Vascular v Alzheimer’s

Bugs

Registered User
Aug 27, 2020
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Can anyone tell me if its only Alzheimer’s that is picked up on a Brain scan. My husband was diagnosed with vascular dementia in December and it was thought he may also have alzheimers. At that time he did not want a scan. However last week he had a TIA and ended up having both a CAT scan and MRI. I phoned the hospital yesterday and asked if the Consultant could look at the scans for signs of dementia. This morning I had a call from the hospital to say there was only the slightest sign of dementia. I am very confused. He absolutely has dementia. He is not the man I married but I think it is vascular dementia from all the strokes he had. I can fully accept that he doesn’t have Alzheimer’s but to say he doesn’t have VD is just nuts. Can anyone shed some light?
 

karaokePete

Registered User
Jul 23, 2017
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N Ireland
Hello @Bugs

I wouldn't lose any sleep pondering that one as the only way to be definitive about the type of dementia suffered is to examine the brain post mortem.

If you look for a web site about the 'Nun's Study' in USA you will find some interesting reading. People have been found to have little brain damage but major dementia symptoms, whilst others have major brain damage and minor dementia symptoms. So many things come into play, like what is known as cognitive reserve that can give some protection against dementia so that a person with a lot of brain damage may have little in the way of symptoms.

When my wife was going through the diagnosis process her CT and MRI scan showed little to explain her symptoms but a deeper PET scan did show the damage that explained things. The Consultant was happy to make the diagnosis before the PET scan as his findings were based on the cognitive tests and the symptoms I recorded and reported.
 

Veritas

Registered User
Jun 15, 2020
315
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Can anyone tell me if its only Alzheimer’s that is picked up on a Brain scan. My husband was diagnosed with vascular dementia in December and it was thought he may also have alzheimers. At that time he did not want a scan. However last week he had a TIA and ended up having both a CAT scan and MRI. I phoned the hospital yesterday and asked if the Consultant could look at the scans for signs of dementia. This morning I had a call from the hospital to say there was only the slightest sign of dementia. I am very confused. He absolutely has dementia. He is not the man I married but I think it is vascular dementia from all the strokes he had. I can fully accept that he doesn’t have Alzheimer’s but to say he doesn’t have VD is just nuts. Can anyone shed some light?
My husband was diagnosed with Alzheimer’s based on symptoms and cognitive testing. A scan was not deemed necessary.

It is possible for the severity of a patient’s symptoms to be out of line with what’s seen on a scan. What’s being reported in your husband’s case may mean that he doesn’t have Alzheimer’s (or if he does it’s a very much smaller contributor to his symptoms than the vascular problems). Either way, if he’s been diagnosed by specialists the scan results won’t change that, unless there has been a significant improvement in his other symptoms - from what you say this seems unlikely.
 

jennifer1967

Registered User
Mar 15, 2020
23,131
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Southampton
my husband had an mri scan before memory test. he has vascular dementia because of the mini-stroke and narrowing of the blood vessels. alzheimers presents in a different way in that it has plaques
 

Moggymad

Registered User
May 12, 2017
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When my mum was diagnosed with Alzheimer's she had had the MRI & cognitive tests. I remember the mental health nurse explaining the MRI scan doesn't diagnose alzheimers it just rules out other forms of dementia.... so as nothing showed up then based on her cognitive testing she was then diagnosed.
 

Sarasa

Volunteer Host
Apr 13, 2018
7,195
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Nottinghamshire
My mother refused to go to the memory clinic but did agree to the MRI scan. The scan showed 'normal signs of aging', though by then mum's behaviour was far from 'normal'. It was only when mum had a meltdown in the doctor's surgery that they arranged for a psychiatrist to go an visit her at home. He diagnosed 'probable vascular dementia'. I'm not sure if that is the correct diagnosis or not, but in the end all dementias end up looking pretty similar to each other anyway. Certainly mum's memory which used to be not that affected, is now very bad and she is somewhere in the 1930s with no memory of my dad.