Alzheimers v Vascular Dementia

Discussion in 'ARCHIVE FORUM: Support discussions' started by sandy25, Jan 7, 2007.

  1. sandy25

    sandy25 Registered User

    Nov 30, 2005
    54
    My dad was diagnosed with VD at 59. The first 4 years (in comparison to now) were relatively symptom free, mainly short term memory problems, speech impairments etc. He was told to stop driving quite early on and couldn't work. In the last 12 months he has detoriated rapidly. His consultant was always a pyschiatrist ( I was told that in our area the pychiatrist specialised in dementia) so he never saw a neurologist...until last month. The pychiatrist had always diagnosed VD from the results of the CT scan showing multi infarcts, restricted blood supply. But when we saw the neurologist last month he said that the detoriation now implies he has Alzeihemers. He said it doesn't really matter now what the diagnosis is. But when I thought about it I thought, hang on, it would have mattered 5 years ago as he could have been given Aricept for Alzeihmers and given him a better quality of life for those first few years. Should I be fuming? :mad:
    I know I shouldn't dwell on the past but has my father been cheated out of quality of life because of a mis-diagnosis? Why does the distinction between the 2 diseases seem so hard to determine? From what I know, Alzeihmers can only really be diagnosed from a brain biopsy or post mortem. But shouldn't they try aricept if they're not sure?!

    Aaaghh! :mad:
     
  2. Margarita

    Margarita Registered User

    Feb 17, 2006
    10,824
    london


    Can’t be sure on that , but I am thinking now your father been told he has AZ can he not get ANY medication at all . My mother was put on Exbixa at the beginning of being diagnosed and its still working for her 4 years on.

    What stage do they say your father at ? as I thought they give medication now when they think they are at a later stage , I think that’s the new ruling of NICE
     
  3. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    69,586
    Kent
    Hi Sandy, I thought, like you, that Alzheimers could only be diagnosed with a brain biopsy.
    I wonder if different psychiatrists/neurologists have differing briefs, re treatment. My husband has been `considered` to have Alzheimers. He had a CT scan which showed abnormal shrinkage, but has only seen geriatric psychiatrists, never a neurologist. He was tried with Aricept and Reminyl but unfortunately neither agreed with him. I am grateful that he was at least given a trial with these drugs.
    The only distinction I assume is that Vascular Dementia sufferers are more likely to have mini strokes than those with.Alzheimers.
    But then I may be wrong.
    Regards Sylvia.
     
  4. sandy25

    sandy25 Registered User

    Nov 30, 2005
    54
    He didn't really say what stage he was at. Other than they can't tell how long it'll be till he hprogresses to the next stage i.e how long is a piece of string.

    I'm starting to feel v.cynical by thinking that have we been cheated out of aricept/ebixa to save the nhs money? (v.cynical I know!) They are doing another CT scan, I didn't realise you could take Aricept in the later stages (i'll do some research soon!) but if you can then I'll definately mention it.
    he's getting so bad now its unbearable to watch...half of me wants to curl in a ball and cry and the other half of me is just so mad.
    Sandy
     
  5. sandy25

    sandy25 Registered User

    Nov 30, 2005
    54
    Hi Grannie G, yes well we always thought he was having these mini-strokes/TIA's but then the neurologist said that he still could have developed alzeihmers?!

    He also has epilepsy (or well so they say) so he's on tablets for that (which appear to be working as he hsan't had any more seizures since), chloesterol lowering tablets, anti-depressants, sleeping tablets and something else. I'm sure if he bounces up and down he'd rattle!

    I hear about people taking aricept after years and still being able to drive! I'm getting myself all worked up and feeling guilty that I should have been asking these questions 5 years ago...:(
     
  6. Helena

    Helena Registered User

    May 24, 2006
    715
    Sandy 25

    You must stop torturing yourself over this issue

    My Mother had Vasculasr Dementia and the last 18 months before her death in Nov were hairy to say the least especially since she was not stopped from driving until July

    However nothing I or the doctors could have done would have stopped the detioration and in all probability what is now being described as AZ is simply the Vascular Dementia

    Your Fathers brain is quite simply "vulnerable "and any infection etc will cause furthur detioration

    I have to actually be very grateful that a hospital aquired infection resulted in my Mothers death and spared us all from more weeks/months of anguish and distress
     
  7. Margarita

    Margarita Registered User

    Feb 17, 2006
    10,824
    london
    I know the feeling xx
     
  8. sandy25

    sandy25 Registered User

    Nov 30, 2005
    54
    I just want him back. I don't want to lose my Dad at 25 (well I've been losing him since I was 20) I'm being so childish!
    Thanks though Helena, deep down I know your right. I try to stop myself thinking/hoping the indignity will end quickly for him as I feel I'm betraying him for thinking like that but it sounds like its normal.
    I think its finally sinking in now - these are definately 'hairy' moments!
    Always thought I was a person who wouldn't have any regrets - now facing my dads gradual loss, I seem to have several...
     
  9. Tender Face

    Tender Face Account Closed

    Mar 14, 2006
    5,379
    NW England
    Dear Sandy .....

    Please never think you're being 'childish' - or accept that at 45 or 65 or whatever -- we are all someone's child - and the pain of of losing our parents is a natural one - and at any age invokes the child in us .....

    As you will know, none of us here are medically qualfied ... but just to share my understanding .... I was told my mum could not be prescribed Aricept until VD (which was initially 'suspected') was ruled out ... (which it has been thanks to brain scans)

    Mum now has a diagnosis of Alzheimers + Lewy Bodies - with a hint of Parkinsons ...... (but how any of it can be certain? - just 'best view' at this moment) ..... and whilst it's not certain that Aricept may help it can at least be tried where with VD I gather it would not have been appropriate ... (although I'm sorry can't offer an explanation as to why) .....

    Perhaps if you look at the converse, and imagine Dad had VD, had been prescribed Aricept and it had gone horribly wrong ..... it's an impossible situation isn't it? And I think we have to respect that until the Psych-geriatricans and Neurologists have better means to diagnose with pin point accuracy (prior to post mortem) they are doing their best to make the best judgements they can with the research and knowledge available to them at the given time.....

    Sorry if that doesn't help you much,

    Just sending you my best wishes .... and admiration for your courage to be facing all this with such maturity ....

    Love, Karen, x
     
  10. Dina

    Dina Registered User

    Regrets are a waste of Time and Energy

    hi Sandy25

    I agree that you must not beat yourself up over this. You cannot possbily know that drug treatment would have made the slightest bit of difference to your dad.

    With regards to vascular v. alzheimers, I thought the main difference was that Alzheimers was a slow gradual decline, whereas with Vascular, as small blood vessels in the brain deteriorate, the declince can be quite sudden.

    I truely feel there is no point in regreting what has past, you have to concentrate on doing what is best for your dad now.

    kindest regards :)
     
  11. Sandy

    Sandy Registered User

    Mar 23, 2005
    6,847
    Hi sandy25,

    Just wanted to mention that there is a condirion called "mixed dementia" where a person has both vascular dementia and Alzheimer's. This is the diagnosis that my father-in-law was given after a scan.

    The Alzheimer's Society's fact sheet on vascular dementia (http://www.alzheimers.org.uk/Facts_about_dementia/What_is_dementia/info_vascular.htm) says:

    Vascular dementia and Alzheimer’s disease (mixed dementia)
    A diagnosis of mixed dementia means that Alzheimer’s disease, as well as stroke or small vessel disease, may have caused damage to the brain.



    Take care,

    Sandy
     
  12. sandy25

    sandy25 Registered User

    Nov 30, 2005
    54
    Thanks all for your replies...it has helped
    will try and get back to the 'no regrets' logic..:eek:
    x
     

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