Posted on August 17, 2010 - by Nurse Virginia

ALZHEIMER’S DISEASE OR VASCULAR DEMENTIA? MAYBE IT REALLY IS BOTH – THE MIXED DEMENTIA

(Part I)

Mixed dementia, is when the elder has vascular dementia and now is also demonstrating signs of Alzheimer’s dementia.  Researchers are now finding on autopsy of the elderly who have had a stroke, almost 45% also have the plaques and tangles associated with Alzheimer’s disease.

Alice had a stroke eight years ago, and her family was told that she has Vascular Dementia. For several years after the stroke, Alice’s level of confusion stayed constant. Alice, who could no longer walk, would “forget” she couldn’t walk. Alice would talk about how during the night in the nursing home her roommate would call out for something. Alice would then tell how she had gotten up and went to help the roommate. It was simple during those years to talk through those reoccurring false ideas. Alice would agree, that what she thought happened couldn’t have happened.

But for the most part Alice was still the Alice everyone knew. She still had a dry sense of humor, recognized everyone, and had her short term as well as long-term memories. Due to the severity of the stroke Alice could no longer take care of herself physically. But mentally she was the sharpest elder at any activity and the staff counted on her many times for trivia answers.

However for the last six months her family and her nursing home family have been concerned about her occasional lapses into an extremely confused state. Mini-strokes (also known as TIAS, transient ischemic attacks) result in partial blockage of blood flow to the brain and will appear as a decline in a step pattern. The elder will decline and then stay at that level of function for some time until another “Mini stroke” and then a further decline.

These declines can be in areas of memory loss, ability to think and reason, increased confusion, slowed thinking as well as declines in function and changes in behavior. But the declines do not follow a pattern; it remains very individualized depending on where the blockage is and how much damage has been done.

Alzheimer’s dementia follows a distinct pattern of losses or stages of decline. From; Stage 1, no cognitive impairment through to Stage 7, very severe cognitive and functional decline, or total care.

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance

www.pleasegettoknowme.com