Mixed Dementia: Alzheimer's and Vascular

Leesee

My DH (67) was diagnosed with Vascular Dementia in Nov. 2023. Neurologist sent him for AD-Detect blood test in Dec. 2023 and he tested positive for Alzheimer's.

DH does not understand he has Vascular Dementia. His physician said the strokes were 'old' so he thinks they are not currently causing problems. He doesn't understand these strokes caused irreparable damage. The majority of his strokes were in the Frontal and left Temporal lobes with lesser number found in the right Temporal and Occipital lobe.

When we met with the Neurologist in January regarding the AD-Detect test results, he was angry that we also discussed his Vascular Dementia diagnosis. He doesn't believe he has VD and now refuses to go back to the Neurologist for anything.

My question is whether Vascular Dementia always progresses. Is it possible he will not have more strokes and his progression will it stop where it is? How often should he have MRI's to determine if he's had further damage?

I know you are not Dr.'s 😉 but thought you might have helpful insight regarding Vascular Dementia.

Thank You!

wctraynor

Hey there, my mom 83 is in the same exact diagnosis. She started signs of memory loss and disorientation in Jan 2022, was deemed Mild Cognitive Impairment in Dec 2022, by July 2023 was mid stage VD and ALzheimers mix. She also did not think there was anything wrong, but we just kept on taking her places and now she cannot be left alone at all. She is just placed on Hospice and is mid stage 6 with the dementias. I can no longer care for her so she will be moving to Long term care home with a side of Hospice care. This disease has progressed so fast it makes my head spin. As far as they can tell with CT scans and MRIs there was only one stroke a could years ago. ( We did not know it at the time so hard to pin point exact time other than symptoms of mild disorientation).

The reason for Hospice is the NueroPhycologist who diagnosed MCI 16 months ago, was quite shocked at her progression since then and has suggested the last stages will go much faster than the first 5. He thought 6 months left maybe a year if she stays perfectly healthy otherwise. Mom fell 2 weeks ago, even though no fractures were detected she is in so much back pain she refuses to get out of bed unless we push her to use the toilet, and even then she has bladder and bowel incontinence 90% of the time.

At this point she only recognizes me and my husband but she has no idea this is her home. So going to a care home will not make much difference to her as long as she is comfortable. I'll visit daily but at least i won't be "on the clock" as I feel now when I spend time with her cleaning feeding toileting etc. I just want to sit and talk or watch squirrels out the window with her.

I know this is hard, but there will be a lot of things you won't need your DH to accept for them to be true. You just make sure he is safe and comfortable and feels loved. That is the best thing we can do for them.

H1235

I am sorry but it does progress. It’s my understanding that the progression in more in steps vs a slow decline. In fact vascular dementia progresses faster than Alzheimer’s. My mom was diagnosed over a year ago and there have been no follow up scans discussed by doctors. I have found that with my moms VD it is less about poor memory and more about poor judgment. There is something called anosognosia that is very common with dementia. Anosognosia is the lack of awareness of their own physical and mental limitations. This for us has been one of our biggest problems. There is nothing that will convince her of these limitations and we have found it’s best to not even try. Since she believes there is nothing wrong she get very angry with any limitations we put on her for her safety. The follow up appointments we have done with the neurologist since diagnosis have been just a chance to get advice on medication and ask questions. Our next visit we will discuss if it’s time for AL. Good luck to you. So sorry for what you are going through.