Now they think it mightn't be AD after all!

[stillcaring]

Hi All,

Just wondered if anyone else had had this experience. My mum had an official AD diagnosis a year ago, having suffered with dementia for about 10 years. Now it turns out that she has really high blood pressure and the GP says that's probably caused vascular dementia and that that is probably the main cause of her dementia. Apart from making me very thankful that I refused Aricept for her after it was awful for her sister (maybe she didn't have AD either??) I feel a bit non-plussed. Does it actually matter or make any difference to what would be the best way of caring for her? Obviously I am now administering blood pressure medication, but is there anything else? Also does it mean that if we control the bp she will be stuck at her present level of dementia indefinitely? That is an awful prospect as she's at that horrid stage of being aware there is something wrong and I have been thinking that at least she will lose that awareness eventually.

 

[Grannie G]

Hello stillcaring

Dementia is dementia as far as I know and all dementias are progressive. Please don`t worry your mum will stay at the same stage for ever, her Vascular dementia will develop more or less as it would if it were Alzheimer`s .

Just continue with the caring you give her now.

 

[Noorza]

It is my understanding that it is a degenerative disease, I know there's no cure and the stage of degeneration varies. The underlying conditions clearly need to be treated so mum's degenerative heart failure is treated as best it can be, stents, medications, pacemaker, defib, blood pressure tablets.

The blood pressure being treated is a good thing but the way we react and respond is the same whether it be Alzheimers or dementia. As Mum's is vascular and senile, the doctor told us that it could take a decade to develop and her heart would take her first. (not a cheery thought) The truth is no one really knows.

Mum's condition has deteriorated after a recent TIA. It's so hard to gauge the future which does make it really hard to cope with.

 

[Nebiroth]

It is extremely hard to differentiate between Alzheimer's and Vascular, espescially in the early stages as they both produce very similar symptoms. There is no definitive physical test that can be used. The main difference is is the way that the disease, and therefore symptoms, progress. Alzheimer's is characterised by a slow, steady decline; Vascular by more sudden, unpredictable declines with periods of relative stability in between. So whilst "dementia" (which is really a name for a group of symptoms) can be recognised fairly easily, specifying the underlying cause is not, and often relies on patient presentation and history more than anything else.

Aricept is only licensed in the UK for use with Alzheimer's although it is prescribed more widely in other countries. It may be given if Alzheimer's is suspected on the basis that it will do no harm (aside from possible side-effects).

It is possible to have both of these diseases, in which case, you have "mixed dementia".

As far as I am aware, Vascular is a progressive, incurable illness in the same way that Alzheimer's is; high blood pressure is a risk factor and controlling it might help and indeed I believe is the only "treatment" possible, but I believe that in actuality there is nothing that can be done to halt or stabilise, let alone reverse, it. In short it is almost certainly going to get worse.

I am surprised hypertension has gone undetected for so long. Usually blood pressure checks are part of the diagnostic routine for most people, espescially the elderly, where the prevalence is much higher. The main risks stemming from it are for heart disease and major strokes.

 

[MReader]

My husband has Vascular dementia and Alzheimer's disease - mixed dementia.
How it was described to me is that Vas Dem progresses in downward steps - on a level plane for a time & then a drop.
However Alz is just a downward slope.
I have experienced both the drops of Vas Dem & the continual downward slope of Alz
Hope the explanation that I received is of help

 

[Margaret1]

Hi All,

Just wondered if anyone else had had this experience. My mum had an official AD diagnosis a year ago, having suffered with dementia for about 10 years. Now it turns out that she has really high blood pressure and the GP says that's probably caused vascular dementia and that that is probably the main cause of her dementia. Apart from making me very thankful that I refused Aricept for her after it was awful for her sister (maybe she didn't have AD either??) I feel a bit non-plussed. Does it actually matter or make any difference to what would be the best way of caring for her? Obviously I am now administering blood pressure medication, but is there anything else? Also does it mean that if we control the bp she will be stuck at her present level of dementia indefinitely? That is an awful prospect as she's at that horrid stage of being aware there is something wrong and I have been thinking that at least she will lose that awareness eventually.

Hello Stillcaring
My mum was diagnosed with Vascular Dementia over a year ago, and I certainly recognise your description of mum being very self-aware. Also we assumed she would be in a level state, followed by a drop, and so on, but in fact she has actually improved in her abilities and her conversation during that time. Unfortunately, with the improvement comes more self-awareness. Still waiting for the drop, so making the most of what she can do now. I assume that what she has experienced is like an improvement from a stroke. I have no doubt that she does have vascular dementia. I wonder if anyone has had a similar experience? I guess part of my conclusion is just that everyone is an individual and we all try and do our best, taking that into account.
Best of luck!

 

[stillcaring]

looking back over the years I would say that my mum's decline has been an overall decline but within that there have been ups and downs. Downs are usually caused by stress - eg her sister being ill, changes of routine caused by things like the hour changing or bank holidays - but are often followed by gradual improvements again. Just thought I'd say that really - guess none of it makes any difference to the day to day routine. Off to Hilliers Gardens this afternoon to give my mum an afternoon's happiness she won't remember by this evening.... At least the sun is shining!

 

[Saffie]

It sounds as though you might be somewhere in my locality unless there are similarly named gardens elsewhere in the uk. I go there quite often with a friend.

My husband doesn't seem to have highs and lows with his vascular dementia, just a downward slope. Rather than strokes, his is caused by peripheral artery disease causing the claudification of the blood vessels, originally in his legs but presumably now to his brain. No scans were carried out but his diagnosis was based on his history. There is a suggestion that Alzheimer's might be involved as well but no proof of that except that Aricept did make him feel better. This was stopped some time ago due to his rapid decline after his amputation operation.

When all is said and done, we have to deal with the here and now and I doubt that which form of dementia it is makes a massive difference to the larger picture.

 

[stillcaring]

I think you're right there, though I do wonder what state my mother might have been in now if she hadn't had untreated high blood pressure for who knows how long. She had only been to the doctors once since moving to England in 2000 until I got the GP to do a home visit last year so can't really blame them for not knowing - they probably told her to come back to have it rechecked and she probably then forgot.

 

[J W]

My parent has been diagnosed with Lewy Body Dementia with Parkinsons Symptoms + Vascular Dementia, in the last month has been aware of far more than in the previous 12 months, not sure if its just temp and a drop is on its way, but it seems strange?.
Still 100% reliant on carers though.

Not on any medication for the dementia because of severe reactions.