Vascular dementia(9)

Sarai

DH underwent testing with a neuropsychologist yesterday.  She was amazing.  Although we will discuss the results next week after she scores and analyzes the data, her initial observation is to rule out alzheimers and frontotemporal dementia due to the rapid decline.  She is looking at vascular dementia and wernicke.  The information is all bouncing around in my brain. What is vascular dementia? I know what the books say, but what does it mean in terms of care giving? Thank you.

harshedbuzz

Sarai-

VD is very similar to Alzheimer's overall and in terms of caregiving. The progression is a bit different, however. Often people with vascular dementia seem to progress in a series of plateaus and drops compared to those with Alzheimer's who tend to have a more linear decline.

While there is no crystal ball, the average life expectancy after a VD diagnosis is about 5 years compared to 10ish for those with an Alzheimer's diagnosis. Two of my mom's sisters had VD at the same time dad had mixed dementia. One of them progressed quite quickly, thought I suspect her diagnosis came quite late; the other lived 10 years past her diagnosis and probably could have been diagnosed 3-5 years earlier. whether VD or ALZ. 

IME, care needs are pretty much the same 

You mention Wernicke's. Did the neuropsych offer any information around that? I mention this because Wernicke's can be treatable if caught early on.

Before seeing the neuropsych, did an MD run blood tests to rule out hormonal and nutritional deficiencies that can mimic dementia? 

Wernicke's is usually part of a syndrome- Wernicke-Korsakoff's- in which Wernicke's is the initial and potentially treatable psychosis before the permanent Korskoff's encepholopathy. Both are caused by a deficiency of Thiamine (Vitamin B1) typically related to alcohol abuse. Eating disorders, bariatric surgery, extreme morning sickness, some cancers and late stage AIDS can also cause it. There also seems to be a genetic predisposition to WKS. My dad, his nephew both had it from alcohol abuse. Treatment in the early stages is treating the cause and IV supplementation. 

HB

Crushed

My mother had and died of vascular dementia (confirmed on autopsy )
My wife has Alzheimer's
 
Just two data points but here is my experience
 
My mother declined physically in Jumps
Her overall mental reactions stayed  high until a month before her death

True story.  My mother called from her assisted living place in Maryland on my cellphone.  She told me she was lost and had no idea where she was and would I come over an help her.   I told her she was in her apartment which I knew  because of the phone number.  She insisted I come over and help her,   My mother was a New Yorker,  I said

 Mom, you called my cell phone I'm in Madison Wisconsin 

Looooong pause,   then she said 
 
"I don't know where I am but Madison is a long way from everywhere"  

 The Neurologist took it as proof she has vascular dementia.  Alzheimer's patients can't make a joke like that .  We sang the Irish national anthem together a month before she died. 

  DW has not recognized me for thee years but she walks on her own and has no non cognitive illnesses. She was of course much younger than my mother was at dementia diagnosis.

Ed1937

My wife was diagnosed with likely vascular dementia in June 2018. But her major problems began in February 2018. The only time I've seen a "drop off the cliff" was when she was fighting UTIs. When the infections were cleared up she returned to baseline. Her progression has been slow, for the most part. So I'm not sure the VD diagnosis is correct. I just don't put any energy into making sure I know which dementia she has. Except for certain medications, I don't think it makes much difference what you call it. Just deal with the problems as they come.

Pam BH

Thank you, Crushed and Harshedbuzz for the comparisons of VaD and AZ. That really validates my observations of my DH. whose diagnosis is mixed dementia, AZ and VaD. What I'm seeing is VaD much more than AZ. His progression has been with sudden decline followed by a plateau, and his mental reactions are normal when not having delusions. Sarai, the caregiving seems to be the same as most of the caregivers have posted about. He's 2 years post diagnosis and just turned 90 so he does have aging problems also. His biggest problem at the moment is needing help walking to prevent falls, and that came on suddenly a couple months ago. Urinary incontinence is getting worse but not total. Delusions and paranoia occur every day, sometimes all day. He does have anosognosia which makes it difficult to confer with anyone without him knowing due to the layout of our house and his paranoia. All in all so far not a bad caregiving situation. We worked together for years and have always spent time with each other so that hasn't been a problem. I have a close friend who comes over once a week so I have an outlet to talk. This forum has been a lifesaver for me and I am so grateful for all the people here.

Sarai

Thank you all for responding.  DH was an active alcoholic for 30 years, which I am convinced masked some of his dementia symptoms.  Thankful member of all anon, where some of the slogans and the serenity prayer apply here as well.  

DH had a terrible fall in April which is when we learned of his brain atrophy and small stroke. The past 8 months have been a challenge.  Always  decline in April after the fall. Then a significant decline in August that has continued until now. 

Thank you all. This forum is a blessing.

Last Dance

My Wife had vascular dementia, I notice memory problems in 2006 and she was official diagnosed in 2012, and if your husband follows her path you will be happy. Her decline was in steps. She would go on a long  plateau and then she would drop somewhat but never any major change until March of 2017 then she stopped eating, lost the ability to walk, and talk she passed away in June 2017. I had the normal things that they all go through, not wanting to bath or brush their teeth, and of course she became incontinent, but on the plus side she never became mean or wondered. When I hear some of the problems other have I feel blessed taking care of her.