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Hi everyone, just found this site and after a bit of advice. My mum, 78, has had memory problems and confusion the last 2-3 years. An MRI Scan showed athlerosclerosis and brain shrinkage. At the memory clinic she gets 28/30 on the mini mental test and her dr says she has vascular dementia so has not put her on an drugs for alzheimers. However her short term memory has nearly gone completely. She never knows where shes been or what shes had for lunch. Like many other people on here I am up the wall and worried that the aricept could be helping her but shes not being given it.
has anyone got any idea how to distinguish between the two? (I know medics say they overlap anyway and it doesn't really matter). But i would like to know. As i said her symptoms are drastic, short term memory loss, she doesn't go wondering, no personality change, still dresses nice with make up. Any advice from anyone with experience? Thanx.

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Thanx for that, the reason i want to know is because if she does have Alzheimers drugs like donepezil ''may' help. But i dont want to be giving her drugs if she has vascular dementia coz she'd be taking them for nothing!!
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Joseph, just remember that Alzheimer's meds only slow down the progression of the disease, they don't restore the memory that is lost. It would take brain imaging ordered by a Neurologist who specializes in aging to get a more specific diagnosis than what you have. Given that she has atherosclerosis, it is more than likely a vascular problem and TIA's will recur over time.
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Joseph also they're not risk-free. Does your mother have any other conditions she's getting treatment for?

When you say memory clinic, was that the full-length assessment with the clinical psychologist, psychiatrist and the works? I'm just wondering how come they're doing a 'mini mental' test (and by the way 28/30 not so bad).

Where are you based? If you're in the tender hands of the NHS I should sit easy: there's been a big shove on for Alzheimer's over the last 12-18 months and if it were in your mother's best interests, honest guv, it would have been prescribed. Probably. Are you unhappy with the care she's been getting in any other way?
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Thanks for your replies. Yes pamstegman i think it probably is vascular dementia, although shes not had any recognisable stroke. Im just scared of missing any opportunity for every bit of help for her. Would hate to think her symptoms could be 'eased' with donepezil and she's not been given them. (I know in some people these drugs are a waste of time, but they're licenced for Alzheimers so they must help in some people).
Countrymouse, we live in northwest England, and yes Nhs. Mums under a 'memory clinic, who sent her for Mri scan. Everytime she goes they do the Mini mental assesment and up to now she keeps getting good results. Never been on medication in her life but now on low dose antidepressant, aspirin. Shes worried sick about her memory which is getting worse by the day. Thanks for replying.
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Joseph, I learned when I took an AAA/Alzheimer's caregiving course that there are some specific exercises and activities for memory improvement.

I don't know whether there are adult day care facilities with memory specific activities in your area, but you might want to check that out.

There also used to be an excellent website with activities for Alzheimer's, dementia and memory loss people but I haven't been able to locate it recently. If I can find any further references to these, I'll post them, but in the meantime, you might want to google "memory activities", "memory loss activities", something like that.

Good luck, and kudos to you for being so concerned about your mother.
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Thanks gardenartist i will google memory activities.
Thanks shakindustoff, glad your mum seems ready to go again.
So hard to watch someone you love deteriorate.
Mum keeps saying to me 'i haven't got Alzheimers have i?' I laugh and say 'don't be so stupid its just the blood cant get to you brain as easy as it used to. I tell her thats why we go on long walks and she takes aspirin to help the blood flow. I can still make her laugh her head off and get enjoyment out of life, but the following day she'l have forgotten everything. Like most other people just want the best for my lovely mum
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Oh dear, it's such a pity. Wish there were easy answers. Ironically, as I'm sure you've already thought about, the worry itself won't be helping. But at least you can tell her pretty much definitively that no she hasn't got Alzheimer's (though she could still - having vascular dementia doesn't stop you developing it too, unfortunately) - it would have shown on the MRI if it had got very far.

Actually, I wonder if you could google some brain images and show them to her. Seriously, she might find it reassuring. "This one is Alzheimer's, mother, and this one is your brain. Observe the important differences."

Is the low dose antidepressant helping? How long has she been taking it? My mother started on a tiny Citalopram dose just over a year ago with ho-hum/good results - it has stopped her fretting disproportionately but my goodness it takes a while.

The walks are the best thing possible; apart from the fresh air and exercise, it's brilliant that she still enjoys them.

Incredibly difficult, isn't it, this balance between facing up to things but not depressing oneself with things you can't do anything to help.

Depending on where you are, exactly, as time goes on the people who can help you with things like outreach, activities, respite care and (should it get to this) residential care are MHA. Their dementia care is THE best, and in my experience they are lovely, sensible, highly knowledgeable people. Is your mother still living independently?
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It is quite difficult to distinguish vascular dementia from Alzheimer's since the differences are very minor. However, based from infolongtermcare, long-term care Alzheimer's patients decline gradually, unlike with vascular dementia, there is a sudden progress of the disease especially after a stroke. Even with cognitive problems, alzheimer's patients memory impairment declines gradually over time, while with vascular dementia, the person's ability to think and even walk becomes limited as a result of sudden condition like stroke. It would be best to have your mom go through a series of tests including an MRI scan.
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I understand your desire to know which type of dementia you mom has. My husband has three different types of dementia, including vascular dementia. His MRI looks like Alzheimers but his symptoms the first few years were nothing like what is typically seen in Alzheimers.

While it is true that in Vascular Dementia there can be a sudden change in functioning or cognition due to stroke, whereas in Alzheimer's disease symptoms progresses slowly, there can be a diagnosis for Vascular Dementia without any noticeable stroke, which is what occurred with your mom (and my husband). This is due to TIAs, as been mentioned in a previous posting. I never saw any TIAs either. Neurologist can chose this diagnosis due to specific changes seen on MRI. If the TIAs occur in the temporal lobe, there will be more memory problems.

There is brain atrophy (shrinkage) in both conditions, but with Alzheimer's the neurologist will notice changes in the hypothalamus, whereas in vascular dementia the areas affected by TIAs are seen on MRI look like gray areas or shadows, which I saw on my husband's MRI. I also saw significant enlargement of the ventricles due in comparison or normal brains, due to the atrophy.

I took my husband to a Memory and Aging Center for evaluation because his early symptoms didn't resemble Alzheimer's. The 2 hours of testing (in addition to a physical neurological exam) are specifically designed to diagnose what kind of dementia. He was then given a second diagnosis of Fronto-temporal Dementia (due to early personality and behavior changes and other symptoms specific to this disease). Then later in the disease (this is the 18th year)), he had more TIAs which led to another diagnosis of vascular dementia.

This information didn't change the progession of the dementias, but this knowledge I felt empowered me in two ways: it helped me understand what was happening and thus cope better with the symptoms, and I was able to take positive steps toward care planning. Due to the dual diagnosis, he was given Aricept and Namenda, but it seemed him stay the same for 4-6 months, and we weren't sure if this was due to the medication or not, since my husband has sometimes months of being the same without medication. The medications do not reverse the disease. The Alzheimers medications do nothing for Vascular Dementia. But the aspirin may help to thin the blood, reducing the risk for stroke.

Sorry for this long post, but in addition to accepting changes as they occur and not trying to get your mom to remember (she can't), the best thing you can do for yourself is to take care of yourself well while caring for you mom.
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Thank you for that long informative post cher60. I was back at memory clinic yesterday wth mum and had them explain the mri scan to me, (without my mum in hearing distance as thus would massively upset her to hear Alzheimers mentioned).
It was explained to me the mri showed shrinkage of brain and small vessel vascular disease predominanty but, also as you explanined it showed shrinkage in the hypothalamus....indicating alzheimers.
I am devastated, yes i expected it, yes i kniw my mum is 78 and has done reallt well to have enjoyed good health up to now. But im a nervous wreck thinking of the path ahead of us.
Sript for donepezil, but reluctant ti give them to her if it might upset her brain chemistry for the worse......
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Good that you got more explanation about your mom's MRI. It is understandable that you would react / be nervous about this new information and what it may mean in the long term. However, there is hope because dementia often takes a long time to progress (it's just my opinion and experience, but I believe that it took longer to progress in my husband because he was otherwise very healthy). Even with both Alzheimer's and Vascular disease, my husband has lived 18 years.

It also can feel less overwhelming when you consider that there are various ways to have support, both for her as well as you. Whether the help comes from family, friends, adult day care program, in-home caregivers, assisted living, or even if you choose to do most of the care yourself, you can have help. We have used all types of support in the past, and at present, we are using Hospice services, which is gives my husband weekly visiting nursing, a home health aide to assist with personal care, and a weekly respite worker and grief support for me.

It really helps to focus on immediate care issues, and to try not to think on the future so much, since we do not control how the disease progresses. I pray every day and let God heal my feelings when they come up and this gives me peace and confidence. One day at a time. You are not alone.

Donepezil to which you refer: the medication cannot harm her brain chemistry since Alzheimer's and vascular dementia are not disorders of brain chemicals (neurotransmitters). Alzhiemer's is due to plaques and tangles in the brain cells themselves. There are also medications the doctor can prescribe if she has severe anxiety about the cognitive changes, that you can give her 'prn' (as needed). Anxiety is usually a temporary issue because unfortunately the progression of Alzheimer's disease usually eventually affects a person's insight and awareness. Every person is different, though. I am only going by our own experience; my husband is not anxious or upset about his condition since or how he is living because since he has no short-term OR long-term memory, he doesn't remember what he was like before, just lives in the moment with no worries.
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Doesn't Namenda help with vascular dementia? Does nothing help with that type of dementia? My mom 91 has VD and has been on Namenda a few years. Not that it's helping much...
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As far as i know Nikki there aren't any drugs to treat vascular dementia and its a case of keeping bood pressure down and blood thin to avoid any more vascular damage. Often, as in my mums case there is mixed dementia and do an Alzheimers drug may be used.
Thanks cher60 for your reply....you sound like you're copjng well caring for your hudband whivh must be very hard. Like your husband my mum also is in good physical health so im really hoping her dementia will progress slowly. She is living wth her husband, (my dad died 15years ago) and he gets very frustrated wth her for forgetting things. This upsets my mum and im just watching and waiting coz if it continues or gets any worse i will suggest mum comes to live wth me. Im thinking about this alot lately,especially now i know she has alzheimers, but to take her away frm her home would be disorientating for her
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