Post-Stroke Dementia Recovery

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By Daniel Zondervan

There is hope for recovery from post-stroke dementia. The current landscape is full of statements like, “there are no medications to treat dementia, but you can slow its progression.” Also, while slowing the progression of dementia is a small glimpse of hope, there’s room for a lot more hope; because there could also be a way to reverse it altogether. So, why isn’t anyone talking about it?

Reversing post-stroke dementia isn’t wishful thinking. The idea is based on quality science (which we will discuss later) that, unfortunately, doesn’t have much quantity behind it. Medical professionals are forced to be extremely cautious about what they say. That’s why they never mention it. If something hasn’t been proven by dozens of double-blind peer-reviewed studies, then it “lacks validity” and no one talks about it, as if it doesn’t count. But refraining from talking about potentially helpful, non-invasive treatment options for dementia can be viewed as irresponsible. That is why the medical community should be encouraged to talk about it.

It is possible to reverse post-stroke dementia – at least partially, and maybe even fully! Although the research still has a long way to go, we see no reason to withhold it from the discussion – especially when treatment has no negative side effects. To understand how to treat post-stroke dementia, we need to look at what causes it. Post-stroke dementia is a form of vascular dementia that results from the brain damage caused by stroke. The damage in the brain can impair the stroke survivor’s cognitive skills like memory and problem-solving.

It’s important to emphasize that these symptoms arise from brain damage, and although brain damage cannot be reversed, the healthy parts of the brain are capable of taking over impaired tasks. Rewiring the brain is how all other stroke side effects are treated – so why can’t it be used to treat dementia too? The brain has the ability to reorganize itself and form new neural connections through neuroplasticity, which is activated by repetition. Each time you repeat something, you strengthen the neural connections in your brain responsible for that skill. The more you repeat, the stronger those connections become, and the stronger your skills become.

For example, someone with impaired movement after stroke can work to improve movement by doing rehab exercises over and over and over. Similarly, someone with impaired speech after stroke can regain their language skills by doing various speech exercises over and over and over. If the repetitive practice can rewire the brain and heal these stroke side effects, then it can help with post-stroke dementia too.

To treat post-stroke dementia, the therapist should make note of the post-stroke dementia symptoms the stroke survivor has.Next, make note of which ones they have the ability to practice. We’ll call these “practicable” symptoms. Some examples of “practicable” post-stroke dementia symptoms are:

  • Impaired memory
  • Impaired problem-solving skills
  • Impaired attention
  • Impaired language/communication

Whatever dementia symptoms the stroke survivor is struggling with, they should practice those things. Cognitive training exercises are a great place to start. They can get really creative with it, too. For example, if the survivor struggles with memory, they can start practicing memory games. Because of neuroplasticity, memory training can improve memory! Also, of all the dementia symptoms, memory training has the most research behind it. If the survivor struggles with problem-solving, they can start playing problem-solving games like Sudoku.

Here’s another example: If they have trouble paying attention, they can try having “attention practice periods” where they practice paying attention to something (like rehab exercises) for a small amount of time. They can start with just one minute. Then increase it to two minutes. Then try three minutes.

Post-stroke dementia symptoms should be treated as skills that simply need to be relearned. The survivor can try relearning through repetitive practice. It takes patience in slowly rebuilding skills. Though this may seem simple in theory, it’s going to take a LOT of hard work and consistency on behalf of the survivor to see results. Therapists can find getting survivors to practice these skills can be challenging. However, they should encourage the survivor to practice their skills every single day for a month, and see if their condition improves. It’s all a matter of putting in the reps and seeing what happens.

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