The Stages of Vascular Dementia as it Progresses

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Know More About The Stages of Vascular Dementia

 

Stages of Vascular DementiaThe stages of vascular dementia and the dementia stages are the same. Next to Alzheimer’s disease, vascular dementia is the most common type of dementia.. There are several causes for this condition aside from genetics and stroke. The main cause for vascular dementia is due to lack of blood circulation in the brain. Even if a person doesn’t suffer from a stroke, he or she might present symptoms and sometimes it could go unnoticed. A person with this condition suffers from memory loss and the loss of cognitive abilities. This is caused by a lack of oxygen supply in the brain. Blockage of the veins that supply blood to the brain is one of the many reasons for this condition.

See tabbed module at bottom of post for a complete explanation of The Stages of Vascular Dementia.

The symptoms are different depending on which of the stages of vascular dementia the sufferer is in. Sometimes it is confused with Alzheimer’s because the same symptoms are present in the patient. After a stroke, vascular dementia can progress in different stages but this can worsen if there is a heart attack. Patients will sometimes experience this condition in two stages. One is the early onset (stages 1,2 and 3 and another in the 4,5,6 and 7th) stages. Both of these situations will present fast deterioration of motor functions and the cognitive abilities of the person.

The stages of vascular dementia may vary from one person to another. Age can also play a role in the progression of the disease. The outcome is due to various factors. There is no universal treatment for the condition and it varies depending on the person suffering from it. The life expectancy of the patient also varies. Unfortunately there is still no treatment that could reverse the problem. Although there are treatments that could help in managing the symptoms and this could prolong the life of a patient.

In the early stages of vascular dementia, the symptoms are gradual. The patient will notice problems in walking and thinking. It could hamper day to day activities. They might also notice that they can’t  follow lengthy conversations. Signs of trouble would also include inability to concentrate and memory loss for a short time. Since the early symptoms might occur slowly, people with this condition are more aware of the things happening to them. In order to live a normal life, they would need reminders and little guidance from other people.

When one reaches the later part of stages of vascular dementia, they need supervision all the time. Their mental abilities are limited to the point that it could be dangerous. A person suffering in the later stages can also suffer from hallucinations, confusion and delusion. The disease can progress severely which might make a person weak and immobile. Most patients in this stage would have a tendency to become violent especially to the ones caring for them. They also need a lot of understanding from the people around them. Hiring a care giver is a wise move for a patient suffering in the later stages of vascular dementia.

 

The Stages of Vascular Dementia using the GDS as a Guide

NO COGNITIVE DECLINE: During the first of the stages of vascular Dementia there is no subjective complaints of memory deficit. No clear memory deficit on clinical interview.
VERY MILD COGNITIVE DECLINE (Age Associated Memory Impairment): Subjective complaints of memory deficit, most often in following areas: (a) forgetting where one has placed familiar objects; (b) forgetting names one formerly knew well. No evidence of memory deficit on clinical interview. No objective deficits in employment or social situations. Appropriate concern about symptomatology.
MILD COGNITIVE DECLINE (Mild Cognitive Impairment): During second of the stages of vascular dementia one might see clear-cut deficits. Manifestations in more than one of the following areas: (a) patient may have gotten lost when traveling to an unfamiliar place; (b) co-workers become aware of patient’s relatively poor performance; (c) word and name finding deficit becomes clear to intimates; (d) patient may read a passage or a book and retain relatively little material; (e) patient may show decreased facility in remembering names upon introduction to new people; (f) patient may have lost or misplaced an object of value; (g) concentration deficit will be clear on clinical testing. Objective evidence of memory deficit obtained only with an intensive interview. Decreased performance in demanding employment and social settings. Denial begins to become manifest in patient. Mild to moderate anxiety accompanies symptoms.
MODERATE COGNITIVE DECLINE (Mild Dementia): Clear-cut deficit on careful clinical interview. Deficit manifest in following areas: (a) decreased knowledge of current and recent events; (b) may show some deficit in memory of one’s personal history; (c) concentration deficit elicited on serial subtraction; (d) decreased ability to travel, handle finances, etc. Frequently no deficit in following areas: (a) orientation to time and place; (b) recognition of familiar persons and faces; (c) ability to travel to familiar locations. Inability to do complex tasks. Denial is dominant defense mechanism. Flattening of affect and withdrawal from challenging situations often occur.
MODERATELY SEVERE COGNITIVE DECLINE (Moderate Dementia): Patient can no longer survive without some help. Patient is unable during interview to recall a major relevant aspect of their current lives, e.g., an address or telephone number of many years, the names of close family members (such as grandchildren), the name of the high school or college from which they graduated. Frequently some disorientation to time (date, day of week, season, etc.) or to place. An educated person may have difficulty counting back from 40 by 4s or from 20 by 2s. Persons at this stage retain knowledge of many major facts about themselves and others. They invariably know their own names and generally know their spouses’ and children’s names. They need no help with toileting and eating, but may have some difficulty choosing the proper clothing to wear.
SEVERE COGNITIVE DECLINE (Moderately Severe Dementia): May occasionally forget the name of the spouse upon whom they are entirely dependent for survival. Will be largely unaware of all recent events and experiences in their lives. Retain some knowledge of their past lives but this is very sketchy. Generally unaware of their surroundings, the year, the season, etc. May have difficulty counting from 10, both backward and, sometimes, forward. Will need some help with activities of daily living, e.g., may become incontinent, will need travel help but occasionally will be able to travel to familiar locations. Diurnal rhythm frequently disturbed. Almost always recall their own name. Frequently continue to be able to distinguish familiar from unfamiliar persons in their environment. Personality and emotional changes occur. These are quite variable and include: (a) delusional behavior, e.g., patients may accuse their spouse of being an impostor, may talk to imaginary figures in the environment, or to their own reflection in the mirror; (b) obsessive symptoms, e.g., person may continually repeat simple cleaning activities; (c) anxiety symptoms, agitation, and even previously nonexistent violent behavior may occur; (d) cognitive abulla, i.e., loss of willpower because a person cannot carry a thought long enough to decide on a purposeful course of action.
VERY SEVERE COGNITIVE DECLINE (Severe Dementia): Here in the last of the stages of vascular dementia  all verbal abilities are lost over the course of this stage. Frequently there is no speech at all, only unintelligible utterances and rare emergence of seemingly forgotten words and phrases. Incontinent of urine, requires assistance toileting and feeding. Basic psychomotor skills, e.g., ability to walk, are lost with the progression of this stage. The brain appears to no longer be able to tell the body what to do. Generalized rigidity and developmental neurologic reflexes are often present.

Sources

National Library of Medicine

Helpguide.org

Mayo Clinic

www.alz.org

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