Vascular dementia is a term that applies to a number of different conditions that result in reduction of cognitive skills due to lack of blood flow to the brain. Although the changes may be sudden, for example following a stroke, as a general rule, the loss of memory, disorientation as to time and place, deterioration of problem solving capability and judgment all evolve slowly over time.
Evaluation Criteria used for Staging Vascular Dementia
There are several different staging systems for people who suffer from cognitive loss. The most common one used for those with vascular dementia is the Clinical Dementia Rating Scale (CDR). The health professional evaluates six different areas of cognitive functioning:
- Judgment and problem solving.
- Community affairs.
- Home and hobbies.
- Personal care.
According to these six criteria, the severity of each one is assessed in order to determine what stage the patient is at in the downward progression of the disease.
Stages of Vascular Dementia
There are four stages of vascular dementia depending on the severity of the cognitive loss as determined by the six criteria of cognitive functioning.
- Questionable: There are some memory issues and difficulty with problem solving. Daily life is only slightly impaired.
- Mild: There is moderate memory loss for recent events. The patient is oriented for place, but may have trouble with time and relationships so that daily life is impaired. The patient needs help functioning at community affairs. People at this stage likely do not seem impaired to casual observers, yet those who know them recognize that they are impaired and need help with problem solving and have impaired judgment.
- Moderate: The patient has a more profound memory loss, retaining only “highly learned material.” Patients are now frequently disoriented as to place and time. They have difficulty dealing with even the simplest of problems, have severely impaired judgment, few interests and are unable to complete more than a few simple chores.
- Severe: They have no orientation as to place and time and no problems solving abilities at all. They cannot function outside the home and need help with all activities of daily living. They require assistant with their personal care and may even be incontinent.
The importance of an individual care plan for dementia patients cannot be over-emphasized. Meeting the specific needs of each patient increases the quality of life and patient safety.