Thursday, 3 April 2008

Vascular Dementia

I've seen a young lady with vascular dementia. I thought it was F01.0 Vascular dementia in acute onset but on sleuthing it out over the last few weeks it seems it's in fact F01.1 Multi-infract dementia. I was interested 'cause I like to know (but not in such a psychopathic Gregory House sort of way) but also if it is acute then clever physicians could try and sort out why.

But this difference largely is irrelevant.

She has vascular dementia.

It's pretty classical. She has very well preserved "islands of ability" meaning some things are completely perfect. She can recognise faces and people, she can sequence tasks, she's good concentration, she's got mildly impaired memory, she's got only mild disorientation. She's no dyspraxia. She can manage buttons on her blouse, she managed her espresso coffee machine that looked as complex as the dashboard of the space shuttle, she managed to use fiddly buttons on her mobile 'phone to text a friend.

She has profound nominal aphasia. She knows what she wants/means, she just can't connect with what the word for that is. She was able to tell me she wanted "that thing" to stir a coffee but simply couldn't generate the word "teaspoon" at all.

This has had a significant impact on her, socially. She's stopped meeting friends, no longer enjoys her walks around the village to the bookshop and back, she's stopped having lunch in the local cafe every Tuesday "with the girls" as she used to, she's stopped going to antique/second hand shops and browsing for a certain type of pottery she likes to collect. Why? She's too self conscious that she can't speak fluidly any more.

She's bright, animated, intelligent, active and oh so very aware. But she's locked in. She's a massively constrained social repetoire as a consequence of her impaired expressive aphasia.


Milk & Two Sugars said...

She sounds like a woman with great potential: one of the ones whose life could be hugely improved with appropriate psychotherapy to help her deal with her new, certainly disabling situation. I wish you luck with her.

Xavier Emmanuelle said...

How interesting, we had a lecture on vascular dementia last night.

I hope that there can be some way to try to re-integrate her into her normal routine.

Elaine said...

Without wanting to denigrate this poor lady, I always remember Terry Wogan - "it's the nouns that go".

I too find that I often know what I want to say, but cannot immediately recall the word, so reaort to describing it (a bit like one of those word games...). I am always pleased to recall the word shortly after.

Thankfully I have a large vocabulary to work from.

Still, at least I can still play bridge.

Dragonfly said...

I also wish you luck with her.
I would imagine that the incidence of this will, sadly, only increase.