Is it Alzheimer’s or Vascular Dementia?  And does it matter?

My mother received her diagnosis of Alzheimer’s disease on April 14, 2015, my 57th birthday.

Her memory was slowly, but steadily slipping away right before our eyes. I had “gotten used to” her diagnosis of vascular dementia, which she received in 2013. I had convinced myself at the time to take comfort in the fact that “at least she didn’t have Alzheimer’s.” How little I knew about dementia and Alzheimer’s disease!

When my mom started having increasing incidents of anxiety and agitation, her doctor suggested we try one of the newer drugs. The doctor didn’t make any promises, but I still hoped it would magically work for my mom. Well there wasn’t any magic and she actually had some very unpleasant side effects from the medication.  As time passed, she started having episodes where she would forget something that had just happened. One of the first times was after a trip we took to the coast for Thanksgiving.  A couple of days after we got home my mom said she had no memory us all being together for the weekend. She was scared and devastated and I didn’t know what to say or how to comfort her. I kept repeating, “it’s okay, it really happened, you had a nice time,” or something stupid like that. Another time, she was convinced she had worked “yesterday” and wanted to know how she was going to get home. And where was her car?  In her mind she had driven the car only yesterday. I tried to gently explain that she didn’t work, hadn’t worked for years and had given her car to Judi. She was inconsolable. I was relieved for both of us the next day, as she had forgotten the entire conversation – maybe there is a small silver lining with memory loss…

Ellie and I decided it might be a good time for my mom to see a neurologist for an evaluation. Based on a review of her history, an MRI and a series of memory tests, the neurologist, Dr. Wong, was ready to speak with us. She had scored 17 out of 30 on one test, which was abnormal. Ellie and I had secretly followed along as he asked her questions, wondering how we would have scored. Dr. Wong talked with us at length about short and long term memory, memory loss due to aging and changes in the brain with the onset of dementia. He told us there was no cure for what my mom was experiencing, but that she could still have a happy life. My mom’s response was, “I do have a happy life.”

After 14 minutes and 51 seconds of conversation with Dr. Wong I leaned over and whispered to Ellie, “Is he talking about Alzheimer’s?” I didn’t have the courage to ask the question myself so Ellie did it for me. “Yes,” Dr. Wong stated, “this is Alzheimer’s disease.