People with vascular dementia may experience:
Patchy cognitive defects – this means that the damage is localised. A person may have, for example, big problems with memory, but still be able to carry on a normal conversation.
Difficulty with making decisions, weighing up options or planning for the future.
Depression – probably because they are well aware of their condition.
Mood swings and extreme responses to trivial happenings.
Physical weakness or paralysis caused by the stroke(s). Which parts of the body are affected will depend on which part of the brain was damaged – each half of the brain controls the movement on the opposite side of the body.
Hallucinations and/or delusions (but not to the same extent as people with Lewy body dementia).
“Good days and bad days” that is, fluctuations in the ability to function, and sometimes more confusion in the evening or at night.
As in the case of other illnesses which can result in dementia, it is not possible to reverse the damage, and normally the dementia will gradually worsen. However, in some cases, if treatment and a change of lifestyle results in no further strokes occurring, it is possible that the dementia may cease to progress. Long periods of stability, interrupted by intermittent worsening are usual. People will usually survive for an average of eight years with vascular dementia, but the cause of death is usually related not to the dementia but to the underlying risk factors of stroke and heart attack.
We all need to be mindful of potential warnings signs, especially if you have previous indicators for vascular disease. Therefore warning signs should never be ignored. Symptoms of a transient ischaemic attack (TIA) develop suddenly, and usually peak in less than a minute. The duration of symptoms varies, but symptoms usually go within an hour (typically within 2-15 minutes). Sometimes symptoms last up to 24 hours. The symptoms that develop depend on which part of the brain is affected. Different parts of the brain control different parts of the body. Therefore, symptoms may include one or more of the following.
* Weakness or clumsiness of a hand, arm, or leg.
* Difficulties with speech.
* Difficulties with swallowing.
* Numbness or pins and needles of a part of the body.
* Brief loss of vision, or double vision.
If someone experiences any of these symptoms you should call a doctor immediately, because diagnosis and treatment could prevent a more serious stroke.
It is important for us all to be “stroke aware” because many deaths from stroke could be avoided if help was sought immediately. So if someone experiences a sudden, severe headache, an unexplained fall or dizziness, difficulty speaking or understanding, visual disturbances in one or both eyes or numbness or weakness of the face, arm or leg, you should immediately consider whether they might have had a stroke.
Ask the person to:
* Raise their arms above their head
* Repeat a simple sentence, such as “it is raining today”
* Stick out their tongue
If the tongue goes to one side, or there is any problem with any of the above actions, call an ambulance at once.