Can a CT scan tell you how far gone a person’s dementia is?

Kikki21

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Feb 27, 2016
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East Midlands
I know a CT scan is done when Dementia is diagnosed as that’s a physical aspect of the diagnosis.
I’m asking the question as my mum had another CT scan done when she was readmitted to hospital in December 2017 as she had had a big seizure & several TIA’a.
The consultant for her care is the lead clinician for stroke at this large hospital.

He had a candid conversation with us & said that her life expectancy was likely to be measured in weeks & months as her general health is not good either.

A person on the forum questioned this as he never heard a doctor give such a prognosis. The conversation came up as the doctor wanted to put a DNR in place as he explained that my mum’s odds of surviving a heart attack or stroke were extremely minimal so that is why we asked the life expectancy question.

Obviously I would expect this prognosis to be accurate because he must know what he is talking about having looked at her scan & over seen her general health. Is it standard practice to keep doing CT scans?

For example would another one be done for a CHC decision?
 

karaokePete

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Jul 23, 2017
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N Ireland
In my wife’s case a CT scan showed the vascular damage in her brain but did not show the deeper brain shrinkage that a PET scan showed later on. As it appears to be strokes that are causing problems in your mums case I suppose the CT scans are valuable as they will show any progression in the vascular damage, although that’s just my layman’s opinion.
 

Kikki21

Registered User
Feb 27, 2016
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East Midlands
In my wife’s case a CT scan showed the vascular damage in her brain but did not show the deeper brain shrinkage that a PET scan showed later on. As it appears to be strokes that are causing problems in your mums case I suppose the CT scans are valuable as they will show any progression in the vascular damage, although that’s just my layman’s opinion.

Thank you @karaokePete - never heard of a PET scan. From her latest CT scan, they could see the vascular dementia damage as well as the Alzheimer’s. My mum never had the diagnosis told to her, I was the one the memory clinic told of her diagnosis so I never got the chance to talk anything through with her consultant at that time.

I’m just reading & reasearching as I go & thinking up questions! I’m not doubting what he has said because her decline has gone down massively in just 1 year.
 

Pete R

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Jul 26, 2014
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Staffs
..........said that her life expectancy was likely to be measured in weeks & months as her general health is not good either.

A person on the forum questioned this as he never heard a doctor give such a prognosis.

I think the diagnosis was questioned because of what you said that the diagnosis was because of the VasD, which is different to what you say above.

Also I have to bear in mind what the consultant said about her life expectancy - his prognosis is weeks & months not months & years due to her vascular dementia.
 

Kikki21

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Feb 27, 2016
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East Midlands
I think the diagnosis was questioned because of what you said that the diagnosis was because of the VasD, which is different to what you say above.

I did go on to explain in the other post to the other person that my mum doesn’t just have mixed dementia but plenty of other medical issues which led to the consultant saying what he said.
I don’t know if he would have had access to the original CT scan to show the deterioration. It’s something I am interested in. I did see a post somewhere in TP that a PWD with dementia had declined severely & a CT scan was done & confirmed they had entered the end of life stage so clearly a consultant can see something on the scan that would indicate that.
 

canary

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Feb 25, 2014
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South coast
Hello kikki
Im afraid that a scan doesnt show exactly how much someone is affected. A scan will show if there is damage and where it is, it will often tell an experienced doctor what sort of dementia it is (though you cant be 100% sure until after death during a postmortem) and it will show progression of the disease. BUT, although in general the more extensive the damage seen on a scan, the worse the dementia, some people can have very extensive damage, but only relatively few problems and other people can have only mild damage, but very bad symptoms.

So, you see, a scan is not helpful in determining how badly they are affected and isnt of any help at all for CHC purposes.
 

Amy in the US

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Feb 28, 2015
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USA
Canary said that a lot better than what I tried to write, so let's go with that explanation, which is also my understanding. Disclaimer: not a medical professional.

I would imagine that in general, if an older scan is compared with a newer one, it might reveal changes that have happened between the dates of those two scans. Even so, I am not sure exactly how much useful information it would give you about how the disease is presenting in your mother.

I also think it's likely that the physicians are using information from the scans, plus information about other current medical conditions, plus medical history, plus your descriptions, for a fuller picture, plus their professional experience, and possibly arriving at a conclusion after putting all the pieces together, as it were.

There are a number of assessments, or scales, that are used to describe stages of dementia. I don't personally find these terribly helpful, but others do. It's important to remember that a person can show symptoms from early, middle, and later stage dementia all at the same time, and won't have every symptom, and that things can vary from day to day and even moment to moment. Other medical issues, and age, will also impact symptoms and a person's general health, of course. There isn't anything very exact, just guidelines.

Having said that, I can point you in that direction if you wish.
 

Kikki21

Registered User
Feb 27, 2016
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East Midlands
Canary said that a lot better than what I tried to write, so let's go with that explanation, which is also my understanding. Disclaimer: not a medical professional.

I would imagine that in general, if an older scan is compared with a newer one, it might reveal changes that have happened between the dates of those two scans. Even so, I am not sure exactly how much useful information it would give you about how the disease is presenting in your mother.

I also think it's likely that the physicians are using information from the scans, plus information about other current medical conditions, plus medical history, plus your descriptions, for a fuller picture, plus their professional experience, and possibly arriving at a conclusion after putting all the pieces together, as it were.

There are a number of assessments, or scales, that are used to describe stages of dementia. I don't personally find these terribly helpful, but others do. It's important to remember that a person can show symptoms from early, middle, and later stage dementia all at the same time, and won't have every symptom, and that things can vary from day to day and even moment to moment. Other medical issues, and age, will also impact symptoms and a person's general health, of course. There isn't anything very exact, just guidelines.

Having said that, I can point you in that direction if you wish.

Thank you @canary & @Amy in the US - i was just interested in what the scan reveals & whether a doctor can tell what is going on in the brain as to what areas are going faulty so to speak. But then I read that if some parts go faulty, the brain tries to reroute that area.
 

karaokePete

Registered User
Jul 23, 2017
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N Ireland
Thank you @canary & @Amy in the US - i was just interested in what the scan reveals & whether a doctor can tell what is going on in the brain as to what areas are going faulty so to speak. But then I read that if some parts go faulty, the brain tries to reroute that area.
Yes, that rerouting does take place and that is one of the reasons why it’s important to try to keep a PWD involved in activities as that keeps the brain active. I have seen my wife have bad periods but then bounce back and I have no doubt that this is caused by a part of her brain dying and then a rerouting taking place. Unfortunately the time comes when the damage is too great for this rerouting to be done but I feel it’s important to keep working at it for as long as possible in the meantime.
 

Kikki21

Registered User
Feb 27, 2016
2,270
0
East Midlands
Yes, that rerouting does take place and that is one of the reasons why it’s important to try to keep a PWD involved in activities as that keeps the brain active. I have seen my wife have bad periods but then bounce back and I have no doubt that this is caused by a part of her brain dying and then a rerouting taking place. Unfortunately the time comes when the damage is too great for this rerouting to be done but I feel it’s important to keep working at it for as long as possible in the meantime.

I do wish my mum would take part in activities but we can’t persuade her & we have tried dozens of times. I’m thinking of getting her some adult colouring in books to see if she will do some colouring in. She used to be a dressmaker so she can draw.
 

jugglingmum

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Jan 5, 2014
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Chester
I do wish my mum would take part in activities but we can’t persuade her & we have tried dozens of times. I’m thinking of getting her some adult colouring in books to see if she will do some colouring in. She used to be a dressmaker so she can draw.

From what I've read on TP this re routing tends to happen in early stages and is why early stages progresses slowly, I think that it also happens more in Alz as the damage is slower. Once a certain amount of damage is done, then the rerouting stops happening as the brain is too damaged.

I think that many PWD get to the point when they can no longer cope with activities, I think what stimulates in early MCI and dementia stages, causes stress and anxiety in later stages, from what I've read on TP.

When my mum had her CT scan they said it showed normal age related shrinkage, so indicated that there was nothing on the scan in terms of Alz, however they did state they had taken the information provided by the family to make the diagnosis (my mum was unable to live without carers by this stage). The letter that the memory clinic sent to my mum (not best practice!) very much played everything down, which didn't really help when we were refusing to let her return to her house.