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I am trying to figure out what is going on with my 82 year old father. He was recently diagnosed with vascular dementia after getting two MRIs and a EEG (along with some other tests). But his symptoms are strange:


1. He has had these episodes where he collapses into semi-consciousness, then wakes up totally confused, to the point he can't remember his own name, the date, etc. He doesn't recognize family members and is "out of it". But he then recovers to some degree, and becomes more coherent and lucid. This has happened at least twice, and the last time it landed him in the hospital for 7 days. In addition to the problems above, he was combative and uncooperative.


2. Over the last couple of years, he has become much weaker, walks very slowly, and has very poor balance (has to grip onto things to keep from falling). He has some back and shoulder problems (arthritis), but the physical symptoms have gotten much worse in the last 6 months or so. He tends to drag his right foot a bit.


3. He has memory issues, but they aren't always obvious. he will say his grandson is 10 years old, when the actual age is 16. He forgets dates, and has trouble with his finances. He can't write a check, and has to have someone else do it for him.


4. After checking him into a rehab facility after the last major "episode", he was found wandering the halls naked in the middle of the night.


5. He is depressed, anxious, and his personality seems to have changed to some degree.


What confuses me are the "ups and downs" --sometimes he is obviously impaired, and at other times he is pretty lucid (although his eyes seem glazed, almost as if he is drunk --he is on a lot of meds).


Is this normal with vascular dementia? To have these periods of lucidity followed by major cognitive episodes?

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My dad is 92 and has dementia. We have good days and we have bad days. Sometimes I leave there and he's so put together and lucid and other times (more often than not anymore) we have a bad day. All the ups and downs have become the norm anymore. Medication has helped stabilize the highs and lows. But in all of this, his mind remains pretty sharp when it comes to his finances. He doesn't write too many checks anymore (I do that for him) but he is very aware of what is due when. Certain parts of his brain still work and some don't. And I should say he has totally lost his 'social filter'. His patience level is zero. He yells out stuff while in line in at the store, etc. if it's taking too long. I a bit embarrassing.
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Reply to Babs75
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Silas I am sorry to say that every single one of the five things you describe rings bells with me, from when I was looking after my mother. To be fair, she wasn't naked when she turned up in the kitchen late one night. She was in her underclothes.

And at one point she thought she could still write. She would start a word off confidently and then lose track of where she'd got to, e.g. "thannananank youu for the..." Discreetly removing the pile of Christmas cards she'd embarked on and then abandoned was one of the sadder moments of my life.

I don't suppose it will help at all that her diagnosis was "vascular dementia, ?w/ Alzheimers involvement." She was in her late eighties and had had the classic, common or garden form of CHF for fifteen+ years.

I know we're told (alz.org is a useful source of information on all dementias, if you haven't already come across it) that vascular dementia follows a "stepped" pattern, with a loss of function, then a stable period, then a further loss of function etc. Although that's true, it didn't seem to me to take into account possible fluctuations in brain function related to poor blood supply in the actual minute, day to day; and it didn't either take into account the range of things mother would find to obsess about, or whatever impact her existing personality might have.

I wouldn't ignore the depression symptoms. Report them and don't let them be brushed aside. We found an SSRI helpful in taking the edge of the bleak, nameless misery my mother began to experience, I hope this or something else might help to nip your father's mood difficulties in the bud.

But overall, yes it's normal. It still sucks, but you're not missing anything obvious that I can see.
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Reply to Countrymouse
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I would be suspicious that there is more going on than Vascular Dementia, his absent episodes sound suspiciously like seizures to me. I have to admit I am somewhat prejudiced against the opinions of doctors you meet in a hospital, in my experience their focus is acute crisis care and they give little consideration to who the person was before they met them and don't invest much effort into looking beyond the obvious.
As for the fluctuating cognitive abilities - in the early days days my mom couldn't tell you her own name and yet other parts of her mind seemed to be perfectly intact right up to the end, it is a very confusing disease.
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Reply to cwillie
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Two doctors at the hospital where he was admitted (a neurologist and an internist) made the diagnosis based on the MRIs that showed cerebral atrophy and ischemia (along with some other tests).

He was admitted into a rehab/nursing facility (technically for two weeks, but it could turn into a long-term care)

The problem is, when he is lucid, he is outraged at being in a home. He has threatened to disown his family, disinherit us, sue us, etc. --all of it is pretty extreme and paranoid.

I don't know how we could get on by himself (he lived with a girlfriend), since he has had multiple incidents of falling, hospitalization, etc.

I'm just confused at how this disorder seems to have its ups and downs.
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Ahmijoy Oct 23, 2018
Dementia is defined by its unpredictability. My mother could be bright as a penny one day and upon my next visit, tell me I was her co-star on the Broadway stage and when would we be studying for “our next play”. When a loved one (LO) has dementia, it’s completely one day at a time. Trying to figure out the disease will only give you a headache and stress you out. Sometimes I think the term “roll with the punches” was coined by someone who was caring for a LO with dementia.

If his brain is atrophying, I believe this is called frontotemporal dementia. People with this form of dementia can be impulsive. They lose their social filters and act out, saying outrageous, sometimes hurtful things. Then, five minutes later, they’ve forgotten they’ve said these things while we’re sitting there, upset and wondering what the he** just happened.

I would still speak with the diagnosing doctors and ask for their prognosis. They can also steer you toward support groups.
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Can I ask, where is the diagnosing doctor in all this? Is Dad now in a facility or living in someone's home? Is he consistently “off the wall” but with different behaviors with each episode—like one days he’s wandering, the next day he’s confused about people, dates, days, etc? It sounds like he needs to be in a Memory Care. You need to make an a
pointment with his doctor to discuss what Dad’s diagnoses and prognosis is. Share what you’re seeing regarding Dad’s behavior with the doctor and ask about what meds he’s on and what they’re for. If you have a better idea of what’s going on with your Dad, you will feel a lot less lost over what’s going on.
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