Thursday 26 June 2008

Dementia Can Hit After A Stroke In Prime Life

(Source:  http://www.usatoday.com/news/health/2008-06-23-vascular-dementia_N.htm)

   

In November 2005, Davida Godett seemingly had it all. She had a great job and was on the fast track to earning her MBA.

 

Then, on an otherwise uneventful Monday morning, Godett crashed: She had a mini-stroke that temporarily stopped the blood flow to her brain.

 

Godett went to a nearby emergency room and recovered. She didn't really dwell on the fact that she was at high risk for another attack. After all, she reasoned, strokes strike older people, and she was only 29.

 

Then, right around Valentine's Day 2007, Godett started to slur her words. One side of her body felt numb. She had had a severe stroke.

 

This time, when Godett, an accountant in Philadelphia, tried to resume her life, she ran into major problems. At work, she had trouble adding up numbers, planning ahead or even thinking clearly.

 

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The damage from the stroke had left her with vascular dementia, the second-leading cause of dementia in the USA behind Alzheimer's. Godett was only 31 at the time. Most people who have dementia are 65 or older, but according to the Alzheimer's Association, an estimated 500,000 people ages 55 to 64 struggle with some form of dementia.

 

Work becomes impossible

 

"No one knows how many people such as Godett face the demon of dementia before age 55 — a time when the demands of work and family life are intense," says Katie Maslow, Associate Director for Quality Care Advocacy at the Alzheimer's Association.

 

"Anyone who has been working and has dementia is going to lose their job," Maslow says. "Patients often have trouble qualifying for disability insurance and struggle to pay for housing, food and medical care," she says.

 

"Vascular dementia occurs when a stroke or a series of strokes temporarily blocks blood flow to the brain," says Claudette Brooks, a Neurologist and Stroke Expert at the West Virginia University School of Medicine in Morgantown.

 

Godett's stroke damaged parts of her brain that let her store and retrieve information.

 

"Before the stroke, I could add numbers in my head. I was gifted in that area," Godett says. Back on the job, she started to have trouble closing out the books each month. She'd pick up the phone and forget what she was about to say.

 

"I didn't realize it at first," she says. But a colleague noticed the lapses. "I was getting worse."

 

In April 2007, two months after the stroke, she had to leave her job.

 

According to a 2006 report by the Alzheimer's Association on early dementia, only 22% of people with disabling memory or cognitive problems stay on the job. The report notes that 62% of such people had an annual income of less than $11,000.

 

"We often hear from families who are quite desperate," Maslow says. Some people, including Godett, get disability insurance through an employer or from the federal government. But Godett says her disability check doesn't cover her living expenses.

 

"I have outstanding medical bills," she says. "It's been difficult to maintain everything."

 

The effect on families goes beyond finances. Maslow says dementia patients may not be able to fully care for children at home. In some cases, roles are reversed, and children are put in the position of caring for a parent, she says.

 

Daily tasks aren't easy, either

 

The damage to Godett's brain has left her with permanent disabilities. She still takes her son to school each morning and does her own household chores, but she has to expend a lot of effort on the simplest things.

 

Take grocery shopping

 

Godett can't easily put the steps together in her mind to go to the grocery store. She can't plan well enough on her own to gather her list, drive to the store, go through and pick out the items she needs and pay for them.

 

Never mind counting the change

 

Things she used to take for granted now tax her mind and leave her exhausted by day's end. "This has been so difficult," she says.

 

Brooks says people who have early-onset dementia often fall through the net of social services. They don't qualify for Medicare, the health insurance program for the elderly. They often have trouble going through the steps they need to collect disability, and the bills they face are enormous.

 

"African-Americans such as Godett are at twice the risk of having a stroke. They are also at higher risk of developing vascular dementia," says Emil Matarese, the Neurologist who treats Godett.

 

"The high risk can be traced mostly to other health conditions such as obesity, diabetes and hypertension," says Matarese, who is also a spokesman for the American Stroke Association.

 

But other than her race, Godett has none of the known risk factors for stroke. "She's a beautiful, thin, healthy lady," Matarese says. "She did everything right."

 

But Godett represents a fact of life: There's nothing modern medicine can do to alter her risk profile.

So she does the best she can to provide for her 5-year-old son. She relies on family members to help drive her to the grocery store. She struggles to pay the bills.

 

And she prays.

 

"Every morning when I wake up, I give thanks," she says. "I really believe that it helps."

 

Godett says she has found an unexpected joy in her life, one that comes with not dwelling on the past or fretting about the future.

 

"I cherish every single second of the day," she says. "Because you just never know."

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