Questions about Vascular Dementia

Searching for Hope

My husband was diagnosed Nov 2024 with Vascular Dementia following a MRI. In looking back the signs were present around 3 years ago……..but I the time we didn’t know it was Vascular Dementia. He had a “spell” Feb 2022 that was diagnosed as ketoacidosis due to being a non-compliant diabetic. In looking back to this day there has been a gradual decline in his cognition. Family and friends started noticing before I did. Maybe I wasn’t paying attention related to working out of town and only being home a few days a month……..or it may of been I didn’t want to see it. However, in July 2024, I had my wake up moment when he was unable to perform a task he had done multiple times and could normally complete with his eyes closed. After this event I stared paying closer attention and spoke with his PCP. His PCP ordered the MRI and confirmed the diagnosis of Vascular Dementia. Saw a neurologist last month that reviewed the MRI and agrees with the diagnosis and states he has had multiple strokes. The neurologist has ordered additional testing, including a EEG and a FDG-PET scan…….neither have been done yet. I’m searching for understanding of this disease and how to cope as a caregiver/wife. When reading about the different stages I can identify with more than one. He had no reasoning skills, only exhibits two emotions…..crying and laughing. As
mentioned earlier, he is a non-compliant diabetic and this is the cause of his Vascular Dementia. It is a struggle dealing with both and he doesn’t comprehend the association with both. Doesn’t want to eat meals prepared at home and only wants fast foods…….not healthy and gets expensive. He is having episodes of vomiting and occasional episodes of being incontinent of bowels, without any noticeable pattern. It is just a lot as many of you in this group can relate. Just seeking support from folks that can relate. And I forgot to mention he is only 62 years old……..💔

midge333

My wife developed vascular dementia from type 1 diabetes that she has had since she was 8 years old. It started when she was 56. She was diagnosed when she was 60. She is now 69 and has been in memory care for 3 months. With vascular dementia, executive function is typically lost first followed by memory loss. It also tends to progress in a stair step fashion with plateaus and intermittent drop offs. Vascular dementia is different than alzheimers so I am not sure that the 7 stages apply perfectly. In the end, I think it probably all looks the same.

H1235

My mom has vascular dementia. As midge333 described executive functioning is moms most prominent symptom. She also has anosognosia (doesn’t see her limitations), short attention span, lacks logical thinking, inability to prioritize, lacks empathy… Her memory is still quite good. Because her memory was so good I was late in getting her diagnosed. Without memory loss I didn’t think it could be dementia. I find the good memory creates many problems. People with Alzheimer’s can be distracted, told we will do it tomorrow etc, when being difficult or stubborn. I find there is no distracting or putting things off with mom. She remembers all the ways I have mistreated her (not letting her live in her own home, not allowing her to handle her finances…). I also understand that it progresses in steps, but mom was diagnosed 2 years ago and we have seen no step down. I have read an average life expectancy of 5 years from diagnosis.

Biggles

Welcome to this wonderfully helpful and kind forum. My DH has VD and aphasia, so speech and communication is extremely hard. Diagnosed with MRI and ECG scans and all sorts of other tests about 5 years ago. Sadly this is an ongoing downhill 24/7 disease. I have just reread my notes written 12 months ago and I didn’t realise I was in such a bad way, very sad, bewildered and desperate. I am much better these days after using this site every day, venting and asking questions. I have given in to this horrible disease and understand it much more. I found the medical community quite unhelpful and ignorant. I now view my DH with love and affection knowing he cannot help being where he is and I am his lifeline. Good luck, take good care of yourself.

KayJH

https://alzconnected.org/discussion/72555/questions-about-vascular-dementia

https://alzconnected.org/discussion/72555/questions-about-vascular-dementia

https://alzconnected.org/discussion/72555/questions-about-vascular-dementia

My husband is believed to have vascular dementia but his MRI just came back normal. He is also a diabetic who will only take meds and follows diet part-time. If the MRI was negative, does that mean his diagnosis is wrong?

midge333

No. My wife's MRI early in the course of the disease was fairly normal. Especially with diabetes, vascular dementia is a disease of the small blood vessels which may not show up on the MRI. As the dementia progresses, the MRI will become abnormal. Neuropsych testing will be helpful to establish the diagnosis.

Vitruvius

After talking to numerous spouses at my DW’s day care, and later at her MCF, all noted that their PWD’s MRI was “normal”. For my DW’s, she’s now Stage 7f, the result indicated only normal minor shrinkage consistent with her age (at time). I was told at one point by her neurologist that MRIs are mainly intended to see if there are other causes for cognitive issues that could benefit from treatment and were not the result of dementia. It was a PET scan that was used to confirm she had Semantic Dementia.

KayJH

https://alzconnected.org/discussion/comment/238786#Comment_238786

Thank you for your reply. The 'normal' shrinkage for age was the same on my husband's MRI. He had the neeuropsyche test 3 years ago showing mild cognitive disorder but that diagnosis seems to be ignored by current DRS. What type of dementia does not show up on tests? How then is the diagnosis made?

midge333

@KayJH : If your husband is much worse, repeat neuropsych testing may be helpful in establishing a diagnosis. My wife had neuropsych testing 1 year apart. First showed mild changes and second was consistent with early vascular dementia. I would have liked a third testing further down the road but my wife refused.

Repeat MRI after my wife reached severe stage of dementia showed "moderate chronic microvascular ischemic changes and mild to moderate generalized cerebral atrophy".

KayJH

https://alzconnected.org/discussion/comment/238781#Comment_238781

https://alzconnected.org/discussion/comment/238829#Comment_238829

Wow. So frustrating for you! It seems it has to reach a late stage before being diagnosed. I don't know what treatment or care is available after diagnosis but I'm flailing on my own here trying to manage him. His memory is surely bad but also behaviors/personality changes and general safety issues are such a worry. I feel like a babysitter but with no help or even a diagnosis to get the help. He is a former alcoholic

if that means anything to the mix.

He had a neuropsyche test 3 years ago and received a diagnosis of MCD..mild cognitive disorder likely due to cerebrovascular disease…at that time. He is so much worse now but the MRI was good. Now what??