Question

Scenario: A 74-year-old male, retired accountant, with a long-standing history of hypertension and atherosclerosis, begins to exhibit some personality changes, deterioration in grooming, trouble understanding news events, and difficulty managing personal finances. He also stopped attending social events and dropped out of his chess club. His wife of 50 years becomes concerned and schedules an appointment with his healthcare provider, who diagnoses him with Vascular Dementia, Alzheimer’s type. Arrangements have been made for a visiting RN to come to the house once weekly. Initial Discussion Post: Address the following: In what stage of Alzheimer’s disease is this client? What criteria did you use to determine this? What are 3 priority RN assessments when home visits are made? What are some anticipated caregiver issues that this client’s spouse will personally experience? List and describe 3 intercollaborative referrals that may be needed for this client within the next year or so.

Answer 1

In vascular dementia, changes in thinking skills sometimes occur suddenly following strokes that block major brain blood vessels. Thinking problems also may begin as mild changes that worsen gradually as a result of multiple minor strokes or other conditions that affect smaller blood vessels, leading to cumulative damage. A growing number of experts prefer the term "vascular cognitive impairment (VCI)" to "vascular dementia" because they feel it better expresses the concept that vascular thinking changes can range from mild to severe.

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ALZHEIMER'S & DEMENTIA

Vascular Dementia

Vascular Dementia
Vascular Dementia
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Vascular dementia is a decline in thinking skills caused by conditions that block or reduce blood flow to the brain, depriving brain cells of vital oxygen and nutrients.

About
Causes and risks
Symptoms
Treatment
Diagnosis

About vascular dementia

Inadequate blood flow can damage and eventually kill cells anywhere in the body. The brain has one of the body's richest networks of blood vessels and is especially vulnerable.

In vascular dementia, changes in thinking skills sometimes occur suddenly following strokes that block major brain blood vessels. Thinking problems also may begin as mild changes that worsen gradually as a result of multiple minor strokes or other conditions that affect smaller blood vessels, leading to cumulative damage. A growing number of experts prefer the term "vascular cognitive impairment (VCI)" to "vascular dementia" because they feel it better expresses the concept that vascular thinking changes can range from mild to severe.

Vascular brain changes often coexist with changes linked to other types of dementia, including Alzheimer's disease and dementia with Lewy bodies. Several studies have found that vascular changes and other brain abnormalities may interact in ways that increase the likelihood of dementia diagnosis. Sign up for our e-news to receive updates about Alzheimer’s and dementia care and research.

Other dementias share some common symptoms

Vascular changes that start in brain areas that play a key role in storing and retrieving information may cause memory loss that looks very much like Alzheimer's disease.

Vascular dementia is widely considered the second most common cause of dementia after Alzheimer's disease, accounting for 10 percent of cases. Many experts believe that vascular dementia remains underdiagnosed — like Alzheimer's disease — even though it's recognized as common.

Learn more: Key Types of Dementia, Mixed Dementia.

Symptoms

Vascular dementia symptoms can vary widely, depending on the severity of the blood vessel damage and the part of the brain affected. Memory loss may or may not be a significant symptom depending on the specific brain areas where blood flow is reduced.

Symptoms may be most obvious when they happen soon after a major stroke. Sudden post-stroke changes in thinking and perception may include:

Confusion.
Disorientation.
Trouble speaking or understanding speech.
Vision loss.

These changes may happen at the same time as more familiar physical stroke symptoms, such as a sudden headache, difficulty walking, or numbness or paralysis on one side of the face or the body.

[Alzheimer's Association - Logo]
MENU
24/7 HELPLINE 800.272.3900
DONATE

Alzheimer's & Dementia
Help & Support
Research
Get Involved
Local Resources
About
News
Events
Professionals
E-news

ALZHEIMER'S & DEMENTIA

Vascular Dementia

Vascular Dementia
Vascular Dementia
Share or Print this page
  

Vascular dementia is a decline in thinking skills caused by conditions that block or reduce blood flow to the brain, depriving brain cells of vital oxygen and nutrients.

About
Causes and risks
Symptoms
Treatment
Diagnosis

About vascular dementia

Inadequate blood flow can damage and eventually kill cells anywhere in the body. The brain has one of the body's richest networks of blood vessels and is especially vulnerable.

In vascular dementia, changes in thinking skills sometimes occur suddenly following strokes that block major brain blood vessels. Thinking problems also may begin as mild changes that worsen gradually as a result of multiple minor strokes or other conditions that affect smaller blood vessels, leading to cumulative damage. A growing number of experts prefer the term "vascular cognitive impairment (VCI)" to "vascular dementia" because they feel it better expresses the concept that vascular thinking changes can range from mild to severe.

Vascular brain changes often coexist with changes linked to other types of dementia, including Alzheimer's disease and dementia with Lewy bodies. Several studies have found that vascular changes and other brain abnormalities may interact in ways that increase the likelihood of dementia diagnosis. Sign up for our e-news to receive updates about Alzheimer’s and dementia care and research.

Other dementias share some common symptoms

Vascular changes that start in brain areas that play a key role in storing and retrieving information may cause memory loss that looks very much like Alzheimer's disease.

Vascular dementia is widely considered the second most common cause of dementia after Alzheimer's disease, accounting for 10 percent of cases. Many experts believe that vascular dementia remains underdiagnosed — like Alzheimer's disease — even though it's recognized as common.

Learn more: Key Types of Dementia, Mixed Dementia.

Symptoms

Vascular dementia symptoms can vary widely, depending on the severity of the blood vessel damage and the part of the brain affected. Memory loss may or may not be a significant symptom depending on the specific brain areas where blood flow is reduced.

Symptoms may be most obvious when they happen soon after a major stroke. Sudden post-stroke changes in thinking and perception may include:

Confusion.
Disorientation.
Trouble speaking or understanding speech.
Vision loss.

These changes may happen at the same time as more familiar physical stroke symptoms, such as a sudden headache, difficulty walking, or numbness or paralysis on one side of the face or the body.

Multiple small strokes or other conditions that affect blood vessels and nerve fibers deep inside the brain may cause more gradual thinking changes as damage accumulates. Common early signs of widespread small vessel disease include impaired planning and judgment, uncontrolled laughing and crying, declining ability to pay attention, impaired function in social situations, and difficulty finding the right words.

Learn more: Warning Signs from the American Stroke Association.

Diagnosis

Because vascular cognitive impairment may often go unrecognized, many experts recommend professional screening with brief tests to assess memory, thinking and reasoning for everyone considered to be at high risk for this disorder. Individuals at highest risk include those who have had a stroke or a transient ischemic attack (TIA, also known as a "ministroke"). Additional high-risk groups include those with high blood pressure, high cholesterol, or other risk factors for heart or blood vessel disease.

Professional screening for depression is also recommended for high-risk groups. Depression commonly coexists with brain vascular disease and can contribute to cognitive symptoms.

If brief screening tests suggest changes in thinking or reasoning, a more detailed assessment is needed. Core elements of a workup for vascular dementia typically include:

A thorough medical history, including family history of dementia.
Evaluation of independent function and daily activities.
Input from a family member or trusted friend.
In-office neurological examination assessing function of nerves and reflexes, movement, coordination, balance and senses.
Laboratory tests including blood tests and brain imaging.