Recently, dementia has been in the news a great deal. Further, most of us have watched helplessly as a beloved relative suffered from it. Questions remain about dementia, symptoms, diagnosis, treatments and concerns.

Vascular Dementia

The brain requires a great deal of open, healthy blood vessels to provide oxygen for proper function. High blood pressure and excess blood glucose (sugar) damage arteries leading to atherosclerosis or a blockage in the brain vessel. Over of 87% of strokes are caused by a blood clot that blocks one of the arteries. Anything distal to the blockage will die without oxygen. Blood thinners are available to open up a blocked artery, but few people reach the hospital in time to be able to use them. They must be given within 3.5 to 4 hours after the first symptoms of the stroke appear.

The other 13% of strokes are caused by a rupture or tear in a damaged artery leading to hemorrhage (bleeding). Anything near or distal to the bleeding will die. Hemorrhagic strokes are treated with watchful waiting or immediate surgery.

A special x-ray called a CT of the brain will determine whether the stroke was caused by a clotting problem (87%) or ruptured blood vessel (13%).

Symptoms of a Stroke (FAST)

F          Face Drooping Ask the person to smile. Is the face drooping on one side?

A         Arm Weakness Ask them to raise both arms. Does one arm drift downward?

S          Speech Difficulty Is their speech garbled or confused?

T         Time to call 911! Get them to the hospital quickly to find out if they’re a candidate for a blood thinner. It can only be given within a 3 to 4.5 hour window from first symptoms).

A bleeding stroke may also cause a severe headache. Don’t ignore it!

Finally, silent tiny strokes may occur without the person even being aware of it. In fact, a great deal of brain damage may occur before the function of the brain is altered.

Neurological Dementia

There are various neurological problems that can damage the brain such as Alzheimer’s and Parkinson’s Disease. They are diagnosed with an experienced neurologist. Alzheimer’s Disease results in a buildup of harmful proteins in the brain that interfere with function. Parkinson is a disease of the nerves which develops slowly and progressively gets worse. It begins with a tremor then progresses to slow rigid movements, speech and writing impairments. Either type impairs brain function and cognitive abilities.

10 Early Warning Signs of Dementia

1. Memory loss that disrupts daily life.
2. Challenges in planning or solving problems.
3. Difficulty completing familiar tasks.
4. Confusion with time or places.
5. Trouble understanding visual images or spatial relationships.
6. New problems with words and in speaking or writing.
7. Misplacing things and losing the ability to retrace steps.
8. Decreased or poor judgement.
9. Withdrawal from work or social activities.
10. Changes in mood and personality.

Diagnosis of Dementia

Neurologic exams, cognitive and functional life testing, CT and MRI scans, blood work and brain biopsies may all be used to determine the cause of a poorly functioning brain. Most aging adults with dementia are reluctant to give up independence. They often don’t comprehend their level of impairments and are reluctant to receive assistance and give up driving. The cognitive and neurologic exams are a powerful tool to assist families in understanding the extent of the brain dysfunction in their loved one.

Treatments for Neurological Dementia

A variety of medications and strategies are used to treat Alzheimer’s and Parkinson’s neurological disorders. The earlier they are given, the better the long-term outcomes but dementia remains a progressive debilitating disease process. It gets worse with time.

On A Personal Note:

My Mom and mother-in-law both suffered from vascular dementia. Eventually driving and living at home had to be removed and assisted living options utilized to provide safe care. Losing the freedom to drive was probably the most difficult. I asked, Mom, if a ball flew across the road would you be able to take your foot off the gas and hit the brake fast enough to avoid hitting the small child chasing it? Her answer was no and her driving days were over. My mother-in-law needed a neurologist from the Mayo Clinic to deliver the news to her. She failed the cognitive/functional tests and her brain MRI showed massive areas of brain damage.

We obtained Medical and Financial Power of Attorney for them. It helped when we asked, Mom, who will pay your bills if something happens to you? Neurologists have a plethora of tools to determine competency and ability to carry on activities of daily living. You can contact the Alzheimer Association (alz.org) for additional information.

Finally, all of us are aging. Our brains begin to shrink and so does some of our memory and brain function. Healthier lifestyles and activities that exercise the body and brain slows the normal aging process down for most of us. However, others develop a stroke or neurological disorder that leads to dementia and may not be aware of the damage in the brain. Those sufferers are a danger not only to themselves but to society.

Interestingly, airline pilots are mandated to retire at 65 years old to protect the public from a host of aging maladies that may impact their ability to fly people safely. Perhaps it’s now time for Americans to consider age limits for governmental leadership positions as well.

So even to old age and gray hairs, O God, do not forsake me, until I proclaim your might to another generation, your power to all those to come (Psalm 71:18).

Reference:

“Let’s Talk about Stroke Fact Sheet,” American Heart Association (2024),  https://www.stroke.org/en/help-and-support/resource-library/lets-talk-about-stroke

“What Is Dementia?” Alzheimer’s Association, https://www.alz.org/alzheimers-dementia/what-is-dementia

“FAA Tells Congress Not to Raise the Mandatory Retirement Age of Pilots Until It Can Study the Issue,” PBS News (February 2, 2024). https://www.pbs.org/newshour/economy/faa-tells-congress-not-to-raise-the-mandatory-retirement-for-pilots-until-it-can-study-the-issue

Jennie E. Johnson, “Wake Up Call 911: It’s Time to Reduce your Risk for a Heart Attack and Stroke,” Living for A Healthy Heart, LLC, (2016).

If you’d like to read my other blogs you may visit my website for more information (jenniejohnsonrn.com). Author of Helping the Hurting: Nursing Ministry in the Body of Christ (2022) and Wake Up Call 911: It’s Time to Reduce your Risk for a Heart Attack and Stroke (2015).

Jennie E. Johnson, “Wake Up Call 911: It’s Time to Reduce your Risk for a Heart Attack and Stroke,” Living for A Healthy Heart, LLC, (2016).

 I’m a Christian nurse who helps people navigate the murky waters of healthcare.

All rights reserved 2023, Jennie E. Johnson, RN-BC, PhD