Post by norbert1 on Jun 29, 2006 9:40:14 GMT -5
Alzheimers is one kind of dementia, Vascular is another type.
A doctor explained some of the differences seen in Vascular (compared to Alzheimers)
Both have speech difficulties. The person with alzheimers may have stumble, because they have trouble spontaneously remembering the word needed (usually a noun). A person with VaD (Vascular Dementia) will remember the word, but have problems with the actual production of the sound - making the mouth work properly.
A person with VaD will often have a problem with urinary incontinence early in the disease, and will often have problems with gait (walking), taking tiny shuffling steps.
The memory is not as severely impaired early in VaD compared to Alz - but memory loss is definitely part of vascular dementia.
As I understand it, the person with VaD is more likely to have personality problems (such as stubbornness and arguing.)
Caregivers report similar difficulties taking care of a person with vascular dementia, such as lack of insight about the extent of disability and refusal to cooperate in taking meds. These are similar to Alzheimers behavior many caregivers describe.
Standard treatment for VaD is to treat the stroke risk by controling cloresterol, blood pressure and use of a blood thinner (either aspirin or Wafarin) Dementia doctors also have discovered that Aricept does help the person with vascular dementia.
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from Alzheimers Association
Advances newsletter winter 2002
Vascular Dementia:
Complex Pathology, Confusing Symptoms
Although the average brain weighs only three pounds—accounting for just 2 percent of the weight of a 150-pound person—it consumes 20 percent of the body’s oxygen and receives 20 percent of the body’s blood supply. Events that interfere with the brain’s blood supply pose a serious threat—its cells can survive without oxygen for only three to five minutes. When brain cells die, their death disrupts the mental or physical function controlled by the area where the damage occurs.
Vascular dementia is a general term for thinking impairment resulting from disruptions in the brain’s blood supply to cells involved in memory, reasoning, and emotion. The most frequently diagnosed type of vascular dementia is multi-infarct dementia, in which a series of small strokes block small arteries. Individually, these strokes are too slight to cause the catastrophic symptoms associated with a major stroke-such as numbness or paralysis on one side of the body, inability to speak, or loss of consciousness-but their combined effects gradually become noticeable. One rare type of vascular dementia is Binswanger’s disease, in which multiple small strokes tend to occur deep below the brain’s surface in an area called the white matter. Many symptoms considered characteristic of vascular dementia mimic symptoms of other dementias, including Alzheimer’s disease. Common symptoms include problems with recent memory, confusion, wandering or getting lost in familiar places, having trouble following instructions, problems with bladder or bowel control, and laughing or crying inappropriately. In some cases—although not all—mental impairment associated with vascular dementia may occur in discrete "steps" rather than in the slow, steady decline of Alzheimer’s. Another difference is that people with vascular dementia may retain a greater awareness of their mental impairment. Individuals with vascular dementia may also have other diseases of the heart or circulatory system, or risk factors for those disorders such as high blood pressure, elevated cholesterol levels, or diabetes.
Evolving Ideas about a Complex Disorder
Medical thinking about vascular dementia has changed considerably over the past few decades. At one time, doctors attributed almost all mental impairment associated with old age to "hardening of the arteries" in the brain. As scientists gained deeper understanding of other dementing illnesses, Alzheimer’s gradually earned recognition as the most common dementia, and vascular dementia was considered the second most frequent.
Experts now acknowledge that neither the frequency nor the characteristics of vascular dementia are well understood. Several professional bodies have developed different sets of criteria for diagnosing the disorder, making it difficult to estimate its frequency with any precision. Estimates found in recent scientific literature indicate that vascular dementia accounts for anywhere from one-tenth to one-third of dementia cases
Thinking about the pathological changes that occur with vascular dementia and Alzheimer’s also continues to evolve. Autopsy studies suggest that dementia caused exclusively by vascular abnormalities is actually quite rare. Many individuals with dementia have both vascular lesions and pathology associated with Alzheimer’s—a condition sometimes called "mixed dementia." In his book Aging with Grace, which describes investigations into healthy aging and Alzheimer’s with the School Sister of Notre Dame (the Nun Study), David Snowdon reports that sisters with vascular brain lesions tended to have symptoms of dementia only if they also had plaques and tangles-characteristic Alzheimer abnormalities.
------------------------
A good collection of information pieces about vascular dementia can be found at Alzheimers Outreach in the section on other "non-typical" dementias.
Located at -
www.zarcrom.com/users/alzheimers/odem/mid-d.html
Many of the articles there are about multi-infarct dementia because these very small "silent strokes" were thought to be the primary cause of vasucular dementia. I believe that the current thinking is that there can be other specific mechanisms involving blood supply that can also be classified as vascular dementia.
Norbert
A doctor explained some of the differences seen in Vascular (compared to Alzheimers)
Both have speech difficulties. The person with alzheimers may have stumble, because they have trouble spontaneously remembering the word needed (usually a noun). A person with VaD (Vascular Dementia) will remember the word, but have problems with the actual production of the sound - making the mouth work properly.
A person with VaD will often have a problem with urinary incontinence early in the disease, and will often have problems with gait (walking), taking tiny shuffling steps.
The memory is not as severely impaired early in VaD compared to Alz - but memory loss is definitely part of vascular dementia.
As I understand it, the person with VaD is more likely to have personality problems (such as stubbornness and arguing.)
Caregivers report similar difficulties taking care of a person with vascular dementia, such as lack of insight about the extent of disability and refusal to cooperate in taking meds. These are similar to Alzheimers behavior many caregivers describe.
Standard treatment for VaD is to treat the stroke risk by controling cloresterol, blood pressure and use of a blood thinner (either aspirin or Wafarin) Dementia doctors also have discovered that Aricept does help the person with vascular dementia.
-----------------------
from Alzheimers Association
Advances newsletter winter 2002
Vascular Dementia:
Complex Pathology, Confusing Symptoms
Although the average brain weighs only three pounds—accounting for just 2 percent of the weight of a 150-pound person—it consumes 20 percent of the body’s oxygen and receives 20 percent of the body’s blood supply. Events that interfere with the brain’s blood supply pose a serious threat—its cells can survive without oxygen for only three to five minutes. When brain cells die, their death disrupts the mental or physical function controlled by the area where the damage occurs.
Vascular dementia is a general term for thinking impairment resulting from disruptions in the brain’s blood supply to cells involved in memory, reasoning, and emotion. The most frequently diagnosed type of vascular dementia is multi-infarct dementia, in which a series of small strokes block small arteries. Individually, these strokes are too slight to cause the catastrophic symptoms associated with a major stroke-such as numbness or paralysis on one side of the body, inability to speak, or loss of consciousness-but their combined effects gradually become noticeable. One rare type of vascular dementia is Binswanger’s disease, in which multiple small strokes tend to occur deep below the brain’s surface in an area called the white matter. Many symptoms considered characteristic of vascular dementia mimic symptoms of other dementias, including Alzheimer’s disease. Common symptoms include problems with recent memory, confusion, wandering or getting lost in familiar places, having trouble following instructions, problems with bladder or bowel control, and laughing or crying inappropriately. In some cases—although not all—mental impairment associated with vascular dementia may occur in discrete "steps" rather than in the slow, steady decline of Alzheimer’s. Another difference is that people with vascular dementia may retain a greater awareness of their mental impairment. Individuals with vascular dementia may also have other diseases of the heart or circulatory system, or risk factors for those disorders such as high blood pressure, elevated cholesterol levels, or diabetes.
Evolving Ideas about a Complex Disorder
Medical thinking about vascular dementia has changed considerably over the past few decades. At one time, doctors attributed almost all mental impairment associated with old age to "hardening of the arteries" in the brain. As scientists gained deeper understanding of other dementing illnesses, Alzheimer’s gradually earned recognition as the most common dementia, and vascular dementia was considered the second most frequent.
Experts now acknowledge that neither the frequency nor the characteristics of vascular dementia are well understood. Several professional bodies have developed different sets of criteria for diagnosing the disorder, making it difficult to estimate its frequency with any precision. Estimates found in recent scientific literature indicate that vascular dementia accounts for anywhere from one-tenth to one-third of dementia cases
Thinking about the pathological changes that occur with vascular dementia and Alzheimer’s also continues to evolve. Autopsy studies suggest that dementia caused exclusively by vascular abnormalities is actually quite rare. Many individuals with dementia have both vascular lesions and pathology associated with Alzheimer’s—a condition sometimes called "mixed dementia." In his book Aging with Grace, which describes investigations into healthy aging and Alzheimer’s with the School Sister of Notre Dame (the Nun Study), David Snowdon reports that sisters with vascular brain lesions tended to have symptoms of dementia only if they also had plaques and tangles-characteristic Alzheimer abnormalities.
------------------------
A good collection of information pieces about vascular dementia can be found at Alzheimers Outreach in the section on other "non-typical" dementias.
Located at -
www.zarcrom.com/users/alzheimers/odem/mid-d.html
Many of the articles there are about multi-infarct dementia because these very small "silent strokes" were thought to be the primary cause of vasucular dementia. I believe that the current thinking is that there can be other specific mechanisms involving blood supply that can also be classified as vascular dementia.
Norbert