Since I received the results from the PET Scan that I took a month or so back they have changed a number of things related to my diagnosis. 1) They removed me from the clinical trial because I didn’t have enough Amyloid protein on my brain, According to them I had Scant amount of the protein. I felt Down when I received the notice but then a few days later It was on the national news that the study I was being tested for was being closed down because the medicine being tested was not producing the results they had hoped for.
So I felt better since I wasn’t going to be wasting 2 1/2 years on a medicine that was not effective. But that put me back to square one. 2) They changed my Diagnosis from Mild Cognitive impairment due to Alzheimer’s disease To Mild Cognitive Impairment from Vascular Disease in the brain. WOW! I don’t have Alzheimer’s Disease! But what is vascular Diseases in the brain??? Should I celebrate or go hide for the rest of my life?Well as promised here’s what I have found out sofar:
Vascular Dementia, formerly known as multi-infarct dementia, accounts for a Relative small fraction of dementia cases. It is the result of accumulated brain damage from multiple small strokes, which individually may not be clinically obvious though classically a stepwise progression is described. In one of the tests I took for the clinical trial they found that I have already had two small strokes, So I guess it’s starting to fit.It is diagnosed by the documentation of specific neurological deficits such as unilateral weakness or abnormal reflexes and by evidence of multiple strokes on a CT scan or MRI of the head. That’s me.
All of us can be affected by Vascular dementia, but several factors increase the risk. These include: High blood pressure, Smoking, Diabetes, High cholesterol, History of mild warning strokes, Sounds like my health Rape sheet, Evidence of disease in arteries elsewhere and Heart rhythm abnormalities, while no remedy can reverse the damage that has already been occurred,( Can one still hope/) treatment to prevent extra strokes may be very essential.Sounds like a good idea to me!
The signs of vascular dementia differ from patient to patient. One can look for both, physical and behavioral signs.
One of the clinical trials that I read About was a randomised controlled trial that compared acupuncture with medication in 108 patients with vascular dementia. The researchers concluded that acupuncture therapy could improve the clinical intelligence of patient with vascular dementia.
Vascular dementia (VaD) is the second most common cause of dementia after Alzheimer’s disease. It can sometimes be identified as different from AD by a more sudden beginning and association with the vascular risk factors. VaD can be characterized by its stepwise deterioration with periods of relative stability followed by a rather sudden decline in cognitive functions. Most patients, however, have small vessel disease, which is identified by a more gradual and slow pattern of deterioration. Control of vascular risk factors is the treatment of choice, but cholinesterase inhibitors (drugs that are being used in AD) are also suddenly being used to treat vascular dementia.
At the initial assessment, patients with dementia should be checked out for other disorders that could complicate, exacerbate, or be confused with AD. A dementia screen might include routine biochemistry as well as thyroid function tests, vitamin B 12 and folate estimations, and a complete blood count; many would also include syphilis serology, although the frequency of abnormal findings is low. A CT brain scan is not absolutely necessary in many cases and is not an absolutely required investigation in the NINCDS-ADRDA classification, although a worsening atrophy on a CT is considered supportive evidence. Functional scanning (single-photon emission CT (SPECT) in particular) can be useful where regional dementias are suspected, and magnetic resonance imaging can provide supportive evidence where vascular dementia is considered a possibility. An EEG is nearly always non-specifically abnormal even in the early stages of AD, in contrast with frontotemporal degenerations where an EEG remains unaffected at a broadly equivalent severity.
It is very important to know the specific type of dementia you are dealing with so you can be prepared for death and living with dementia and the symptoms that are likely to occur. Dementia is most commonly caused by Alzheimer’s disease in which the chemistry and structure of the brain changes. Vascular dementia happens when oxygen to the brain is cut off suddenly from a stroke or gradually from a series of mini strokes.
Studying the effects of different symptoms and their relationship with the patient’s dementia are also being conducted. These kinds of studies are useful in diagnosing the particular dementia, as there seem to be slight differences in the amount of dysfunction and its progress in different dementias. For example, gait and balance dysfunctions were studied in a group of patients consisting of individuals with Alzheimer’s, Parkinson’s and Vascular dementia. It was seen in this study, as one might expect, that those patients with Parkinson’s disease showed the greatest dysfunction in this area. This is probably due to the fact the Parkinson’s disease also severely affects the patient’s motor control.
Studying the effects of the different symptoms along with their relationship with the patient’s dementia are also being conducted and studied. . These kinds of studies are useful in diagnosing the particular dementia a patient has, as there seem to be slight differences in the amount of dysfunction as well as its progress in different types of dementias. For example, gait and balance dysfunctions were studied in a group of patients consisting of individuals with Alzheimer’s, Parkinson’s and Vascular dementia.This is one study that I would be particular interested in as my balance and gait seem to be the most affected by my diseases. It was seen in this study, as one might expect, that those patients with Parkinson’s disease showed the greatest dysfunction in this area This is probably due to the fact the Parkinson’s disease also severely affects the patient’s motor control. I typically walk around the block after each meal and it seems that I get weaker and more unbalanced as time goes by, especially on uneven surfaces like the side of the road. I do feel safe because I live in a retirement community and most of the neighbors know what I’m fighting and would be the first to help me If I fall, Which has happened before, Thanks to a neighbor who was there to help me back up.
Vascular dementia, which is caused by small strokes, occurs in people with longstanding, inadequately controlled high blood pressure. In my case I have been told for years that I have high blood pressure but have done my best to ignore the warnings, thinking their just trying to ge me on another pill, Uncontrolled high blood pressure is responsible for about 20% to 30% of all cases of dementia. Lewy Body dementia, which often accompanies Parkinson’s disease, can cause hallucinations and mental changes. It is responsible for a little less than 5% of all cases of dementia. Acquired immune deficiency syndrome (AIDS) can also cause a form of dementia called AIDS-related dementia.
There have been a couple of randomised controlled trials published, all with promising results. All are for Vascular Dementia,but not Alzheimer’s and all are from China. All of them compared acupuncture to medication; two also used a combined acupuncture plus medication group. In five of the trials, acupuncture was significantly better than medication and in three it was similar in effect. Various different acupuncture treatment modalities were used: manual needling, electroacupuncture , moxibustion and ear taping/pressing. I will definitely check into the acupuncture, but i’m sure with the prejudice of the AMA today, acupuncture will be considered an 18th century procedure and not considered relevant in our modern society – especially for insurance coverage.
The outlook for people with dementia depends almost solely on the direct cause of the dementia. Treatments are readily available to make symptoms of dementia caused by n Parkinson’s manageable, but there isn’t currently a way to stop or even slow down the related dementia. Vascular Dementia can be slowed down in some cases, but it still cuts short a person’s life expectancy. Some types of dementia are reversible, but most types are irreversible and will instead cause more impairment over time.
Life expectancy of vascular dementia patient varies from person to person. It depends on the malfunction level of cardiovascular system that is causing the dementia, the age of the person, and the other medical conditions of the patient.
Some specific medical conditions can greatly increase a person’s chances of developing dementia. Conditions that affect the heart, as well as arteries or blood circulation can greatly affect a person’s ability of developing Vascular Dementia. These conditions include mid-life high blood pressure as well as high blood cholesterol levels, stroke, diabetes, and heart problems such as a heart attack or irregular heart rhythms. Mid-life obesity, which is also a problem that I can identify with, can also increase a person’s risk of developing dementia in later life.
Vascular Dementia is said to be caused by damage to ones blood vessels that supply energy and nutrients to neurons and generally appears as “silent strokes” on MRI brain scans – I presently show signs of two of these silent strokes on my brain scn. I had a PET brain scan see see post here
Imaging studies are used today in detecting such causes of dementia as a previously undiagnosed brain tumor or abnormal brain structure. Scans can and will show doctors that certain areas of the brain have lost tissue, as happens in AD, and can strengthen a physician’s reason for diagnosing a patient with Alzheimer’s Diseases of which they are not sure of the Diagnosis, but scans cannot by themselves diagnose AD on their own. Scans are used more to eliminate other possible diagnoses and to confirm a suspected diagnosis. Here is a list of the commonly used scans. CT ( computed tomography ) scans are commonly performed, as well as MRI ( magnetic resonance imaging ) scans in patients who are having problems with gait or balance. PET ( positron emission tomography is the scan that I had, even though I have more problems with Gait and balance) and SPECT ( single photon emission computed tomography ) scans can be used to evaluate patterns of glucose (sugar) metabolism in the brain and to differentiate the patterns that are characteristic of Alzheimer’s from those associated with vascular dementia and Pick’s disease.
The drug development process for Alzheimer’s disease is riddled with challenges. One issue for clinical trials is the inclusion of individuals , like myself misdiagnosed with Alzheimer’s disease. Including individuals with vascular dementia, That’s me. Lewy body dementia, or even poorly understood forms of cognitive impairment – all of which can look amazingly like Alzheimer’s – can easily throw off a trial’s results. On the other hand, including those with advanced Alzheimer’s may also through off results because they may have lost too many brain cells already to measurably respond correctly to the therapy.
Vascular Dementia is usually characterized by a distinctive start date that is followed by a decline , during which the individual is aware ‘that something is wrong’.but doesn’t have the slightest idea of what it is. There may be a history of a number of mild episodes of sudden deterioration. As well as the main symptoms seen in all persons with dementia, sufferers of vascular dementia commonly have difficulties with gait (walking) or balance, as we have talked about before, trouble articulating speech, prominent mood swings and sometimes seizures. these last three I have not seen signs of these yet and i am definitely not looking forward to them.