Vascular Dementia
With Alzheimer’s being the number one cause of dementia, vascular dementia is a close second. The word “vascular” refers to your body’s blood vessels and Vascular Dementia is caused by a low supply of blood traveling to your brain. This limited blood supply is caused by the arteries being too narrow to carry a sufficient blood supply or there is a complete blockage of the artery.
Due to several mini strokes (also known as “silent strokes”), that possibility goes unnoticed and is considered the main cause of vascular dementia.
When blood is blocked or interrupted for just a few seconds – brain cells begin to die. This causes direct damage to the Cortex (which is the main area of the brain associated with the ability to learn, speak and where our precious memories are stored).
Vascular Dementia is rarely properly diagnosed in the early stages because it progresses slowly and many people know the symptoms but not the cause. The symptoms of early vascular dementia might include:
Short term memory loss
Difficulty with concentration or walking and problems with performing simple everyday chores
In the later stages of vascular dementia, it is important that the patient is supervised and well cared for as they could become dangerous to others or themselves because of a severe loss of mental capacity. The symptoms most often seen in late stages of vascular dementia are:
Hallucinations, delusions, confusion
Violent and/or very agitated, and the
Tendency to wander from the safety of their home increases
Some physical symptoms that are common among vascular dementia patients include:
Weakness in arms and legs
Equilibrium problems
Loss of bowel and/or bladder control
Tremors
Walking quickly with shuffled steps
It has been reported that about half of all cases of vascular dementia are due directly to high blood pressure and hypertension.
Since there is no known cure, it is important to take preventive steps to keep your body healthy. Start by keeping your weight at a healthy place by enjoying a lower fat and lower salt diet, keep your blood pressure within normal range, and monitor your cholesterol and blood sugar levels. Avoid excess alcohol consumption and if you smoke, quitting is a big preventative step. Enjoy exercising; walking or swimming all are excellent choices, or learn something new – perhaps a game of tennis or golf is more your game. Whatever you decide on for a daily exercise routine, it is so important to keep your body moving.
Laughter is the best medicine, so have fun, enjoy life and be inspired by its many wonders. Worry and stress will just aggravate your condition – as it is a known fact that stress is a major cause of heart related diseases. Find ways to relax your body and mind; play or color with children; get a massage, read something light and funny.
Challenging your brain power will not only give you more memory capability, but will definitely slow the progression of vascular dementia. For an example: when your day ends – take time to relax and recall the events of the day. Doing this mental exercise daily will surely help, and also try to learn something new and do it regularly. Don’t give up or allow yourself to get frustrated.
Below we have listed some tangible ways to make living with vascular dementia easier:
Make a notepad your constant companion. Writing things down (names, dates, appointments and a to-do list) takes the pressure off and removes some anxiety about trying to remember all of it.
Tell people the truth about your condition so there is not a misunderstanding about your actions.
Don’t be afraid to ask someone to repeat a conversation slowly and perhaps break down a message into smaller pieces for your brain to comprehend and repeat it back to them.
When you need to understand or concentrate on instructions or a message, it will help to remove any other distractions like a radio or TV.
To keep you feeling in control, follow a routine. Keep items in the same place all the time so they are easy to find and you don’t have to be burdened with trying to remember where you put something.
Keep blinds to the outside world open so you know when it is daylight and nighttime; this will help you to keep track of the time of day.
When you understand the condition of vascular dementia and have the desire to make the appropriate lifestyle changes, it is possible to prevent any further damage due to blockages.
Lewy Body Dementia
This type of dementia accounts for up to 15% (over one million people) of all dementia cases, and is listed the third on the list of most common types of Dementia (right after Alzheimer’s and Vascular dementia). The signs and symptoms are similar to both Parkinson’s and Alzheimer’s disease. Lewy bodies are small protein deposits called alpha-synuclein that are in the brain. The cause of this protein build-up in the brain is unknown.
Patients that suffer with this type of dementia have symptoms that include:
- Hallucinations
- Attention deficit issues and motor skill difficulty
- Sleep difficulty due to vivid dreams (associated with swinging of arms and legs)
These symptoms can begin several years prior to any symptoms of memory loss being noticed.
Lewy body dementia can be called several different names: such as “Diffuse Lewy body disease”, “Cortical Lewy body disease”, “senile dementia of Lewy type”, “Lewy body variant of Alzheimer’s”, “Parkinson’s disease with dementia”.
It doesn’t matter what you call the disease, the symptoms are the same. The major difference with Lewy Body Dementia is that instead of attacking a specific part of the brain, it affects several areas of the brain, which widens the symptoms of physical and behavioral disorders.
The symptoms that are like Parkinson’s disease will include:
- Shuffling of their feet when walking
- Uncontrollable shaking of hands
- Having a blank or ‘far away’ expression on their face
The symptoms of Lewy Body dementia that are close to Alzheimer’s Disease are:
- Becomes confused easily
- Unable to recall past memories
- Difficulty retaining new information or memories.
It is not easy to diagnose Lewy body dementia because of the similar symptoms of Parkinson’s and Alzheimer’s disease. Two of three characteristics must be met to bring a diagnosis of “probable” Lewy body dementia:
- Have difficulty with staying alert and attentive, although this symptom might come and go at different times. This is referred to Fluctuating cognition.
- The patient believes they are seeing and reacting to a real situation, but it is only a visual hallucination.
- Parkinsonism is when the patient is having difficulty with movement, very similar to the symptoms of Parkinson’s disease.
When you are caring for someone that is dealing with Lewy body dementia, it is important to be flexible and adapt to the situation at hand, because the symptoms associated with this type of dementia usually change from day to day. As Lewy body dementia gets worse, the ability to move easily and remaining balanced gets increasingly more difficult. A cane or walker will be needed to aid the patient with balance and increase their safety from falling and the possibility of causing further injury. In addition to the physical deterioration, as Lewy Body dementia continues, the ability to make proper decisions also decreases. If possible, financial and legal issues should be discussed, and a plan should be in place before this disease reaches the later stages.
There is currently no cure for Lewy body dementia and there is no prescription medication that is approved by the Federal Drug Administration that targets this type of dementia. It has been reported that many patients do benefit from taking cholinesterase inhibitor drugs like Aricept, Exelon or Razadyne. Ask your health care professional which one is best for you. These drugs have been specifically used to target Alzheimer’s disease, but have also been proven to be very effective in patients that suffer from Lewy body dementia. To help with the Parkinson’s symptoms (especially difficulty with movement), the medical drugs Stalevo and Sinemet can be prescribed.
Antipsychotic medications, although effective in reducing hallucinations in most cases, will increase the difficulty of movement in a Lewy Body patient. A trained, medical professional will be able to advise on which is the best course of action in treating the patient that suffers from Lewy Body Dementia.
Originally founded by a few people that were caregivers of patients of LBD and just having the need to vent or chat online, that small group led to the incorporation of Lewy Body Dementia Association (LBDA). The main goal and mission of this non-profit organization is to raise awareness of the Lewy body dementias (LBD), provide support to patients, families and caregivers that are directly affected by this disease. This amazing association is filled with caring and dedicated people who personally understand the struggles of LBD Caregivers. The future vision of this organization is to see a cure available for people that suffer with Lewy body dementia, and to offer quality information and support for the families and patients that are currently living with this disease.
Frontotemporal Dementia
Frontotemporal Dementia is a much less common type of dementia, compared to Alzheimer’s Disease. In fact, it is one of the rarest diseases of the brain. Because of this disease, the frontal and temporal lobes of the brain will most likely shrink. In these cases, brain imaging is very effective in making an accurate diagnosis. Frontotemporal Dementia does not discriminate, as it affects women and men equally. The progression of Frontotemporal Dementia moves along quite rapidly and affects people between the ages of 40 and 65 years of age (a much younger age group than Alzheimer’s disease).
Frontotemporal Dementia directly affects the front and sides of the brain that controls behavior, personality and language. It is documented that about one-third of cases are due to genetics. Besides the fact that Frontotemporal dementia is fast moving and attacks a much younger age group, the other major difference with this type of dementia is that the personality changes that occur are extreme and bizarre to say the least.
The behavior changes in Frontotemporal dementia are early symptoms and can include, but is not limited to things like:
- gambling or reckless spending of monies
- Rude, inappropriate and off-color comments to strangers as well as to family
- Apathy or loss of interest or the other extreme of feeling excessively happy
- Stealing and shoplifting. These types of symptoms will not only keep the caregiver on their toes, but the police will be kept busy as well!
- Difficult time understanding language and speak in a manner that is inappropriate, incoherent or they won’t speak at all
- Have a strong desire to consume food – whether they are hungry or not
The survival rate of people with Frontotemporal Dementia is, on average, seven years. Pick’s disease is responsible for one-third of all Frontotemporal Dementia patients. Picks can last two to ten years; but there is no cure and it is a fatal disease.
Movement is a rare symptom of Frontotemporal Dementia, but they are similar to Parkinson’s disease or ALS (Amyotrophic Lateral Sclerosis) which is more commonly known as Lou Gehrig’s disease. Movement related symptoms can include such things as:
- Tremors
- Involuntary muscle spasms
- Weakness in the muscles
- Poor coordination
The testing involved to diagnose Frontotemporal Dementia can include an extensive (a few hours to complete) assessment of a patient’s memory and reasoning skills. This type of testing is very helpful in assisting in trying to identify the specific types of dementia that a person suffers from, in the diseases early stages of development.
Brain scans are helpful for the doctor to see if any abnormalities exist; such as bleeding or tumors that can be causing the severe symptoms of Frontotemporal Dementia. There are two types of scans that are commonly used in diagnosing abnormalities: The first would be an MRI (magnetic resonance imaging). This device uses radio waves and strong magnetic fields to make detailed pictures of your brain. Although this procedure is painless, it can take up to an hour to complete and some people might experience claustrophobic symptoms. The second type of scan is known as a CT scan (computerized tomography). A CT scan takes X-rays of your brain at difference angles. This is also a painless experience that takes about 30 minutes.
Sadly there is no FDA approved treatment for Frontotemporal Dementia and nothing, whether approved by the FDA or not, has been proven to be effective in relieving, slowing down or minimizing any of the symptoms due to Frontotemporal Dementia. Drugs that are prescribed are usually only to manage the symptoms. Many times they include antidepressants such as Trazodone (Desyrel, Oleptro) as this type of drug might help in reducing the extreme behavioral issues associated with Frontotemporal Dementia. The patients that are having difficulty with language could benefit from the treatment of speech therapy or be taught other ways to communicate their needs and wants to their trusted and compassionate caregiver.
Frontotemporal Dementia patients need 24 hour care and the caregiver needs to make sure they take care of themselves as this could one of the most stressful types of Dementia to care for. Patience and compassion are more than required; make sure that you have an excellent support system in place to vent and share experiences.
