Different Kinds Of Dementia: What It Is, And What To Expect If You Have It
Subcortical vascular dementia usually involves damaged blood supply to the brain that can lead to damage, as well as changes in cognitive ability, behavior, and mobility. Although this disease currently has no cure, certain lifestyle changes and health management strategies can slow its progression. It can be challenging to cope with a dementia diagnosis, whether you are someone living with dementia or a caregiver for a loved one with this disease. It can be beneficial to care for your mental health during this time by talking with a licensed therapist who can help you work through your emotions.
- Psychomotor slowness - Taking longer to turn thought into action
- Forgetfulness
- Changes in speech
- Unsteady gait
- Clumsiness
- Frequent falls
- Personality changes
- Mood changes
- Urinary symptoms
- Weakness or loss of sensation in part of your body
- Having good and bad days – symptoms may be more severe on some days
- Evening confusion
- Depression
- Hallucinations or delusions
- Being able to recognize that you're having memory problems
Diagnosis usually has two phases. First, the person experiencing symptoms or someone who knows them well may talk to a doctor to explain their experiences. Second, the doctor can make an evaluation based on objective facts, like test results.
- It comes on suddenly and quickly causes a loss of independence.
- Brain imaging tests show lesions in specific parts of the brain.
- There's evidence that a stroke happens at about the same time and may be responsible for the loss of function.
It can be important to identify the issue at hand as quickly as possible for several reasons. First, there may be lifestyle changes you can make to slow the progression of the disease. Second, loved ones may better understand how to support you. Finally, knowing your diagnosis can relieve some of the confusion about what is happening to you.
Additional treatments a physician may prescribe include acetylcholinesterase inhibitors, memantine, and cholinesterase inhibitors. Clinical trials have shown that these medications may help manage symptoms and slow cognitive decline.
Perhaps the best thing you can do if you don't have the disease already, but may be at risk of developing it, is to do what you can to prevent it.
For people who don't have dementia right now, prevention may be possible. It can start with knowing what puts you at risk. The risk factors for all types of vascular dementia typically include the following:
- Getting older
- Having a history of heart attacks, strokes, or mini-strokes
- Atherosclerosis, also known as the hardening of the arteries
- High cholesterol
- High blood pressure
- Diabetes
- Obesity
- Smoking
- Arterial fibrillation (A-fib)
While the evidence isn't overwhelming at this point, there may be two more things you can do to decrease your risk of vascular dementia. Modest alcohol consumption - the equivalent of one or two glasses of wine per day - might help. Taking vitamins, like folic acid and B12, may also reduce your risk. Because these remedies are not well-proven yet, it can be important for you to talk to your doctor before you try them.
Knowing what to expect can help you plan for future needs. The course of this disease can be different from person to person.
Early on, you may notice some problems with memory, problem-solving, and planning. There may be times when the disease is stable and unchanging for long periods. Then, symptoms may begin to worsen again.
It can also be beneficial to talk to your loved ones about how you feel. Try to build a good support system of people who care about you. You might also go to dementia support groups to interact with people who understand what it's like to have dementia.
Finally, it may help to stay involved with your usual activities as much as you can. If you like to fish or play cards, continue doing so if you are able. Know that there will likely be good and bad days, and try to take advantage of times when you feel your best.
How to receive professional support
Navigating the emotions surrounding dementia can be hard for both those who have it and those close to them. If the emotional stress becomes too great, though, there are things you can do to cope, including talking to a mental health professional like a therapist.
Benefits of online therapy
Working with a therapist may help you learn to work through difficult feelings, come to terms with a diagnosis, and learn how to prepare for the changes that dementia might cause. When you speak to a licensed therapist online, you can do so from the comfort of your own home. This may be a more comfortable and available option for those living with dementia.
Effectiveness of online therapy
A recent review of over a dozen studies analyzing the benefits of online cognitive behavioral therapy (CBT) found that digital treatment was typically more cost-effective for clients than in-person therapy. The same review also noted that online therapy can be just as effective as traditional in-person options for treating symptoms of depression, which may accompany a dementia diagnosis.
Takeaway
People develop vascular dementia (a cerebrovascular disease) when artery walls thicken and block blood flow to regions of the brain responsible for motor (movement) and cognitive functions.
Note that cerebrovascular disease is not the same as cardiovascular disease (also called heart disease). Though both conditions have vascular contributions (i.e., affect blood vessels), cerebrovascular disease affects brain function, whereas cardiovascular disease affects heart function.
Subcortical dementia affects very small blood vessels in a part of the brain called the white matter. When the walls of large blood vessels like arteries get thick, they affect blood flow to the small blood vessels that directly feed brain cells, leading to brain damage.
White matter refers to neurons covered in myelin—a fatty layer that insulates the nerves and allows brain signals to move quicker. These neurons are often involved in movement, which is why symptoms of vascular dementia include difficulty with walking, swallowing, and even bladder control, in conjunction with cognitive impairments like poor memory.
There are treatments that can minimize symptoms, but there are no cures currently available. There are ongoing clinical trials examining several medications as potential ways to slow disease progression.
You can also have more than one type of dementia at a time, a phenomenon called mixed dementia. One common iteration is a vascular dementia that coincides with Lewy-body dementia.
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