed.

As dementia progresses, behavior problems usually become more severe. Troubling behaviors like agitation, aggression, wandering, sleep disorders, and inappropriate sexual behavior may become unmanageable. The physical demands of caregiving, such as bathing, dressing, grooming, feeding, and assisting with using the toilet, may become overwhelming for family members. Under these conditions, the family may decide to place the person in a nursing home or similar facility.

Vascular dementia appears to shorten life expectancy. The most common causes of death are complications of dementia and cardiovascular disease.

Can We Prevent Memory Loss After Stroke

What is vascular dementia?

The best way to prevent dementia after stroke is to avoid having a stroke. Just controlling high blood pressure can markedly reduce the risk of having a stroke. Having regular check-ups, exercising, eating healthily, keeping a normal cholesterol and blood sugar level, and quitting smoking can dramatically reduce the risk of stroke as well.

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Stroke Vs Dementia: Differences Based On Their Treatment

When a stroke occurs, the first 3-24 hours after is referred to as the golden window or golden hour. It is called so as there is a good chance of reversing any damage that the stroke may have caused to the brain by starting the patient on medication soon after initial diagnosis of a stroke. Early treatment is crucial in stroke cases as blood flow to a part of the brain is cut off due to a clot in the artery. Brain cells are dying every minute and irreversible damage is caused the more delay that occurs. tPA is given via IV so as to dissolve the clot and improve blood flow to the part of the brain being deprived of blood flow.

Dementia treatment depends on the cause firstly. In cases of Alzheimers disease with dementia, there is no cure per se. But the symptoms or progression of Dementia can be slowed down with the help of medication. Symptomatic treatment is the basis for treatment here.

Stroke is caused due to a clot in the artery which obstructs the flow of oxygen to a part of the brain whereas dementia is a decline in mental function, which can pose other risks in day to day life and require constant supervision and support.

It can be difficult to differentiate between a stroke and dementia, but with a little knowledge of the both and also reaching out to someone else if you have the slightest doubt can go a long way in helping save a life.

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Other Tips For Dementia Management

In addition to cognitive rehabilitation, increasing blood flow to the brain can sometimes help improve cognitive function. Here are a few ways to increase cerebral blood flow:

  • Try aerobic exercise.;Aerobic exercise is one of the best ways;to boost blood flow, which will bring more oxygen and nutrients to your brain cells and increase cognitive function. ;Examples of aerobic exercise include activities such as brisk walks, swimming, and bicycling.
  • Lower your blood pressure.;High blood pressure constricts your arteries, making it more difficult for blood to flow up to the brain. Lowering your blood pressure causes the blood vessels to dilate, which can then;allow more blood to reach the brain. Decreasing your blood pressure also reduces your risk of a;second stroke.
  • Stay hydrated.;Blood is largely made up of water. Therefore, when you are dehydrated, your blood will thicken and have a harder time moving through your arteries. Staying hydrated then will thin the blood, increase blood flow, and reduce your risk of blood clots.

These tactics can all help treat the underlying cause of vascular dementia after stroke and potentially reverse at least some of the symptoms.

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Animal Models Of Stroke

Epidemiologic surveys of human populations are essential to identify non-modifiable and modifiable risk factors of stroke, but other methods are needed to advance our understanding and development of stroke therapies . In recent years, attention has been shifting to the use of transgenic mice as animal models of stroke, facilitating biochemical studies of how risk factors impact the brain, resulting in stroke. Identify a few different types of animal models of stroke.

Animal models of stroke have been used in studies of stroke-related risk factors, in particular, the modifiable risk factors of atherosclerosis , hypercholesterolemia and ApoB mutant mouse , hypertension , and hyperhomocysteinemia , and the nonmodifiable risk factor of age .

Overall, cell and models of stroke are useful and important to understand the basic mechanisms of stroke. Further research is needed to better understand early events/mechanisms of stroke.

Key Points About Vascular Dementia

Vascular Dementia: What Is It? Symptoms, Causes, And ...
  • Vascular dementia is a disorder characterized by damaged brain tissue due to a lack of blood flow. Causes can include blood clots, ruptured blood vessels, or narrowing or hardening of blood vessels that supply the brain.
  • Symptoms can include problems with memory and concentration, confusion, changes in personality and behavior, loss of speech and language skills, and sometimes physical symptoms such as weakness or tremors.
  • Vascular dementia tends to progress over time. Treatments can’t cure the disease, but lifestyle changes and medicines to treat underlying causes might help slow its progress.
  • Surgical procedures to improve blood flow to the brain can also be helpful. Other medicines might slow the progression of dementia or help with some of the symptoms it can cause.
  • A person;with;vascular dementia may eventually need full-time nursing care or to stay in a long-term care facility.

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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
  • Wandering or getting lost in familiar surroundings
  • Laughing or crying at inappropriate times
  • Trouble concentrating, planning, or following through on activities
  • Trouble managing money
  • 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.


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