Vascular Dementia

Hello, everyone, and welcome to today’s presentation on vascular presentation. The exhibition will help in better understanding of different types of Dementia as related to neurological disease. Vascular Dementia is one of the neurological diseases that presents with Dementia, making it essential to understanding Dementia. The presentation will focus on the pathophysiology of vascular Dementia. The causes and incidence of the condition will be addressed. Other important aspects that will be discussed at the presentation include health promotion and maintenance, History and Risk factors, signs and symptoms, changes in cognition, changes in behavior & personality, changes in self-management skills, diagnostics, planning and implementation, interprofessional Collaborative Care, psychosocial integrity, medications, and safety considerations.

Dementia refers to loss of memory and problems related to language, thought processes, and the ability to make judgments. Vascular Dementia presents with issues, making it part of Dementia, which is a result of brain damage. The condition is characterized by poor reasoning, judgment, and planning. Memory is affected when there is difficulty in remembering and thinking. Older adults above 55 are at great risk of being affected by the condition. During the early stages of the disease, cognitive problems and judgment difficulties occur. Late stages are characterized by memory loss, where the person cannot recall events and information.

All cells in the body require oxygen and nutrients, which is achieved through a sufficient supply of oxygen. However, in vascular Dementia, there is brain damage due to reduced blood flow to the brain. Reduced oxygen supply to the brain may be due to occlusion or narrowing of the blood vessels supplying the brain (Smith, 2017). Lack of oxygen to the brain cells makes some of the brain cells die. Since the brain is involved in processes such as reasoning, judgment, remembering, and thinking, the death of some cells affects these processes (Smith, 2017). The brain cannot function properly when part of its cells are dead. Thud, the signs and symptoms of Dementia, such as memory loss and language problems, occur.

Reduced blood flow to the brain may be due to narrowed or blocked blood vessels supplying the brain with blood. Conditions such as brain tumors, diabetes, and other cardiovascular disorders may occlude or narrow down the blood vessels supplying the brain with blood. The blood vessels in the brain may rupture due to high blood pressure. Enough blood supply to the brain is essential for providing oxygen and nutrients to the brain cells (Kalaria, 2018). Stroke is another cause of reduced blood flow to the brain, leading to vascular Dementia (Kalaria, 2018). Reduced blood flow to the brain leads to gradual changes in the brain and damage to the brain. Damage to the brain leads to the symptoms of Dementia in patients with vascular Dementia. The incidence of the condition varies from country to country but is common in patients above the age of 65 years (Smith, 2017). 1.2 to 4.2 percent of people over 65 are affected (Smith, 2017). Six to twelve per 1000 people above 70 years are affected by the condition (Smith, 2017).

Vascular Dementia reduces the quality of life, and therefore, various strategies should be taken to prevent the condition and help those already with the need to improve. Health education of community members helps in health promotion. Health education can be done during home visits, school visits, or community events. Through education, people are taught about the condition, how to prevent it, and how to manage those with it (Castellazzi et al., 2020). Mass media reaches many people, and therefore, healthy tips associated with the disease can reach people through mass media. A poster with information on the state can also be displayed to people. The signs, education, and data people should focus on improving nutrition, performing exercises, and providing emotional, social, and psychological support.

People with vascular Dementia should feed on a balanced and healthy diet to improve their memory and supply nutrients to the brain. Self-management is essential, and patients should avoid a sedentary lifestyle such as smoking and drinking alcohol. The patients should perform the exercise to improve the oxygen supply and nutrients in the blood to the brain. Practices also reduce obesity or overweight, hence reducing the risk of complications. Patient education is essential to ensure adherence to medications such as anti-hypertensives and drugs for diabetes Mellitus and the condition (Shabir, Berwick & Francis, 2018). Social interaction helps in dealing with emotional problems, which improves the outcome.

People over 65 are at high risk of being affected by the condition. This is because the people in the age group are affected by hypertension and diabetes. Vascular changes and conditions occur more in old patients. Hypertension may rapture the blood vessels supplying the brain. High sugar levels in the blood affect the blood flow to the brain due to sorbitol. Lifestyle factors like smoking and drinking alcohol affect the flow of blood to the brain (Smith, 2017). Physical inactivity and obesity lead to hypertension and diabetes. High cholesterol levels in the blood may occlude blood vessels. Due to genetics, people with a family history of vascular Dementia are at increased risk of developing the condition.

The major signs and symptoms due to brain damage include memory and brain problems such as slow thought process, concentration problems, Confusion, difficulty in understanding, changes in behavior, and changes in mood and balance (Smith, 2017). There are also remembering situations and disoriented language (Smith, 2017). During the early stages of the condition, there are cognitive issues where reasoning and judgment are a problem. The late stages are characterized by memory problems, where a person forgets easily.

Vascular Dementia affects the cognitive function and ability of the people involved. There is memory loss, where a person cannot recall information and events. A person cannot reason logically as expected. In some cases, the person is always confused, which makes it hard to plan or perform activities in an orderly way (Castellazzi et al., 2020). The person’s language is affected, and a flight of ideas is common. Due to memory loss, poor reasoning, and conclusion, the person cannot make rational judgments.

Behavioral changes occur in the late stages of the condition. Affected people present with agitation and aggressiveness. The people may scream or shout at each other without any reason for the behavior—verbal and physical abusive behavior is present in most of the patients (Smith, 2017). While spending time with the affected people, they may hallucinate where they see or talk about unreal events and things. Some patients may wander around aimlessly.

Major personality changes that occur include avoidant, antisocial, and paranoid traits. A person may have depression or anxiety, which leads to isolation. Due to memory problems, the person thrives on conflict, battling with people they do not know. Interacting with others leads to poor relationships (Smith, 2017). The person may also become paranoid when they do not trust people around.

The self-management skills of a person are affected in such a way that the person becomes disoriented. Planning is poor as the person forgets easily and does not manage time. There is no order in performing tasks, leading to inefficiency and ineffectiveness. The communication skills of the person also become poor due to altered tone and language (Smith, 2017). The person may repeat tasks already done. There is also mismanagement of resources. Poor relationships with others lead to poor management.

Various lab tests help in the diagnosis of the condition. Some infections, such as bacterial infection, may lead to Dementia, and therefore, the blood should be checked for diseases. Hormones lead to stress and anxiety, which affect the brain, and thus, preventing hormone levels in the blood gives important diagnostic information (Smith, 2017). Mediators such as serotonin affect how a person behaves. A complete blood count helps diagnose cardiovascular conditions that may lead to Dementia. High cholesterol may lead to occlusion of blood vessels supplying the brain; hence, the levels should be checked.

The best way to diagnose  Vascular Dementia is through imaging scans. MRI and CT scans show defects in the brain, such as tumors or blood clots, leading to reduced blood flow to the brain (Castellazzi et al., 2020). Electroencephalography shows brain activity in states such as drowsiness.

Positron Emission Tomography measures glucose levels in the brain since low levels may affect brain functioning or activity. Imaging helps finely visualize the brain to identify the parts involved and the extent of damage.

Cognitive and neuropsychological tests such as language skills also help diagnose the condition (Shabir, Berwick & Francis, 2018). The person should be subjected to tests where certain scores indicate the person may have Dementia. A thorough physical examination and medical history may reveal information related to vascular Dementia, such as heredity (Shabir, Berwick & Francis, 2018).

People with vascular Dementia should feed on a balanced and healthy diet to improve their memory and supply nutrients to the brain. Self-management is essential, and patients should avoid a sedentary lifestyle such as smoking and drinking alcohol. The patients should perform the exercise to improve the oxygen supply and nutrients in the blood to the brain. Practices also reduce obesity or overweight, hence reducing the risk of complications. Patient education is essential to ensure adherence to medications such as anti-hypertensives and drugs for diabetes Mellitus and the condition (Shabir, Berwick & Francis, 2018). Educating nurses also improves their skills in managing the disease. Patients diagnosed with the disease are usually psychologically disturbed, and therefore, the nurse should adhere to ethical principles.

Interprofessional collaboration is another best strategy for managing the condition. Nurses, physicians, physiotherapists, psychologists, occupational therapists, pharmacists, and nutritionists are all involved in caring for patients with vascular Dementia. Therefore, they should work together to improve the outcomes (Shabir, Berwick & Francis, 2018). Interprofessional collaboration reduces the burden of caring for the patient, reduces medical errors, and promotes education, which improves the quality of care. Interprofessional collaboration minimizes the use of chemical drugs to manage patients, which may have more adverse effects (Ignatavicius, Workman & Rebar, 2017). Collaboration also improves the experiences of patients with vascular Dementia on self-management.

Patients are usually affected socially and psychologically—depression, anxiety, and isolation are common. Social and psychological support is important. There should be social interaction with patients (Strøm & Engedal, 2021). Interprofessional collaboration improves psychosocial integrity, where psychologists and counselors manage the patient. Ethical principles to be practiced to enhance psychosocial integrity.

The nurse and other medical professionals caring for the patient should keep the patient information private and confidential (Shabir, Berwick & Francis, 2018). The choices made by the patient should be respected. Patient safety is essential, and education of family members and the patient promotes the patient’s safety.

The condition has no cure, but the progression of the state can be slowed down. The symptoms can also be managed using drugs that treat Alzheimer’s disease. Drugs such as aducanumab, Donepezil, Rivastigmine, and Galantamine slow the progression of the condition. Physiotherapy and behavioral therapies are effective in managing the symptoms of the disease. Group and family therapy can also be used. Drug therapy should be the last option when the situation is worsening.

Home safety is essential. The home should always be prepared for an emergency due to falls. Having telephone number displayed or tags help in preparation for safety. Monitoring devices monitor the patient’s activities and behaviors (Brims & Oliver, 2019). Immediate intervention is taken when the symptoms worsen. Alarms help in the safety of the patient when complications arise. Night lights and a good lighting system reduce falls. Bed rails and walking aids prevent accidents resulting from falls due to decreased brain function, such as loss of balance.

These are sources for more information on vascular Dementia. The seeds will help in a better understanding of vascular Dementia. The pathophysiology of vascular Dementia, signs and symptoms, diagnosis, and management helps in a better understanding of Dementia. Thank you.

References

Brims, L., & Oliver, K. (2019). Effectiveness of assistive technology in improving the safety of people with Dementia: a systematic review and meta-analysis. Aging & mental health, 23(8), 942-951.

Castellazzi, G., Cuzzoni, M. G., Cotta Ramusino, M., Martinelli, D., Denaro, F., Ricciardi, A., … & Gandini Wheeler-Kingshott, C. A. (2020). A machine learning approach for the differential diagnosis of Alzheimer’s and Vascular Dementia Fed by MRI-selected features. Frontiers in neuroinformatics, 14, 25.

Ignatavicius, D. D., Workman, M. L., & Rebar, C. (2017). Medical-Surgical Nursing-E-Book: Concepts for Interprofessional Collaborative Care. Elsevier Health Sciences.

Kalaria, R. N. (2018). The pathology and pathophysiology of vascular Dementia. Neuropharmacology, 134, 226-239. https://doi.org/10.1016/j.neuropharm.2017.12.030

Shabir, O., Berwick, J., & Francis, S. E. (2018). Neurovascular dysfunction in vascular Dementia, Alzheimer’s, and atherosclerosis. BMC Neuroscience, 19(1), 1-16.

Smith, E. E. (2017). Clinical presentations and epidemiology of vascular Dementia. Clinical Science, 131(11), 1059-1068.

Strøm, B. S., & Engedal, K. (2021). Ethical aspects in dementia care use of psychosocial interventions. Nursing ethics, 28(3), 435-443.

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Scenario

As a manager on a medical surgical unit, part of the job responsibility includes chart audits.

A trend noted during the most recent audit was overusing the term “dementia.” The nurse manager notes that there may be a lack of understanding of the types of Dementia related to neurological diseases.

The nurse manager developed a survey to evaluate the staff’s understanding of the different types of Dementia. As a result of the survey, you have been asked to create a PowerPoint presentation to increase the nurse’s awareness of the types of Dementia. A display was made.

Instructions

Choose one of the following topics for a focused presentation:

• Alzheimer’s
• Parkinson’s
• Vascular Dementia

The presentation should include the following:

1. Pathophysiology
2. Etiology & incidence
3. Health promotion and maintenance
4. History/Risk factors
5. Physical signs and symptoms
6. Changes in cognition
7. Changes in behavior & personality
8. Changes in self-management skills
9. Diagnostics: laboratory and imaging assessment
10. Planning and implementation
11. Interprofessional Collaborative Care
12. Psychosocial integrity
13. Medications
14. Safety considerations

Using Ignatavicius and one additional resource, develop a presentation to enhance the nurses’ knowledge of the differences between types of Dementia and delirium. Be sure to document your source(s) in your presentation.