Vascular dementia and strokes

[Kayla]

My Mum has Vascular Dementia, which I understand is caused by a series of mini-strokes in the brain, which may only affect one aspect of memory or behaviour. My husband asked me whether my Mum was more likely to have a big stroke, than someone of the same age without Vascular Dementia. I wasn't sure, as strokes can sometimes strike without any warning symptoms. Does anyone else know?

 

[Sarah Day]

Hi Kayla

Vascular dementia is caused by problems with the supply of blood to the brain. You rightly state that one of the causes of this problem is stroke. People with vascular dementia are at greater risk of having a stroke.

However, there are some warning signs that a stroke is more likely. People with high blood pressure, cholesterol, diabetes, or those who are overweight are more likely to have a stroke. It is vital that these conditions are identified and treated as they may be contributing to the progression of the dementia. There are drugs available to treat these conditions but a healthy lifestyle also plays an important part. A good diet - low in saturated fat and salt and high in fruit and veg - physical activity, not smoking and only drinking alcohol in moderation are important recommendations.

Transient Ischaemic Attacks (TIAs) are another warning sign that a stroke may be imminent. The symptoms may be the same as a stroke - a drooping mouth, eyelid or slurring speech, but the problem resolves within 24 hours. Even though the symptoms are not permanent, it is really important that urgent medical attention is sought. It is a sign that there is a problem with the blood supply to the brain and this needs further investigation.

You can find more information in the booklet 'Understanding vascular dementia' which is available to download from the Hearts and Brains project homepage http://www.alzheimers.org.uk/VascularDementia/index.htm.

Best wishes,

Sarah

 

[Kayla]

Risk factors

Dear Sarah,
Thankyou for that link, it was very useful. My Mum has always had a healthy lifestyle and the risk factors don't really apply to her. However she does have Rheumatoid Arthritis and oseoporosis. The vertebrae in her neck have also been crumbling. I've thought that the steroids have had something to do with her problems. After reading the information, I'm wondering if the crumbling neck vertebrae and restricted joint movement in her neck, due to the RA, could have slowed down the supply of blood to the brain.
Mum is very aware of being ill and having problems understanding and remembering things, which seems to make the symptoms all the more distressing somehow. I am concerned that mobility and exercise are important to reduce the risk of strokes and mini- strokes. Mum is now unable to walk following a fall last October, and hip replacement operation. She just sits in her chair all day and has received absolutely no physiotherapy since her four week stay in hospital. Surely wheelchair bound patients should automatically receive some kind of help with moving whatever they are still able to move. Lack of exercise will increase her chances of having a stroke.
The Nursing Home is basically right for her and she couldn't be managed in a Care Home, but she does seem to have more conversation than many of the other residents. I'd like her to be as comfortable as possible and receive some mental and physical stimulation appropiate to her needs. I play Scrabble and Dominoes with her and sometimes take the dogs in to see her, but I think she needs more. She has improved so much since being in the NH.

 

[Sarah Day]

Risk factors

Dear Kayla

Unfortunately, we don't know the full story as to what causes vascular dementia. We know certain factors can put us at risk but some people can have these factors and not develop vascular dementia. Other people, don't exhibit any of the warning signs and still develop it. It clearly indicates more research needs to be conducted.

You are right in thinking that physical activity is important even when dementia has developed but it can be hard to implement when the person has reduced mobility. Does the nursing home run an activity programme at all? You might be interested to look at this publication which is also supported by a training programme. It might be something staff at the home wish to consider investing in for the benefit of those they are caring for.

http://www.alzheimers.org.uk/Working_with_people_with_dementia/Publications/activities.htm

 

[Kayla]

Activities

Dear Sarah,
The NH is quite forward thinking in the way residents are handled and cared for and there is someone to organise activities, but her time is spread between two parts of the home. Mum isn't mobile and can get upset if moved from her room sometimes. She is rather deaf, so can't join in with quizzes or anything which requires listening in a group. She does participate in the monthly Communion Service led by the local Vicar and is visited by someone from our own Church. Children from local schools sometimes come in to sing or perform.
I think she would enjoy some simple craft work, as she used to like painting and drawing, but again the arthritis in her hands make them very sensitive and painful. Mentally, I don't think Mum is that bad, at least compared with some described on TP. Mum's physical problems are limiting her activities so much, but I don't really know what to do to help her. After the summer holidays, the NH are going to try and arrange a physiotherapy assessment if possible and investigate whether Mum's digital hearing aid can be refitted. Her ear has changed shape and the device won't go in properly. Apparently dementia patients can't have new hearing aids because they need to co-operate a lot with the test for it to work.
It all seems so sad that she knows a lot of what's going on and can remember well, events in the past, but her quality of life is not good at the moment.

 

[Helena]

Kayla .......its strange how your Mother and mine suffer pretty much identically

Mine has had severe Arthritis in base of her thumbs for 30 years
severe Osteoporosis for 20 years
High Blood Pressure for nearly 30 years
Severe deafness and will not wear a hearing aid full stop
Feet butchered by a surgeon who failed to check bunions properly
now Vascular Dementia
Mine still gets around but its very slow

She has always drunk strong black coffee, eaten chocolate and cream and cakes and biscuits to a level that to me is most unhealthy so its a wonder shes got to 89 before getting VD


My Mother used to do everything from sewing , knitting to sugarcraft despite the problems in her thumbs but now all of thats impossible

I guess they must have the same genetic make up

 

[Kayla]

Rheumatoid and osteo-arthritis

Dear Helena,
Reading the patient information about the steroids Mum was given for her rheumatoid arthritis over a period of 25 years, it is perhaps not surprising that she suffered ill effects. Osteo-arthritis is the most common type of arthritis, which is caused by wear and tear on the joints and is age or exercise related. Your mother could have developed this in her thumb joints because of her love of craft work.
Rheumatoid arthritis is inflammation of the joints and could be caused by a virus or by the body's immune system fighting its own cells. Not much is known about it and it can only be controlled, not cured. People sometimes have both types of arthritis. As it is a very painful condition, patients can get very depressed and irritable, blaming other people for trivial things or getting worked up over nothing at all. It can last for years and years with no end in sight.
It seems that quite a few people on TP mention RA in their posts and I think links between arthriitis and various forms of Dementia are worthy of investigation.
Helena, it certainly sounds as though our Mums suffer from a similar type of vascular dementia. Does your mother take steroids for her arthritis as well?
Filing away some of her correspondence yesterday, I certainly sympathise with your concerns over your mother's financial affairs. I had to search for the correct file and some contained different things to the title on the file. We're getting there slowly!
Kayla

 

[Helena]

Actually my Mothers Arthritis has also been labelled as Rheumatoid but she has not taken steroids

I believe she has Coeliac disease though because our grandaughter has it and my Mother is the only one in the family who fits the picture but has not been tested .........Coeliac when ignored causes Osteoporosis amongst other things

her Mother died with Bowel Cancer also caused by unrecognised coeliac disease
they were both very thin also typical