Mixed Cortical and SubCortical Vascular Dementia

LJCHR · July 3

My DH was diagnosed with MCI May, 2021. He has progressed to what I think is late stage 4 with some early stage 5 symptoms according to the Tami Cummings chart. Since his Mother plus 4 Aunts all died from Alzheimer’s and his sister is currently in hospice with Alzheimer’s, I just assumed his was Alzheimer’s.

We started with a new wonderful Neurologist who specializes in Parkinson’s and Dementia. She has diagnosed him with Mixed Cortical and SubCortical Dementia with Parkinsonism. She has immediately gotten him in Physical Therapy to help his walking and balance. She is doing a nerve test on him in August for Neuropothy.

I feel happy that the PT will give him a better quality of life, but a little apprehensive that I don’t know that much about this dementia.

Please share any information/experience you have on this type of Dementia and if it is different from Alzheimer’s. I know the ultimate outcome will be the same, but unsure of what I know about this type of dementia.

As always, thanks for being here for support.

Belle · July 3

@LJCHR can I ask what your DH's symptoms have been when this first showed up? I suspect DH will end up with a similar diagnosis. His primary symptoms have been some early complaints of memory issues, word finding issues, urinary urgency, balance issues (could be the neuropathy in his feet causing that), extreme apathy and most significantly slow processing speed and deficits in executive function per neuropsychiatric testing. He also has some tremors in his hands. And like your DH his family has a long history of Alzheimer's.

(Editing my response to add this info: A recent study found that people with my DH's autoimmune disease have a 15x higher risk of getting vascular dementia than healthy people. My best guess, that he has what your DH has, is from the info provided by a cardiologist, his MRI findings and the deficits found in testing. As I mentioned before we are still waiting for a formal diagnosis).

I found a few articles I'll post links to here:

https://altoida.com/blog/patients-ask-what-is-mixed-cortical-and-subcortical-vascular-dementia/

https://www.alzheimers.org.uk/about-dementia/types-dementia/types-of-vascular-dementia

LJCHR · July 4

https://alzconnected.org/discussion/comment/214688#Comment_214688

Belle, your DH sounds almost identical to mine with the exception of the autoimmune disease.

His first symptom was memory loss and executive function. He has trouble using the cellphone and computer. His driving was also a problem at that time, but we stopped his driving when he was diagnosed over 3 years ago.

His MRI in 2021 showed "moderate to severe enlargement of the ventricles and cortical sulci consistent with moderate to severe cerebral tissue volume loss. There is mild T2 and flair signal hyperintensity in the periventricular matter and corona radiata consistent with mild microvascular disease."

The Neurologist and Neuro Psychologist in 2021 both diagnosed MCI concerning Alzheimer's. I was shocked to get this diagnosis last week. I will review the links you sent me. I can also report that he is responding very well to the physical therapy. She did keep him on the Aricept. He tolerates it very well and it causes no problem, and it may be helping. I'm not sure how to gauge if its working or not.

Please keep me updated as you learn more and I will do the same with you.

M1 · July 4

I'm not sure this is a very helpful label as a diagnosis, it basically means that there is widespread vascular damage throughout the brain. Cognition and motor functions are likely to be affected. But without autopsy it's impossible to tell whether Alzheimer's findings are also present. Mixed vascular and Alzheimer's dementia is the most common form. The neurologists probably like these labels but i don't think it helps you much from a practical standpoint.

LJCHR · July 4

https://alzconnected.org/discussion/comment/214734#Comment_214734

M1 - thank you for your feedback. I truly don't know much about this and knew that reaching out to this forum would give me a better understanding. I appreciate the information.

Iris L. · July 4

My neurologist told me I have leukoairiosis.

Iris

H1235 · July 4

My mom was diagnosed with vascular dementia. The biggest difference with Alzheimer’s is that her memory is not so bad. She lacks empathy, has trouble with logical thinking! , anger, slowed progressing time, short attendance span, change in personality, lack of social filter and of course anosognosia(doesn’t see any of the above problems, thinks she can do everything she did 20 years ago). Often when dealing with a difficult situation it is recommended to put something off and they will forget about it. If I tell my mom we will do something tomorrow she will be ready and waiting. The good memory actually makes things very difficult. I suspect everyone is a bit different. With vascular dementia I believe symptoms depend on the part of the brain that is affected most.

LJCHR · July 4

https://alzconnected.org/discussion/comment/214739#Comment_214739

Iris, I always enjoy your post. You speak of experience and strength. Thank you for the feedback. This disease is so mind-boggling. This forum is the voice of experience and my go-to for information. Thanks so much.

LJCHR · July 4

https://alzconnected.org/discussion/comment/214744#Comment_214744

Thanks for your feedback. I guess whatever it is called, it is always the same outcome. 😪

midge333 · July 4

My DW has vascular dementia from 60 years of juvenile (type 1) diabetes. Her early symptoms were balance issues and loss of executive function. Memory loss (and other symptoms) happened years later. I would guess that towards the end, all dementias start to look the same - just the path to the end is different. It all sucks.

Belle · July 5

@LJCHR Just for comparison to what you posted, 10 years ago, the first brain MRI he had found: 1) Two punctate foci of suspected acute ischemia, one in the anterior left parietal lobe and one within the right frontal lobe. and 2) Mild white matter disease in the periventricular subcortical white matter. Subsequent MRI's have mentioned global parenchymal volume loss perhaps age related and continue to mention mild white matter disease. His MRI findings have remained very stable even while his MMSE and other test scores have begun to decline. I have read here before not to put too much weight on MRI's for diagnostic purposes with dementia.

Mixed Cortical and SubCortical Vascular Dementia

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