My sister thinks mum is showing signs of vascular dementia

[MultiBird]

She's basing that on how her DH's aunt was around the time she was diagnosed.

Mum is rude, short tempered, defensive. DSis says her tone is just like Aunty S. She's always been like that, but she mostly had the good manners to mask it. As she's got older (76) she's become one of those older people who don't care what people think.

She's a good kind hearted person too, one of those "heart's in the right place" kind of people, but there's no doubt she can be very frustrating.

I'm not concerned, to me it's how she's always been, but I live locally and see her regularly, DSis sees her less frequently so perhaps sees changes more than I do.

It doesn't really make a difference as there's no way mum would agree to see a doctor, but do you think the concerns are valid?

Without any other symptoms I don't think that is necessarily dementia.

I was the first one to spot dementia in my mum because we live the furthest away and saw her the least. The changes were fairly obvious, but it was more about her short term memory. She would ask the same question a few minutes later and had obvious forgotten our previous conversation. It was indeed dementia and got steadily worse.

Being a bit more rude and forthright may just be a product of getting older and caring less about social "niceness".

Any other indications?

Where did your sister get her medical degree? Older people (and I'm basing this on experience not ageism) can get a bit shorter tempered and rude. Mostly it's because they're past giving a shit having to people please all the time.

Symptoms of vascular dementia vary. Just because Aunty S was similar doesn't mean your mum has it too. As PP said, any other worrying symptoms?

I agree that it’s an ageing thing, not necessarily a dementia thing.

At that age surely theres a possibility? Why not observe her and see what you think, whether she might have started down the dementia path.

Sounds just like my mother was in the fairly early days of vascular dementia.

You don't necessarily need a medical degree to spot the tell-tale signs of dementia. I saw a celebrity on a TV quiz show with the same baffled look as my DM and immediately clocked correctly that he was suffering mild dementia. He was in the news shortly afterwards because he'd got lost.

Presumably your DSis has known your DM all her life, so is able to allow for the fact that she's always been brusque. Less frequent visitors are often more able to see changes. I'd keep an eye open.

Why specifically vascular dementia and not another type? Vascular dementia is caused by mini strokes cutting off blood supply to the brain. They might not always be obvious, but often come with other physical symptoms like increased frailty/decreased mobility.

My mum was diagnosed with mixed dementia (part vascular, part Alzheimer's) in her 60s though the symptoms were there for probably 5-10 years prior.

She died from it a couple of years ago at the age of 71, but at no point did it make her rude or short-tempered.

Her initial symptoms were forgetting things like her pin number, leaving the cooker hobs on, and as a PP says, repeating the same questions in a conversation as she'd forgotten she'd already asked them and the answers. Then forgetting eg the processes in cooking something.

It's the short-term memory that goes first.

People with some types of dementia do have personality changes, but I think it's more common in eg Alzheimer's than vascular dementia.

My Dad became much more irritable and rude around the age of 68. We all put it down to ageing.

He needed a CT scan of his brain for other reasons and they found evidence of historical strokes which explained this behaviour change, none of us had any idea he had had any strokes (including him).

A personality change is worth talking to a GP about.

Because that's what Aunty S had, but also because mum has high blood pressure and a suspected mini stroke, although refused to see the doctor.

Sis isn't claiming to be a doctor, just mentioned that she can see some similarities.

My mum had personality changes as part of her dementia, and it was the first thing that made me think there was something properly wrong with her. And for sure, her filters got taken off, so things she might have thought before and not said got said straight out.

Is your mums blood pressure under control? If not, then thats the biggest thing to focus on either way

She takes medication, but who knows if it's monitored. She's always been very secretive and defensive about anything health related.

I've had more than one person with dementia -a sh*t disease!- in the family. Imho it's often easier for a stranger or sb on the outside to point out the weirdness than sb who's with the sick person everyday. The reason for that, I think, is that you slowly slowly get used to the weird things, to the point that they become normal so you might not see the signs. It's this process you go through, wheres the outsider only sees point A and point B but because they've missed the walk, it's more obvious to them.
e.g. 1) My uncle lived with my great-aunt until he got married. Years later, my DM, a nurse, admitted her into a psychiatric hospital to be evaluated, because she noticed things. It then became known she'd already been (self-)admitted years before -while she was living w/ him- because she too had noticed changes (early stages) but he never knew this and he was shocked to find that out. So, he lived with her and she had all these quirks then, which became normal for him, so he missed all the signs and started saying she was "difficult".
e.g.2) I saw and talked to neighbour a couple of years ago who lived in the same building as I had lived as a kid. I thought he was "a bit off and strange", in fact, another relative of mine had said he was "very rude now". At the time I actually mentioned it to my mum. Another neighbour said he was bit off too, so he avoided him altogether because he didn't want to argue. Fast forward a few months and I'm pretty sure he's got dementia though I'm not sure the wife's caught on but all the other neighbours know.
e.g.3) another neighbour of over 15 years. I walk past her and say hi, she looks at me and says "Oh, Hello!" Sorry dear, who are you?..." (I lived in the flat across the hall from her and it's a very small building, we're the only two on that floor). Her DH passed away, then the kids took her to theirs and she's now in a nursing home because she's lost the plot.
e.g.4) My DM started taking Statins. She turned into the Devil's sister, always ready to fight (even w/ strangers, she was beyond effing rude) and she started forgetting things. I said, she changed meds and was back to normal after a few days.
So, maybe your DM's fine, maybe it's the meds or maybe it's sth else? She should see a neurologist, do an MRI, do some more tests (my DM did a bunch of then just to be sure she wasn't going bonkers), then you'll know for sure. If it is the beginning of sth, you need to started planning ahead. You need to go to court and make sure she's legally stopped from getting married or getting rid of stuff, because she'll be in a very vulnerable position. A large part of my great-aunts's $$ went missing.

Some older people just do become a bit obnoxious - lose their ‘filter’ and say offensive things, etc. Dh had an old aunt like this - there was no dementia - but she could be decidedly embarrassing, e.g. saying very loudly in a pub, ‘Why does that waitress wear such short skirts with legs like that?’ 😱

My widowed FiL had vascular dementia and the very first sign ( before we realised that anything was amiss) was when he asked, when all dressed up for a son’s wedding, ‘Where are we going again?’

It was only a while later when visiting him, and finding him unshaven and wearing a dirty jumper (both unheard of before) that we twigged that something was seriously wrong.
He started having TIAs (mini strokes) too, so his speech would become completely garbled, but he’d recover within a few days.

Other early signs we didn’t register at first, were e.g. several packets of sausages in his fridge - he’d evidently forgotten that he already had plenty.

It doesn’t sound as if anything like this applies to your mum, not yet anyway.

Another early sign I forgot in FiL, was imagining that neighbours had stolen something nobody in their right mind would ever want anyway.

My DM had Alzheimer’s, and she would have similar bees in her bonnet about neighbours having stolen this or that totally trivial item that she’d mislaid or hidden. From all I’ve ever heard, v common in dementia.

imagining that neighbours had stolen something nobody in their right mind would ever want anyway
My great-aunt got padlocks put in every single door, even the kitchen and cabinets! She'd be walking in and out and opening/closing them behind. My uncle thought it was normal...

Well, the first thing a GP would do is a basic memory test.. Will ask a series of questions like what is the date, who is the prime minister, get them to draw a clock, then interspersed with that, tell them a name and an address and at the end get to repeat it.

If she's also having issues with her memory, then it will pretty quickly become obvious and she'll be referred to a memory clinic. If not, then I imagine it will be a case of wait and see.

The thing will be actually getting her to a GP though if she's reluctant and doesn't see any problem.

I had to personally go to the GP myself about my mum as by then she was in no fit state to and my father (another long story) just had his head in the sand.

Tbh though, for vascular dementia there isn't a lot that can be done medically, other than decreasing the risk for further damage, by eg cutting the risk factors, controlling blood pressure, doing exercise, cutting out alcohol, healthy diet etc.

And even at my mum's relatively late stage, there wasn't a huge amount of other support either, given details for social groups, an every so often check uo at GP..

Based on your update and those risk factors then I would say there is a good chance the changes your sister can observe not seeing your mum regularly may indicate VD. VD is often characterised by fluctuating ability so one day someone cannot do something they could yesterday such as put their trousers on correctly but the next day is back to normal. The Alzheimer's Society doesn't just cover AD so you may want to have a read on their website and see what resonates between you and your sister's observations.

I haven't noticed any memory problems and she's still clean, if a bit scruffy, but she's always been "presentable" rather than overly concerned about her appearance.

She never misses a birthday and she'll still remind me about arrangements etc. DS has a doctors appointment tomorrow and she'll remember to call to see how it went and offer to collect any prescription he needs.

My DF is now 88 and diagnosed with Alzheimer’s 5 years ago. I first noticed subtle changes in his demeanour when we went away as a family for his 80th birthday. At that time I lived further away and so didn’t see him very often. My DM denied it for years, and even now will try to find other reasons for his failing health and capacity.

It is a horrible illness.

Dementia can present with changing abilities in any area of functioning, not just memory. So language, movement, personality, sense of self in space etc. Maybe have a read up and think a bit broader than memory if anything else is amiss.

People with dementia are often very adept at managing around it in the earlier stages.
If your Mum has it, she may not be aware of it.
Vascular dementia often goes in step changes and is connected to damage caused by leaky blood vessels in the brain. Making sure blood pressure is well controlled is important.
Other signs, repeating questions or bits of conversation, I noticed my Mum became less aware of hygiene - especially food hygiene, so raw meat kept with salads etc, my MIL was the same. It's sometimes easier for people who aren't around all the time to notice little changes.

She's having a lot of falls. I'm not usually there so I have taken what she and dad say at face value and believed that she slipped/tripped, but having witnessed the most recent, I'm not convinced she didn't "collapse" iyswim.

If she is falling or possibly collapsing then she needs to see her doctor, easier said than done but it could be mini strokes or something that needs checking. Did they call for medical help last time it happened.

They did, but only because I was there and she had a nasty cut to her head. I was disappointed with the 111 response TBH. They did all the checks for concussion, which were fine, but didn't ask or consider the reason for the fall, didn't ask if there'd been previous falls and didn't suggest she should see a doctor. So, you see, they were right and I was wrong, it was a big fuss over nothing.

Its tricky isn't it, it can be just someone's personality mixed with aging, or could be something more. Unless it's hugely affecting her then unless she agrees to be checked by a GP there's unfortunately not much you can do anyway. I would say often those who don't see someone often notice changes more as rather than them being gradual they're more obvious.

They won't though... 111 is only to check if there is an immediate need for medical attention.

If she is having repeated, unexplained falls then it needs to be checked by a GP and relevant referrals made as appropriate, but as previously stated, this will be dependent on her willingness to see GP and acknowledge the need, unless you contact her GP yourself to discuss your concerns.

What happens next will be dependent on the GP.. My mum's was quite good and got my mum and dad in on the pretense of a medical check and managed to convince my dad from there.