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Vascular Dementia Signs and Symptoms and the 7 Stages of Dementia

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Vascular dementia is the second most common type of dementia, following Alzheimer's disease as the first. While excess protein build-ups in the brain cause Alzheimer's and some other forms of dementia, vascular dementia is caused by impaired blood flow to the brain, such as a stroke.

When the blood supply to the brain is interrupted, brain cells are deprived of vital oxygen and nutrients, causing damage to the cortex of the brain, the area associated with learning, memory, and language. While the strokes may be unnoticeably small, the damage can add up over time, leading to memory loss, confusion, and other signs of dementia.

Like other types of dementia, vascular dementia typically progresses in a stepwise fashion, where lapses in memory and reasoning abilities are followed by periods of stability, only to give way to further decline.

There are seven different stages that dementia patients can go through. And we’re here with our expert, Valeria Baldivieso, MD, to walk you through the seven stages of vascular dementia along with its signs and symptoms so you can stay aware.

What are the 7 Stages of Dementia?

With seven distinct stages, as with other forms of dementia, vascular dementia still affects each patient uniquely. The amount of time a person spends at each stage differs. Some people experience a slow dementia progression spread over a long time, while others experience a more rapid decline.

Here are the seven stages of dementia explained, which includes vascular dementia:

Stage 1: No Impairment — Normal Memory

Considered early-stage dementia, the person at this stage of vascular dementia won’t know they have the condition yet because they will have no concerning symptoms. But undetected changes in the brain will have already started.

Stage 2: Minimal Impairment — Normal Forgetfulness

The first signal that someone might have vascular dementia is forgetfulness.

“Memory lapses and changes in thinking are rarely detected by friends, family, or medical personnel," explains Dr. Baldivieso.

Stage 3: Early Confusional — Mild Cognitive Impairment

Forgetfulness increases slightly during the third stage of vascular dementia. According to Dr. Baldivieso, “You or your loved one may have difficulty retrieving words, planning, organizing, misplacing objects and may forget recent learning, which can affect home and work life. Depression and other changes in mood can also occur. The duration for stage two is typically 2 to 7 years.”

Still considered early-stage dementia, at stage three, the disease may be progressing unknowingly to the person who has it and those around them.

Stage 4: Late Confusional — Mild Cognitive Impairment

Mild cognitive impairment is the fourth stage of dementia. At this point, many people get a diagnosis as their symptoms become more evident. The duration of stage 4 is roughly two years.

“The patient will forget recent events and conversations more frequently. But most people in this stage still know themselves and their family members. Challenges carrying out sequential tasks, including cooking, driving, ordering food at restaurants and shopping are common. The person often withdraws from social situations,” explains Dr. Baldivieso.

Stage 5: Moderate Dementia — Severe Cognitive Decline

Dr. Baldivieso explains, “Stage 5 is when daily living starts to become difficult, and the person requires assistance. They’re no longer able to manage life on their own or remember details like personal history and contact information. People in this stage experience a severe decline in numerical abilities and judgment skills, which can leave them vulnerable to scams and safety issues. Basic daily living tasks like eating and dressing require increased supervision.”

The average duration of stage 5 is one-and-a-half years.

Stage 6: Moderately Severe Dementia

By stage 6, agitation and hallucinations often show up in the late afternoon or evening. Dramatic personality changes such as wandering, getting lost, or suspicion of family members, are common. Many can’t remember close family members, but know they are familiar. The duration of stage 6 is approximately two-and-a-half years.

Dr. Baldivieso states, "Often, people in stage 6 are no longer aware of present events and can’t accurately remember the past. They progressively lose the ability to take care of daily living activities like dressing, toileting and eating. They are still able to respond to nonverbal stimuli and communicate pleasure and pain through their behavior.”

Stage 7: Late Severe Dementia

In this final stage of dementia, speech becomes severely limited, as well as the ability to walk or sit.

“Total support around the clock is needed for all functions of daily living and care. Duration is impacted by quality of care and the person’s overall health, but the average length is one to two-and-a-half years,” says Dr. Baldivieso.

Signs and Symptoms of Vascular Dementia

Depending on which part of the brain's blood flow is impaired, vascular dementia symptoms vary from person to person. The most significant signs of vascular dementia usually involve speed of thinking and problem-solving rather than memory loss (as in Alzheimer’s).

Signs and symptoms of vascular dementia include:

  • Agitation
  • Apathy
  • Confusion
  • Decline in ability to analyze, plan and communicate
  • Depression
  • Difficulty concentrating or paying attention
  • Difficulty with decision-making
  • Difficulty with organization
  • Incontinence
  • Memory problems
  • Restlessness
  • Slower thinking
  • Unsteady gait

Caring for Vascular Dementia Patients in Body, Mind and Spirit

While there is currently no cure for vascular dementia, there are treatment options available that can slow the progression of the disease. Lifestyle changes to improve other areas of the patient’s health, such as eating a healthy diet, staying physically active as tolerated, and effectively treating conditions like high blood pressure, can make a difference to the person’s prognosis.

At the AdventHealth Neuroscience Institute, find comfort in knowing we specialize in helping individuals and their families understand what they are facing. Our Maturing Minds Program offers a dedicated team, including board-certified geriatricians, nurse practitioners, nurses and social workers who will provide a thorough diagnosis and help create a whole-person treatment plan. They'll also connect you with additional resources, recommendations and referrals for ongoing support.

Visit us here to learn more about our program and how we can help you. You deserve to feel whole.

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