Parietal or Atypical Alzheimers

PattiRN2

I’m just wondering if anyone out there has a loved one with parietal Alzheimer’s. My DH’s AD is on the left parietal lobe. This is a very different path than the usual AD. His first symptoms were severe deficits in Math. We noticed he kept over tipping waitresses, who didn’t mind at all.

His social skills were the same for years, now declining. But his executive functioning skills (what an adult would be able to do) have been mostly lost. When I look at the AD stages, they don’t line up with the parietal changes we see in atypical AD. Does anyone else out there have this situation?

RetiredTeacher

I found your post interesting. My husband has had 3 strokes, all in the parietal lobe. When I retired and spent more time with DH I realized the defecits with executive function. His first stroke must have happened before I retired but he had no long term physical symptoms, just executive function changes. I wondered if it was normal aging or from his alcohol abuse. He started having physical problems 8 yrs ago: chronic constipation, orthostatic hypotension, fatigue, weigh loss and weakness. We sought a diagnosis a diagnosis with multiple tests. After ruling out everything from Addison's disease, cancer, multiple system atrophy, etc, they finally said the MRI showed evidence of cortical shrinkage and an old parietal stroke. I was stunned about the stroke, we had no idea. Cognitive testing showed MCI. He doesn't like Drs and didn't want further testing, neurologist or geriatric psych appt. He did have more testing several years ago and i was told it was Vascular Dementia, from the strokes. Fast forward 8 yrs and 2 more strokes later that I witnessed and 2 vascular surgeries to fix an AAA and clean our his carotid artery, he is still going. Physically he is declining faster than cognitively. Legs are weak and walking any distance needs a walker or shopping cart. Personality has changed, more depressed, withdrawn, apathetic and negative. Difficulty with comprehension and some word finding difficulties but memory is surprisingly good. Problem solving, multiple step directions, showing any initiative, noticing what needs to be done, helping with chores and everything else has really deteriorated. Attention span is short, sits in front of the TV passively most of the time but follows me around from room to room when I'm not sitting next to him. He has urge incontinence with urinating but manages to get to the bathroom. He is able to feed himself if the food is prepared, dresses himself but that is getting harder, fighting with long pants and long sleeves, he is still ambulatory but resists a shower even with reminding. It's hard, I've offered to shower with him, help him, we have grab bars, good shower seat with arms and hand held shower but he sometimes goes 3-4 weeks between showers! Thankfully he has no body odor. Everybody's journey is different and vascular dementia is different in many ways than Alz but there are similarities. Interesting that his online medical history states cognitive disorder not VD. I guess it doesn't matter what they call it, the end result is the same. I would be interested in hearing more about your experience with VD.

PattiRN2

Thank you for sharing your experience. Many of the symptoms you describe about your DH are eerily similar to my husband’s behaviors. You captured the obscure ones, such as not noticing what needs to be done. Years ago, he was told he had small VD but that discussion dropped off and solely became atypical alz. But I wonder if that’s still there, just not relevant anymore. His MMSE scores are borderline mod/severe, but I think that test is skewed toward assessing mostly the executive functioning. He is much more functional in reality. He can carry out ADLs independently with prodding and occ. assistance. Similar to your husband can feed himself if food is prepared. The personality changes are also similar to your DH as you describe. He shadows me and can be overly affectionate with hugging and saying I love you repeatedly. He was always clumsy. It was a going joke, but not anymore. I hope we can stay in touch. This was really helpful. Thank you.

H1235

My mom has vascular dementia. This can affect different parts of the brain. For mom I think it is the frontal lobe. Unlike most with Alzheimer’s her memory is not too bad. She struggles with executive functioning, makes bad decisions, has no sense at all of her limitations, problems with mood, judgment and personality changes. She used to be indecisive and lack confidence, now she is demanding and almost arrogant. Where most with dementia often seem confused mom is confident and determined about things that make no sense at all. While this site is wonderful I find many of the suggestions just don’t work for mom. Telling her I will do something tomorrow to avoid something difficult wont work. She will remember and be waiting by the door and probably complaining I’m late. I know these symptoms are different than what you are dealing with, but I just wanted to let you know that your not alone in dealing with symptoms that don’t quite follow the “normal” pattern most here see with Alzheimer’s.

RetiredTeacher

VD is different than ALZ but there are many with VD that also have mixed dementia with ALZ and VD. MY MIL and BIL both died from ALZ. I wonder if my DH has mixed dementia due to family history. Since he refuses further evaluation I guess it really doesn't matter. For those of you dealing with VD, do your spouses walk with short, shuffling, tiny steps? Do they freeze when encountering unexpected things in their path, such as walking down the hallway and someone comes out of a doorway in the opposite direction? My husband has difficulty navigating stairs but doesn't want a handrail installed that would assist him. He refuses going to a day program and pouts whenever I leave even for a couple of hours once a week. I'd like to hear from people dealing with similar situations. Ty everyone here for your ongoing support.

H1235

When they tested mom they considered lewey body dementia. I think one of the things they were looking for was the stoping mid walk. I believe this type of dementia causes more of the movement related issues.

RetiredTeacher

Ty H1235, I will look into that.

RetiredTeacher

https://alzconnected.org/discussion/comment/262218#Comment_262218

How is your DH doing and how are you holding up? My DH with VD has been struggling to get some thoughts out lately. Previously it was an occasional word he couldn't recall. He also thought our truck key fob opened the garage door. His mobility is declining. It's harder for him to get up from sitting, has difficulty standing without leaning on something and his ability to walk even short distances is decreasing. Today I saw him sit down on my make up bench to brush his teeth. He won't use his walker in the house but I insist he use it when we're out and he uses a scooter at the grocery store. He is coughing more when he is eating, which is worrisome to me. I do realize all of these things are part of the progression of VD. I way wondering if your DH exhibits any similar declines? Please stay in touch. Many of the posts on the main group pertain more to ALZ so it's been helpful to reach out to another VD caregiver.