How is VAD different from AD?


Registered User
Jan 9, 2008
Hi Everyone

I seem to remember that one of school teachers used to tell me that I asked too many
questions.... I guess old habits die hard:)

I have read the various factsheets on VAD and AD and am still somewhat confused. In the early stages of dementia what are the "common" presenting symptoms of VAD. Basically when I first joined TP I was almost convinced that my dad was showing signs of AD but now I am not so sure. I have read many posting concerning VAD and to me it seems that it is my dad.

I appreciate that every person who suffers will be slightly different, I would be grateful to hear of your own experiences.



Registered User
Jul 10, 2006
south lanarkshire
Hi Burfordthecat

In my humble opinion, VAD sufferers are harder to handle than Alzheimer's sufferers.

I have a friend who has worked in care homes and said to me that "THEY ARE HAPPY IN THEIR OWN WORLD" I WISH!.

This may be true for Dad, but no way does this opinion apply to Mum.

Although I believe Mum has VAD, it has never been confirmed medically.

I only know she has been very hard to care for, ie, compared to Dad, who has Ahzheimers, but then again Dad has always been a lovely, patient gentleman, whereas Mum has always been very active and very much in control

Don't know that this reply helps you much



Registered User
Jan 31, 2004
near London
Very often, it seems to me, Vascular Dementia presents as part of a mixed dementia.

My wife has mixed dementia - Vascular and Alzheimer's.

In such situations it is difficult - nay impossible - to appreciate where the symptoms of one end and the other starts.

The truth is that nobody on Talking Point is an expert in the subject of mixed dementia, Alzheimer's or Vascular Dementia, other than in the case of their own relative(s).

My Jan certainly has had a massive struggle with her dementias - seemingly compared to the other 23 residents of her home, but then, what do I know of their circumstances before they reached their current stage.

The key difference that has stood out for me is the stepped nature of the Vascular element. I could never figure out why Jan didn't have that so slow decline, and that her condition worsened erratically. Then I asked for more detail of her condition and I was told about the vascular dimension. They never volunteered that information.


Registered User
Jan 15, 2008
Hello, there

Brucie is right - none of us (unless you all know differently!) are medical experts so we can only give our anecdotal evidence of what we've found with our own loved ones.

My Mum was diagnosed with VAD last August (but had shown symptoms of dementia from about 8-9 months before that, at least). As I understand it, vascular dementia, as Brucie mentions, is a stepped decline, ie someone seems to go along with the same level of confusion and/or restlessness.

My Mum is also what you might call "changeable" - what seems perfectly acceptable as an idea is a full assault on her capabilities and life skills just a couple of days later. Don't get me started on this one! She also has problems understanding money and gets confused regarding her bank accounts and pension.

Personality changes may also be a symptom (as is certainly the case with my Mum) as aggression (both physical and verbal) starts to be seen.

Her reasoning and judgement are also affected.

There's lots of other symptoms but as I say I'm no expert and VAD sometimes has the same symptoms as AD. With VAD, though it has a cause - heart problems, stroke, heart attack - that sort of thing. The brain gets less and less blood and oxygen and that blocks the vital blood vessels to the brain - so they die.

BTW, the outlook for VAD isn't that good, apparently, as there are underlying heart problems and it's this that normally causes death.

Hope this helps - only my experience here.

Grannie G

Volunteer Moderator
Apr 3, 2006
And then there`s vascular dementia and vascular dementia.

My husband has been told he has Alzheimers, and possible vascular dementis caused by poor circulation through diabetes.

I would say he is having a slow decline in comparison to some, that again is relative.

I`ve also heard that `happy in their own world ` expression. I wonder who originally made such an ignorant observation. I`d like to invite them to live with us for a day or two.

I don`t even think the doctors know. When talking to me, our consultant now only speaks of dementia.


Registered User
May 24, 2006
Others with AD patients may correct me if i am wrong but it seems to me that VD patients lurch far more from periods of total reality to periods of utter confusion

Certainly with my Mother she could have days where she appeared totally and utterly normal certainly in the early years of her VD ........she could argue the hind legs off a donkey

Yet she also had bad days where it was obvious to all that she was on another planet entirely and there was no getting through the fog .

2 years before her death she would sometimes say "oh my brain" when she could not remember even the ordinary names for plants that she used to rattle off the Latin names for and word association was a game played to establish what she was talking about ..........the biggest thing we noticed being at a distance was the change in her attitude from one week to the next when you phoned her

She would be in a blazing bad mood with you one week ( we never knew why ) to all sweetness and light the next

There had been frequent phone calls over silly things like "tv had no sound" and she refused to accept she had a remote control and that the mute button had been pressed

She called out numerous mechanics /engineers to her Car ( the garage had put something in it that meant it would not start )

The fridge wasnt right because there was water on the floor (she had turned the dial to defrost !!)
The washing machine would not work ( she was trying to open the door midcycle )

Yet when the washing machine finally died and we arrived with a new one ( she did not like that because it was whiter than the fridge )

She talked about it being too difficult to park her car in the back room !

But in between all of this she had periods where she was perfectly OK and lived fiercely independantly and alone

Later these episodes would change rapidly within hours or minutes and it was clear to all that something was seriously wrong

A CT scan will as I understand it show the infarcts that confirm a diagnosis of VD ......the problem is the medics do not do a CT scan early enough and they dismiss too many symptoms as "just getting old " and the GPS wont go and see the patient at a relatives request they say "the patients must ask for assesment themselves " which is of course totally crazy since the patients in denial that anything is wrong


Registered User
Jan 29, 2008
Ashford, Kent
Up until Friday, I didn't think they had actually 'labelled' my Dad. However, after a lengthy conversation with the CPN she read to me word for word the letter that the consultant had sent her. (I didn't think my Dad had even seen the consultant).

The word Alzheimers was not mentioned at all. It said that in view of the decline after his stroke, and uncontrolled diabetes (Mum used to let him have far too many treats. She used to have far too many herself) that there is a large vascular element to his dementia.

The report then went onto say that they had offered medication, but Dad had said no because he took too many pills already! (Surely, if he needed it they could have just given it? Also... my understanding is that medication is only licenced for Alzheimers). Another point was, that my Dad has Glaucoma, and this is a contraindication as the medications increase pressure in the optic nerve.

I am seeing the CPN next week, she is re-assessing Dad. I am going to insist that he is re-seen by the consultant (who fully discharged him).

My Dad's symptoms started 5ish years ago with him going out and not remembering what he had gone out for.

His decline is gradual, but there are times of acute confusion, and then totally lucid moments. The acute confusion is mixed really. He thinks he has lived with us 2 weeks, instead of the 5 years it has really been. That is constant, he never ever has clarity on that. He tells me he believes what I say, but cannot rationalise in his brain where those years have gone. Very very rarely he wakes up asking who's house it is, and the confusion is terribly acute.

It's hard to really reason with him at times. He wants to go to the bank, and doesn't believe me when I say we have already been - thankfully, he leaves it at that though.

He hides things. He does have moments of paranoia (thinks my husband tries to poison him).

I am hoping that now I control his diabetes completely, and his sugar is totally normal... that a decline will be slow as his brain is (fingers crossed) as well oxygenated as possible.

Who knows.. maybe I am just kidding myself that I can control his decline.


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