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Old 07-26-2011, 02:50 AM   #1
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Question Vascular Dementia Diagnosis?

Hello,

I suspect my mom, who is only in her mid-70s, could have vascular dementia. She definitely has short-term memory loss.

Brief history: She broke her ankle in late 2008 and had a head injury in a fall in April 2009. She had a very intense headache while on vacation with my dad in July 2009, which I suspect might have been a mini-stroke.

She is not herself, and hasn't been since late July/early August 2009. Her main symptoms are short-term memory loss (which might be from taking Ativan for her anxiety), plus crying jags, low mood, depression, anxiety, confusion, poor balance, and she tires very easily.

She is not interested in most of her old pastimes, which required sustained thought/concentration and effort. But she can still do crossword puzzles, reads constantly, including complex non-fiction books, and can usually handle cooking, although sometimes she makes mistakes or forgets key ingredients.

I'd like to know if a diagnosis of vascular dementia usually comes from an MD, a geriatric psychiatrist, or a vascular specialist. She is going to see a geriatric psychiatrist soon, for symptoms of clinical depression. Would a geriatric psychiatrist also be able to diagnose vascular dementia?

Sorry for the novel, but if you have any ideas for me, I'd appreciate it!

Thanks!
busydaughter

 
Old 07-26-2011, 08:29 AM   #2
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Re: Vascular Dementia Diagnosis?

Busy, welcome Sorry you needed to search us out here but glad you found us. From what you describe, yes it does sound like some type of dementia but you will need a proper diagnosis to determine which dementia and what the cause might be. Memory loss is the symptoms we think of when we think of dementia... but the behavioral and emotional changes are probably the first symptom. The ability to process and concentrate is also impaired.

Your general physician can do a MMSE test. That is the Mini Mental Status Exam. It is nothing more than 30 questions that the doctor ask the patient. A perfect score of 30 means there is probably no cognitive decline. The lower the score, the more the cognitive decline.

Your physician will need to do a complete physical to determine if there are any other reasons for the decline. Then you need to ask your physician for a referral to a geriatric neurologist or other dementia specialist. They will be able to make the accurate diagnosis. Sad to say, most general physicians are not familiar enough with the disease to make the proper diagnosis. Dad was misdiagnosed for years with Alzheimer's when in fact he had Vascular Dementia. Mom was diagnosed by a Memory Assessment Research Service with Alzheimer's. I then had them both under the care of a geriatric specialist. Find a doctor that you can talk to!!

Keep typing your questions. I remember being where you are now. It's scary and upsetting but with a little help you will get through this

Love, deb

 
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Old 07-26-2011, 08:55 AM   #3
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Re: Vascular Dementia Diagnosis?

Thank you, Deb. I forgot in my haste to mention that she had a neuropsych evaluation in February 2010. The diagnosis at that time was mild cognitive decline and short term memory loss possibly brought on by the use of Ativan for anxiety. (The neuropsychologist said Ativan can aggravate a mild case of memory loss so that someone who has been able to compensate well will seem to suddenly lose their short term memory.) She also said that she might get worse or get better, and we should bring her back for another evaluation in a year. With all the medication changes in the past year we weren't sure about getting another evaluation at that time. It seems pretty clear that her mood has worsened to something resembling clinical depression, so I was hoping that a geriatric psychiatrist could evaluate her both for that and for dementia.

As for getting a thorough examination from her G.P., I wish that seemed like a reasonable expectation. Her doctor seems to think his job is to look at the numbers (cholesterol, blood pressure), write her prescriptions if any of the numbers are off, and give us referrals to specialists. The other day he referred to himself as a "traffic cop". At least he gave us a referral to the local geriatric psychiatrist - who I've heard is a thorough and caring doctor.

I'm going to try to make her the psych appointment today, and meanwhile another local MD who saw her at the hospital (for "breathing difficulties", which are actually anxiety attacks) has said he is willing to write her a scrip for Celexa. I'm going to talk to him today as well.

 
Old 07-26-2011, 01:39 PM   #4
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Re: Vascular Dementia Diagnosis?

i hope you find out something and welcome. its frustrating when you cant get answers. dementia is a horrible disease so i hope you can take a deep breath and take it day by day. keep posting.

 
Old 07-26-2011, 01:45 PM   #5
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Re: Vascular Dementia Diagnosis?

Oh how I understand!!!! Mom was misdiagnosed with depression for several years when it was truly the early stages of Alzheimer's. It is true that it is very difficult to tell the difference. There are also medication reactions... and what you described is exactly why I get on my soap box when a doctor prescribes Ativan or Xanax for a dementia patient! There are those blood work numbers that can tell you if the calcium level is off or the potassium or some other number that might create the same symptoms, but there is no blood test for dementia so most doctor's don't get dementia right. I think with the geriatric psychiatrist you are probably on the right track, as long as he is familiar with dementia as well as the other psychiatric problems. Sad to say, the way they diagnose dementia is to look at the symptoms and rule out other possibilities.

Mom was actually diagnosed by a Memory Assessment Research Service (MARS) that is part of the local university psychology department outreach research. They are looking for way to early diagnose dementia. I was lucky to have them as a resource. Where I am now we do have a Memory Center run by a neurologist who specializes in Memory loss. We also have a Geriatric Psychiatrist that is wonderful at adjusting medication. I have used his services since Mom arrived here. It's a matter of finding the right doctor. Somebody that is thorough, will listen, and search for the right diagnosis.

The mild cognitive decline and short term memory loss is the beginning of dementia but as the neurologist said it can also be because of medication, heath problems, or other issues. Depression can cause symptoms that mimic early dementia or the depression can be brought on by the early stages of dementia. Yep, it's a complicated confusing business to get the right diagnosis! I wish you luck with the psychologist and hope you get the information you need to make plans and go forward!! Hang around... and keep us informed as to what you find out.

Love, deb

 
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