New Vascular Dementia diagnosis A & E

[Elizabeth34]

Hi there,

glad to find this forum.

My Step-father has been recently diagnosed in A& E - my Mum took him as he was so confused and his BP so high.

He was diagnosed by the stroke team, they used an MRI.

When my Mum got the discharge letter it said '?Vascular cognitive Impairment' as the diagnosis and this has caused her much concern that actually he is not diagnosed at all - or that it could be something else.

Has anyone got any experience of this or know whether this is now a questioned diagnosis - or just how they do it in A & E.

Personally I would be astounded if they had sat them down and told them Vasuclar Dementia if they were not actually sure...

Thanks in advance for any ideas anyone has on this.

Elizabeth

 

[Grannie G]

Hello @Elizabeth34 Welcome.

From what I've learned Vascular Cognitive Impairment is not the same as Vascular Dementia. It is impairment rather than full blown dementia

I'm no medic so rather than express my `opinion`, which is opinion only, I think you'd be best visiting your GP and asking for a full explanation of the difference.

 

[Elizabeth34]

Thanks Grannie G - I can't understand why on earth they would tell them one thing in A & E - ie - full VD diagnosis and then write something different on the letter ... Blows my mind why they would mess with them like that... Its why I wondered whether it was the way they do it in A & E - until he has been seen by a Dementia team or similar ...

I know they told them that he has big lesions on the top of his brain - and that there had been Ischemic attacks - not full stroke -

He is losing weight fast ... my Mum tells me 2lb every couple of days...? We are very worried about him, but do not seem to be getting much support to help him right now. The GP is doing more bloods tomorrow... =0(

Thanks for your reply xx

 

[Phil2020]

Mum had an MRI scan several years ago following a fall; she'd had a number of 'mini-strokes' a couple of years before the fall. The outcome of the MRI scan was a report of 'vascular cognitive impairment'. Her GP picked up on this and mum was referred to a consultant/specialist to be assessed whether or not she had dementia. The report from the consultant says something along the lines that she is 'most likely to be suffering from mild/moderate vascular dementia'. It does not definitively say that she HAS vascular dementia.

Having pondered the - what seemed to me to be - the 'NOT a diagnosis' - for some while, I spoke to mum's GP about it - out of curiousity about what constitutes a 'diagnosis' more than anything. The GP was non-committal as to whether or not it was a formal diagnosis partly, I think, because she felt not qualified to 'second guess' what a consultant/specialist, with greater experience in the field, had said. The GP said it was often difficult to be 100% certain as to the existence of dementia in a one off assessment unless it was well developed in a patient but she was also clear though that 'vascular cognitive impairment' and 'vascular dementia' were two different, but often related, things.

We've never had a problem with the status of mum's 'diagnosis' and it clearly carries 'weight' because mum's been able to avail herself of all and any support that comes with 'having' vascular dementia. Generally I get the impression that many in the medical profession take the view that if everything is pointing to vascular dementia then that's how they will address the patient. Having been doing this now for several years, I don't believe mum has been treated any differently, or has 'missed out' on anything, than would have been the case if the report from the consultant had said specifically, 'you HAVE vascular dementia' and, consequently, I don't see the point in expending energy (always needed elsewhere!) in trying to 'nail down' a formal and precise diagnosis.

 

[Elizabeth34]

Thanks Phil, your story has really helped me understand what may be happening.

I think you have a great perspective on this too. Really helpful, much appreciated.

Best wishes, Elizabeth

 

[Izzy]

Welcome to the forum @Elizabeth34. I wondered if this leaflet would be of any interest re vascular cognitive impairment -

https://www.dementia.org.au/sites/default/files/helpsheets/Helpsheet-DementiaQandA14-VascularCognitiveImpairment_english.pdf

 

[Elizabeth34]

Thanks so much Izzy ,that's really helpful - I will pass it on to my Mum.

 

[SAP]

I think maybe this is due to the fact that A and E staff and probably the stroke team, don’t diagnose dementia, that needs to be done at a memory clinic by a psychiatrist or clinical psychologist.
Mild/ Vascular Cognitive Impairment is not dementia but it can be a forerunner to a dementia diagnosis. It is common for people who have had a stroke to also have dementia at some point .
Hopefully,the GP will pickup on this and your dad will be referred to the memory clinic. My mum, who is in nursing care “probably “ has Alzheimer’s according to the psychiatrist who assessed her, 7 years later she possibly has vascular dementia now as well , I opted for her not to have any further scans as it would stress her out too much.

 

[Jaded'n'faded]

I'd echo what others have said. The report of vascular cognitive impairment probably comes from a scan. I'm pretty sure diagnosing dementia is not really something A & E do so they'd just include their observations.

I'd suggest your mum gets onto the GP for further clarification. It may be your father will now be referred to the memory clinic for further assessment. They do all sorts of written and cognitive tests to determine the extent of problems so are better placed to give a full diagnosis.

 

[Elizabeth34]

Thanks so much for the replies - it makes sense now. E x