Stage : Second Last Stage Middle Vascular Dementia
Individuals in this severe stage begin to lose memory and usually recollect things happened and things they did in their past. They become more delusional and even cannot remember close friends and family members names. Some bodily changes also turn up including incontinence, difficulty with muscle and motor functions and difficulty with controlling bladder flow. They need assistance to do daily activities and finish tasks. These signs and symptoms are enough to diagnose middle vascular dementia.
Weight loss: Almost all of the people with vascular dementia lose weight in the later stages of this disorder, although sometimes some people eat so much and put on weight. In fact, weight loss can affect their immune system, making the people fight infections more difficultly. It can also increase the possibility of falling. Ensure that they consume enough food and water. They can need encouragement with drinking and eating. Besides, problems with swallowing and chewing are common as their muscles no longer work properly.
Problems with continence: Many people cannot control their bladder and bowels. This can occur most or all of the time.
This is also a stage one on the list of vascular dementia stages that people should not miss out but consider changing their lifestyles to prevent themselves from getting this disorder.
How Is Vascular Dementia Diagnosed
In addition to a complete medical history and physical exam, your healthcare provider may order some of the following:
- Computed tomography . This imaging test uses X-rays and a computer to make horizontal, or axial images of the brain. CT scans are more detailed than general X-rays.
- FDG-PET scan. This is a PET scan of the brain that uses a special tracer to light up regions of the brain.
- Electroencephalogram . This test measures electrical activity in the brain
- Magnetic resonance imaging . This test uses large magnets, radiofrequencies, and a computer to make detailed images of the brain.
- Neuropsychological assessments. These tests can help sort out vascular dementia from other types of dementia and Alzheimer’s.
- Neuropsychiatric evaluation. This may be done to rule out a psychiatric condition that may resemble dementia.
Stage : Early Stage Moderate Vascular Dementia
This is also one of the most important vascular dementia stages that everyone should not look down but watch out carefully for good! This stage is the only one wherein the signs and symptoms are clear for the first time. This is because the condition has advanced to the 4th stage and is very clear and evident. People suffering from vascular dementia in this stage tend to stay away from their family and friends. They find it hard to frame sentences and maintain a conversation.
This stage will last for 2-3 years before everything gets more serious if there is no treatment. The most effective way to treat this condition is to stimulate the individual who are suffering from this disorder to join a community workshop. At this place, he or she will be instructed to play games, which have effect on sharpening the motor and memory skills. In this stage, individual will be diagnosed with moderate vascular dementia.
This is actually also one out of the vascular dementia stages that a lot of people in the world have been diagnosed and have been trying to minimize the damages.
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Nearly Everyone Gets The First Stage Of The Vascular Dementia Small Vessel Disease As We Grow Older
A wifes question: Can anyone help me understand? My husband is in the early stages of Vascular Dementia. We were told that tiny blood vessels in the brain have been damaged by blood clots. This makes sense to me. What Im struggling with is why, after the damage has been done, is he still progressing? He does have Atrial Fibrillation so theres reduced blood flow to the brain as well.
Vascular Dementia is the diagnosis in about 15% of dementia cases. It is the result of brain damage due to reduced or blocked blood flow in blood vessels in your brain. This damage can be caused by stroke, infection of a heart valve or other blood vessel conditions that deprive brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die.
A major cause of vascular dementia is multiple TIAs , sometimes called mini-strokes or silent strokes. Each one is like a stroke, producing similar symptoms, but usually lasting only a few minutes or less. A TIA may or may not produce visible symptoms, may or may not be noticed by the person having it, and may happen when they are awake or asleep. Once someone has a TIA, they are at an increased risk of having more in the future. And, left untreated, about 1 in 3 people who have a TIA will eventually have a stroke.
Even though there is no cure now for vascular dementia, potential treatments to slow its progression might include:
How Does Vascular Dementia Progress
Vascular dementia usually progresses gradually in a step-wise fashion in which a person’s abilities deteriorate after a stroke, and then stabilise until the next stroke. If further strokes do not occur, the abilities of people with Vascular dementia may not continue to decline, or in some cases, may improve. However, these improvements may not last. Sometimes the steps are so small that the decline appears gradual. On average though, people with Vascular dementia decline more rapidly than people with Alzheimer’s disease. Often they die from a heart attack or major stroke.
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What Is Vascular Dementia And Its Symptoms
In short, vascular dementia is when the brain lacks blood flow. In other words, brain cells do not receive enough blood on what damages and even kills them.
Even the smallest brain injury due to poor blood flow can affect the overall condition of a human being significantly.
When the brain lacks blood flow consistently, the effects may cause the development of vascular dementia. One of the most common causes is a stroke.
Bear in mind, although vascular dementia is the second most regular, it is considered underdiagnosed.
That said, today, we will look at the most common vascular dementia symptoms which will give you a better understanding of the disease.
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.
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The Necessity Of Neuropsychiatric Evaluation
Neuropsychological assessment is crucial for differential diagnosis of vascular dementia, says UCLA. Other diagnostic tools include CT scan of the brain, FDG-PET scan , MRI of the brain, and EEG.
Vascular dementia is caused by reduced or blocked blood flow to the brain . In more specific terms, the NIH explains that underlying etiology is vascular brain injuries, stroke, or a series of mini-strokes . The size, location, and number of brain injuries influence the development of dementia symptoms.
Can I Reduce My Risk
By making healthy lifestyle changes, such as stopping smoking and exercising regularly, and treating any health conditions you have, you may be able to reduce your chances of getting vascular dementia.
This may also to help slow down or stop the progression of vascular dementia if you’re diagnosed in the early stages. Find out more about treating vascular dementia.
But there are some things you cannot change that can increase your risk of vascular dementia, such as:
- your age the risk of vascular dementia increases as you get older, with people over 65 most at risk
- your family history your risk of problems such as strokes is higher if a close family member has had them
- your ethnicity if you have a south Asian, African or Caribbean background, your risk of vascular dementia is higher, as related problems such as diabetes and high blood pressure are more common in these groups
In rare cases, unavoidable genetic conditions can also increase your risk of vascular dementia.
Page last reviewed: 05 March 2020 Next review due: 05 March 2023
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End Of Life And Legal Issues
If you have been diagnosed with dementia, you might want to make arrangements for your care that take into account the decline in your mental abilities.
This may include making sure that your wishes are upheld if you’re not able to make decisions for yourself.
You may want to consider:
- creating an advance decision, which makes your treatment preferences known in case you’re unable to do this in the future
- having a “preferred place of care” plan, which outlines where you would like to receive treatment
- giving a relative lasting power of attorney, enabling them to make decisions about you if you’re unable to
Caregiving And Vascular Dementia
There are many ways to help your family member or friend maximize his or her independence and cope with the cognitive symptoms of vascular dementia. Unlike Alzheimerâs disease, individuals with vascular dementia might better remember things in their daily life when repetition and context are provided. Likewise, simple cues can jog recall when remembering is difficult for the person. Structured and predictable routines can be helpful. Assistive devices and technology, such as pill boxes or electronic reminders on a phone, might be useful as well.
Breaking down complexânow overwhelmingâtasks into smaller and more manageable steps will make them easier to complete. Itâs also useful to simplify explanations and directions. As the disease progresses, even tasks learned years ago, like shaving or brushing teeth, may require step-by-step directions.
Problems with attention can make focusing and concentrating more difficult for your family member. Ensuring an environment that is not overly busy or noisy will make it easier to pay attention. Multi-tasking can be particularly difficult. Individuals with vascular dementia might have an easier time completing tasks when they focus on a single activity at a time, instead of dividing their attention between multiple tasks.
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What Are The Symptoms Of Vascular Dementia
The symptoms of vascular dementia depend on the location and amount of brain tissue involved. Vascular dementia symptoms may appear suddenly after a stroke, or gradually over time. Symptoms may get worse after another stroke, a heart attack, or major surgery. These are signs and symptoms of vascular dementia
- Increased trouble carrying out normal daily activities because of problems with concentration, communication, or inability to carry out instructions
- Memory problems, although short-term memory may not be affected
- Confusion, which may increase at night
- Stroke symptoms, such as sudden weakness and trouble with speech
- Personality changes
- Mood changes, such as depression or irritability
- Stride changes when walking too fast, shuffling steps
- Problems with movement and/or balance
- Urinary problems, such as urgency or incontinence
How Is Vascular Dementia Linked To Stroke
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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Vascular Dementia Treatment And Support
A person can live well with vascular dementia with drug and non-drug treatment, support and activities.
The person should have a chance to talk to a health or social care professional about their dementia diagnosis. This could be a psychiatrist or mental health nurse, a clinical psychologist, occupational therapist or GP. Information on what support is available and where to go for further advice is vital in helping someone to stay physically and mentally well.
Sudden And Frequent Headaches
Based on the underlying cause and also each individual case from one person to the next, vascular dementia symptoms vary significantly.
However, experiencing sudden and frequent headaches is amongst the earliest signs that someone is suffering from the condition. Headaches can strike any time, meaning, they appear unexpectedly.
When experienced frequently following a medical event like suffering from a stroke is highly likely to have a connection with the onset of vascular dementia.
Vascular dementia comes about when there is inadequate blood flow going to the brain. It could also be the result of damaged blood vessels in the brain and these initial changes manifest as headaches.
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Vascular Contributions To Cognitive Impairment And Dementia
Vascular contributions to cognitive impairment and dementia are conditions arising from stroke and other vascular brain injuries that cause significant changes to memory, thinking, and behavior. Cognition and brain function can be significantly affected by the size, location, and number of brain injuries. Two forms of VCIDvascular dementia and vascular cognitive impairment arise as a result of risk factors that similarly increase the risk for cerebrovascular disease , including atrial fibrillation , high blood pressure, diabetes, and high cholesterol.
Symptoms of VCID can begin suddenly and progress or subside during one’s lifetime. VCID can occur along with Alzheimer’s disease. People with VCID almost always have abnormalities in the brain on magnetic resonance imaging scans. These abnormalities include evidence of prior strokes, often small and asymptomatic, as well as diffuse changes in the brain’s “white matter”the connecting “wires” of the brain that are critical for relaying messages between brain regions. Microscopic brain examination shows thickening of blood vessel walls called arteriosclerosis and thinning or loss of components of the white matter.
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.
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Vascular Dementia Is A Group Of Diseases
VCI and its end-stage of vascular dementia are now considered a group of diseases rather than a single disease. A major stroke is often followed by vascular cognitive impairment, as in Marys case. The smaller silent strokes, called lacunar infarcts, can lead to VCI in people who have not experienced larger strokes. But Marys father, with his white matter disease, is typical of the largest number of people with VCI. His damage is the result of thickening and narrowing of arteries that feed the deep layers of white matter in the brain. Marys fathers condition used to be called Binswangers disease and is now considered a common type of VCI.
VCI can develop in other ways, too. In people who have experienced bleeding into the brain from an aneurysm or other cause, cognitive effects may remain. VCI can also be the result of some rare hereditary disorders such as CADASIL , which stands for cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.
Management Of Conditions That Increase Risk
Treating disorders that increase the risk of vascular dementiaâdiabetes, high blood pressure, and high cholesterol levelsâcan help prevent and slow or stop the progression of vascular dementia.
To help prevent a future stroke, doctors recommend measures to manage risk factors for stroke , to stop smoking, to lose weight if overweight, and to increase physical activity.
Doctors may prescribe a drug that makes clots less likely to form, such as aspirin, or, if people have atrial fibrillation or a disorder that causes excessive clotting, warfarin . These drugs help reduce the risk of another stroke.
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The Difference Between Parkinsons & Vascular Dementia
The biggest difference between vascular dementia and Parkinsons disease is that Parkinsons doesnt always lead to dementia. Parkinsons affects mobility, similar to vascular dementia, and both are brain disorders that may stem from vascular problems. Parkinsons disease may also affect memory like vascular dementia but not in every case.
Vascular dementia symptoms include memory loss, reduced ability to organize thoughts or actions, confusion and trouble concentrating, trouble paying attention.
Parkinsons disease symptoms include slowed movement, muscle rigidity, shuffled walking, quiet speech, issues with swallowing.
During the end-stage of all types of dementia, the symptoms tend to be the same across the board.
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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