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What Are The 7 Stages Of Vascular Dementia?

Fonthill House, St Albans, Hertfordshire

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Vascular dementia is a common type of dementia caused by damage to blood flow in the brain. There are 7 stages of vascular dementia that begin when blood vessels are damaged. The stages of vascular dementia have different care needs, from being able to manage regular life to needing round-the-clock care.

What is vascular dementia?

Vascular dementia is one of the most common types of dementia. Dementia is the general term for memory, reasoning, planning and judgement problems. The causes of dementia can differ depending on the symptoms and underlying conditions. The most common type of dementia is Alzheimer’s disease, followed by vascular dementia. 

While many experts believe that Alzheimer’s disease is caused by the build-up of abnormal protein in the brain, vascular dementia is caused by brain damage from impaired blood flow to the brain. Vascular dementia is often caused by blood flow disruption from an event such as a stroke or mini-stroke.

How is vascular dementia different from Alzheimer's disease?

Unlike Alzheimer’s disease, memory loss isn’t the typical first symptom of vascular dementia. Instead, people with vascular dementia can show different signs based on the affected area of the brain. About 1 in 10 people with dementia have vascular dementia making it the second most common type after Alzheimer’s.

What are the 7 stages of vascular dementia?

1. Normal behaviour

In the first stages of vascular dementia, patients will not show any changes to their behaviour, which makes vascular dementia hard to catch early. However, despite no obvious changes to a person’s behaviour, changes have begun to happen in the brain, such as damage to the blood vessels beginning to form.

2. Very mild changes

Over time, you and your loved ones may notice mild confusion as the brain changes begin to manifest outside. With other types of dementia, mild forgetfulness begins to show at this stage, but vascular dementia tends to begin with confusion and problem-solving.

3. Mild cognitive decline

Around this stage, symptoms become more noticeable to friends and family. Symptoms include confusion, difficulty paying attention or concentrating, trouble organising thoughts or making plans and communicating them, slowed thinking, and memory loss. Vascular dementia symptoms can occur suddenly after a stroke or similar event, or they can come on gradually, like other types of dementia.

4. Moderate cognitive decline

At this stage, symptoms become more obvious. Safety becomes more of a concern at this stage, with patients finding it difficult to perform daily tasks such as cooking, cleaning and taking their medication. If they have not yet received their dementia diagnosis, it usually happens at this time. Many dementia patients begin to forget to pay bills or have difficulty trying to work out the money. Simple things like being able to recall their last meal might also happen at this point.

5. Moderately severe cognitive decline

Patients need increasing support at this stage with daily living assistance. For example, they’ll often need assistance with getting dressed and help to remember important facts and details. This stage is the beginning of late-stage dementia, and patients can begin to forget things like their address, phone number and how to dress appropriately. At this stage, most patients can still recall their family and friends and typically remember childhood memories vividly.

6. Severe cognitive decline

At this stage, patients will need a high level of support and care. The severe cognitive decline means patients need daily assistance and supervision to ensure safety. They’ll also need support with dressing, meals, bathroom use, and washing. Caregivers will need support at this time from professionals; loved ones will experience severe personality and behaviour changes that can be difficult to manage. However, patients can be soothed during this time by family members playing their favourite songs, looking at old photos and watching their favourite movies.

7. Very severe cognitive decline

In late-stage dementia, around-the-clock care is needed by professionals. Patients will need support and care with activities such as eating and drinking. They may forget that they are thirsty or hungry and cannot communicate. At this stage, the focus shifts to end-of-life care, where preserving the quality of life become the top priority. 

If your loved one has vascular dementia, it can be worrying to think about the progression. However, these 7 stages of vascular dementia can happen in different time frames for different patients, and most receive their diagnosis around stage 4. Deciding when someone with dementia should go into a care home isn’t an easy decision, which is why experts are at hand to help.

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