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Ubuhlungu Be-Vascular

Uhlolojikelele

Ukuwohloka kwengqondo okuhambisana nezinhlungu zezinzwa yigama elihlanganisa izinkinga zokucabanga, ukuhlela, ukwahlulela, ukukhumbula nezinye izinqubo zokucabanga ezihambisana nokulimala kwengqondo okuvela ekungasebenzi kahle kwegazi ebuchosheni bakho. Ungathola ukuwohloka kwengqondo okuhambisana nezinhlungu zezinzwa ngemva kokuthi isifo sokuqhaqhazela sivale umthambo ebuchosheni bakho, kodwa izifo zokuqhaqhazela azibangeli njalo ukuwohloka kwengqondo okuhambisana nezinhlungu zezinzwa. Ukuthi isifo sokuqhaqhazela siyakuthinta yini ukucabanga nokuqonda kwakho kuncike ezingeni nokuthi isifo sokuqhaqhazela sikhona kuphi. Ukuwohloka kwengqondo okuhambisana nezinhlungu zezinzwa kungase futhi kuvele kwezinye izimo ezilimaza imithambo yegazi futhi zunciphisa ukujikeleza kwegazi, zishiye ubuchopho bakho bungenawo umoya okhulayo nezondlo. Izici ezandisa ingozi yakho yesifo senhliziyo nesifo sokuqhaqhazela — kufaka phakathi i-diabetes, ukucindezeleka kwegazi, ukuphakama kwe-cholesterol nokubhema — futhi zanda ingozi yakho yokuwohloka kwengqondo okuhambisana nezinhlungu zezinzwa. Ukulawula lezi zici kungasiza ekuphuculeni amathuba akho okuthola ukuwohloka kwengqondo okuhambisana nezinhlungu zezinzwa.

Izimpawu

Izimpawu ze-dementia ye-vascular ziyahlukahluka, kuye ngengxenye yobuchopho bakho lapho ukugeleza kwegazi kunciphile khona. Izimpawu zivame ukufana nalezo zezinye izinhlobo ze-dementia, ikakhulukazi i-dementia yesifo se-Alzheimer. Kodwa ngokungafani nesifo se-Alzheimer, izimpawu ezibaluleke kakhulu ze-dementia ye-vascular zivame ukubandakanya ukushesha kokucinga nokuxazulula izinkinga kunokulahleka kwenkumbulo.

Izimpawu nezimpawu ze-dementia ye-vascular zihlanganisa:

  • Ukuphazamiseka
  • Ubunzima bokuqaphela nokugxila
  • Ukunciphisa ikhono lokulungisa imicabango noma izenzo
  • Ukwehla emandleni okuhlaziya isimo, ukwakha uhlelo oluphumelelayo nokuxhumana lolo hlelo kwabanye
  • Ukucabanga okuhamba kancane
  • Ubunzima lokulungisa
  • Ubunzima ekubeni unqume ukuthi yini okufanele uyenzani ngokulandelayo
  • Izinkinga zenkumbulo
  • Ukungakhululeki nokukhathazeka
  • Ukuhamba okungazinzi
  • Ukufisa okungazelelwe noma okuvamile kokuya emathisini noma ukungakwazi ukulawula ukuphasa umchamo
  • Usizi noma ukungabi nandaba

Izimpawu ze-dementia ye-vascular zingabonakala ngokucacile lapho zenzeka ngokuzumayo ngemva kokushaya. Lapho izinguquko ekucabangeni nasekuqondeni kwakho zibonakala zihlobene ngokuqondile nokushona, lesi simo ngezinye izikhathi sibizwa ngokuthi i-dementia ngemva kokushaya.

Ngezinye izikhathi iphethini ebonakalayo yezimpawu ze-dementia ye-vascular ilandela uchungechunge lwezinkinga zokushona noma izinkinga ezincane. Izinqubo ekucabangeni kwakho zenzeka ngezinyathelo ezibonakalayo eziya phansi ezingeni lakho langaphambili lokusebenza, ngokungafani nokuwa okuqhubekayo, okuzinzile okuvamise ukwenzeka e-dementia yesifo se-Alzheimer.

Kodwa i-dementia ye-vascular ingathuthuka kancane kancane, njengoba nje i-dementia yesifo se-Alzheimer. Ngaphezu kwalokho, isifo se-vascular nesifo se-Alzheimer zivame ukwenzeka ndawonye.

Izifundo zibonisa ukuthi abantu abaningi abane-dementia nobufakazi besifo se-vascular ebuchosheni nabo bane-Alzheimer's disease.

Izimbangela

Ukuwohloka kwengqondo okuvela emithanjeni yegazi kuvela ezimweni ezilimazayo imithambo yegazi yengqondo yakho, kunciphisa ikhono layo lokupha ingqondo yakho inani lokudla noketshezi olulifunayo ukuze isebenze ngokuphumelelayo imicabango.

Izimo ezivamile ezingabangela ukuwohloka kwengqondo okuvela emithanjeni yegazi zihlanganisa:

  • Isiguli (ukuthinteka) okuvimba umthambo wegazi wengqondo. Iziguli ezivimba umthambo wegazi wengqondo ngokuvamile zibangela uchungechunge lwezimpawu ezingahlanganisa ukuwohloka kwengqondo okuvela emithanjeni yegazi. Kodwa ezinye iziguli azibangeli zimpawu ezibonakalayo. Lezi ziguli ezingabonakali zisanda kulisongo lokuwohloka kwengqondo.

Ngokuqondene neziguli ezibonakalayo nezingabonakali, ingozi yokuwohloka kwengqondo okuvela emithanjeni yegazi iyanda ngenani leziguli ezivelelayo ngokuhamba kwesikhathi. Uhlobo olulodwa lokuwohloka kwengqondo okuvela emithanjeni yegazi oluhilela iziguli eziningi lubizwa ngokuthi ukuwohloka kwengqondo okuningi okuvela emithanjeni yegazi.

  • Ukuphuza kwegazi ebuchosheni. Ngokuvamile kubangelwa ukucindezela kwegazi okuphezulu okubuqaphile umthambo wegazi okuholela ekopha ebuchosheni okubangela ukonakala noma ukuqongelelana kwamaprotheni emithanjeni emincane yegazi okuvela ngokuguga okubuqaphile ngokuhamba kwesikhathi (ukuguga kwe-amyloid ye-cerebral)
  • Imithambo yegazi yengqondo ecindezelekile noma eyonakele isikhathi eside. Izimo ezicindezela noma eziqeda umonakalo omude emithanjeni yegazi yengqondo yakho zingabangela ukuwohloka kwengqondo okuvela emithanjeni yegazi. Lezi zimo zihlanganisa ukugqwala okuhambisana nokuthanda, ukucindezela kwegazi okuphezulu, ukuguga okungalungile kwemithambo yegazi (atherosclerosis), isifo sikashukela
Izici eziyingozi

Ngokuvamile, izimbangela ezingozi ze-dementia yezinzwa zifana nalezo ze-sickness yentliziyo kanye nokushaya kwesikhathi. Izimbangela ezingozi ze-dementia yezinzwa zihlanganisa:

  • Ukukhula komuntu. Ubungozi bakho be-dementia yezinzwa bukhula njengoba ukhula. Lesi sifo asivamile ngaphambi kweminyaka engama-65, futhi ubungozi bukhula kakhulu uma useneminyaka engama-90.
  • Umlando wokuhlaselwa yentliziyo, ukushaya kwesikhathi noma ukushaya kwesikhathi okuncane. Uma uke wahlushwa yisigameko sentliziyo, ungase ube sengozini enkulu yokuba nezinkinga zezinzwa zegazi ebuchosheni bakho. Ukonakala kobuchopho okwenzeka ngokushaya kwesikhathi noma ukushaya kwesikhathi okuncane (ukuhlaselwa okungapheli kwesikhashana) kungase kukhulise ubungozi bakho bokuthuthukisa i-dementia.
  • Ukuguga okungavamile kwezinzwa zegazi (atherosclerosis). Lesi simo senzeka lapho ama-deposits e-cholesterol nezinye izinto (ama-plaque) ekhahlela emithanjeni yakho futhi enciphise imithambo yakho yegazi. I-atherosclerosis ingakhuphula ubungozi bakho be-dementia yezinzwa ngokunciphisa ukugeleza kwegazi okondla ubuchopho bakho.
  • I-cholesterol ephezulu. Amazinga aphezulu e-lipoprotein ephansi (LDL), i-cholesterol "embi," ahlotshaniswa nobungozi obukhulu be-dementia yezinzwa.
  • Uxinzelelo lwegazi oluphezulu. Uma uxinzelelo lwakho lwegazi luphezulu kakhulu, lubekela uxinzelelo olukhulu emithanjeni yegazi yonke emzimbeni wakho, kuhlanganise nobuchopho bakho. Lokhu kukhuphula ubungozi bezinkinga zezinzwa zegazi ebuchosheni.
  • I-Diabetes. Amazinga aphezulu e-glucose abangela ukonakala emithanjeni yegazi kulo lonke umzimba wakho. Ukonakala emithanjeni yegazi yobuchopho kungakhuphula ubungozi bakho bokuhlaselwa yisikhathi ne-dementia yezinzwa.
  • Ukubhema. Ukubhema kwenza umonakalo ngqo emithanjeni yakho yegazi, kukhuphula ubungozi be-atherosclerosis nezinye izifo zokujikeleza kwegazi, kuhlanganise ne-dementia yezinzwa.
  • Ukukhuluphala. Ukuba ngumuntu omkhulu kuyimbangela ezaziwayo yengozi yezifo zezinzwa zegazi ngokuvamile, futhi ngakho-ke, cishe kukhuphula ubungozi bakho be-dementia yezinzwa.
  • I-Atrial fibrillation. Kulolu hlobo olungavamile lokubetha kwenhliziyo, amakamelo aphezulu enhliziyo yakho aqala ukubetha ngokushesha nangokungalingani, ngaphandle kokubambisana namakamelo aphansi enhliziyo yakho. I-Atrial fibrillation ikhuphula ubungozi bakho bokuhlaselwa yisikhathi ngoba ibangela ukwakheka kwama-blood clots enhliziyweni angaphula futhi aye emithanjeni yegazi yobuchopho.
Ukuvimbela

Impilo yezinsimbi zegazi ezingqondweni yakho ixhunyaniswe eduze nempilo yakho yonke yentliziyo. Ukuthatha la manyathelo ukuze ugcine inhliziyo yakho iphilile kungasiza futhi kunciphisa ingozi yakho yokuphazamiseka kwengqondo okuhambisana nezinsimbi zegazi:

  • Gcina uxinzelelo lwegazi luphilile. Ukugcina uxinzelelo lwegazi lwakho luqhele ngokujwayelekile kungasiza ukuvimbela kokubili ukuphazamiseka kwengqondo okuhambisana nezinsimbi zegazi kanye nesifo sika-Alzheimer.
  • Vimbela noma ulawule isifo sikashukela. Ukugwema ukuqala kwesifo sikashukela sohlobo 2, ngokudla nokuzivocavoca, kuyindlela enye enokwenzeka yokunciphisa ingozi yakho yokuphazamiseka kwengqondo. Uma usuvele unesifo sikashukela, ukulawula amazinga akho e-glucose kungasiza ukuvikela izinsimbi zegazi ezingqondweni yakho ekubhujisweni.
  • Yeka ukubhema. Ukubhema utshaba kulimaza izinsimbi zegazi yonke indawo emzimbeni wakho.
  • Thola ukuzivocavoca komzimba. Ukuzivocavoca komzimba okuvamile kufanele kube yingxenye ebalulekile yeqophelo lokuphila kwempilo yomuntu wonke. Ngaphezu kwazo zonke izinzuzo zalo, ukuzivocavoca kungakusiza ukugwema ukuphazamiseka kwengqondo okuhambisana nezinsimbi zegazi.
  • Gcina ikolesterol yakho ilawulwa. Ukudla okunempilo, okunemafutha aphansi kanye nezinambuzane zokunciphisa ikolesterol uma uzidinga kunganciphisa ingozi yokushaya kwesisu kanye nokushaya kwenhliziyo okungabangela ukuphazamiseka kwengqondo okuhambisana nezinsimbi zegazi, mhlawumbe ngokunciphisa inani leziqephu zokwakha ezakhiwa ngaphakathi kwe-arteries yengqondo yakho.
Ukuxilongwa

Odokote cishe bajabona ukuthi unedimentia, kodwa ayikho ivivi eliqondile eliqinisekisa ukuthi une-dementia ye-vascular. Udokotela wakho uzokwenza isahlulelo sokuthi i-dementia ye-vascular ingumsuka onamandla kakhulu wemizimba yakho ngokusekelwe kolwazi olukuphethayo, umlando wakho wezokwelapha we-stroke noma izifo ze-heart nemiphunga, kanye nemiphumela yezilingo ezingasiza ekuchazeni ukuxilongwa kwakho.

Uma irekhodi lakho lezokwelapha lingahlanganisi amanani amasha ezibonakaliso eziyinhloko zempilo yentliziyo yakho nemiphunga, udokotela wakho uzohlola:

Ungase futhi alayishe izivivinyo ukuze akhiphe ezinye izimbangela ezingaba khona zokulahleka kwenkumbulo nokudideka, njengokuthi:

Udokotela wakho cishe uzohlola impilo yakho yonke ye-neurological ngokuhlola:

Amaphethini engqondo yakho angabonisa ukungapheleli okubonakalayo okubangelwa yi-stroke, izifo zemiphunga, iziphumu noma ukulimala okungabangela ukushintsha ekucabangeni nasekuqondeni. Ucwaningo lwe-brain-imaging lungasiza udokotela wakho ukuba aqonde izimbangela ezivame kakhulu zemizimba yakho futhi akhiphe ezinye izimbangela.

Izindlela ze-brain-imaging udokotela wakho angase azincoma ukuze usize ukuxilonga i-dementia ye-vascular zihlanganisa:

Magnetic resonance imaging (MRI). I-Magnetic resonance imaging (MRI) isebenzisa amaza erediyo kanye nendlela enamandla ye-magnetic ukukhiqiza izithombe ezinemininingwane yengqondo yakho. Ulela etafuleni elilukhuni eliya etafuleni le-tube-shaped MRI machine, eliyenza imisindo emikhulu yokushaya ngenkathi likhiqiza izithombe.

I-MRI ayinabhlungu, kodwa abanye abantu bazizwa bevaleleke ngaphakathi komshini futhi baphazanyiswa yimisindo. I-MRI ngokuvamile iyivivinyo elihehayo lokufana ngoba i-MRI inganikeza imininingwane engaphezulu kunokuhlola kwe-computed tomography (CT) mayelana ne-stroke, i-ministroke kanye nokungahambi kahle kwemiphunga futhi iyivivinyo lokukhetha lokuhlola i-dementia ye-vascular.

Computerized tomography (CT) scan. Nge-CT scan, uzolela etafuleni elilukhuni eliya ekhamera encane. I-X-rays idlula emzimbeni wakho ngezindlela ezahlukene, futhi ikhompyutha isebenzisa lolu lwazi ukudala izithombe ezinemininingwane eziqhelelene (izlice) zengqondo yakho.

I-CT scan inganikeza ulwazi mayelana nesakhiwo sengqondo yakho; ukutshela ukuthi yiziphi izindawo ezibonisa ukunciphisa; nokubona ubufakazi be-stroke, i-ministroke (izimpawu ezithambekele ekuhlukaniseni), ukushintsha kwemiphunga noma isiphumu.

Lolu hlobo lokuhlola luhlola ikhono lakho lokwenza:

Izivivinyo ze-Neuropsychological ngezinye izikhathi zibonisa imiphumela eqondile kubantu abanezinhlangothi ezahlukene ze-dementia. Abantu abane-dementia ye-vascular bangase babe nobunzima obukhulu ekuhlaziyeni inkinga nasekuthuthukiseni isisombululo esisebenzayo.

Bangase bangabi namandla okufunda ulwazi olusha nokukhumbula kunabantu abane-dementia ngenxa yesifo se-Alzheimer ngaphandle uma izinkinga zabo zemiphunga zithinta izindawo ezithile zengqondo ezibalulekile ekukhumbula. Noma kunjalo, ngokuvamile kunokuhlanganiswa okukhulu kwemiphumela yokuhlola kubantu abane-dementia ye-vascular kanye nabantu abanezinhlangothi zengqondo zesifo se-Alzheimer.

Nakuba kunokuqaphela okukhulu ekuhlukaniseni i-dementia ye-Alzheimer ne-dementia ye-vascular, kuvela ukuthi ngokuvamile kunokuhlanganiswa okukhulu. Abantu abaningi abaxilongwe nge-dementia ye-Alzheimer banezingxenye ze-vascular futhi ngokufanayo abantu abaningi abane-dementia ye-vascular banezinga elithile le-Alzheimer ehlangene ezinguqondweni zabo.

  • Uxinzelelo lwegazi

  • I-Cholesterol

  • I-Sugar yegazi

  • Izifo ze-Thyroid

  • Ukungabi nazinto ezibalulekile

  • I-Reflexes

  • I-Muscle tone namandla, nokuthi amandla ngakwesinye uhlangothi lomzimba wakho aqhathaniswa kanjani nohlangothi olunye

  • Ikhono lokukhuphuka esihlalweni nokuphambuka phezulu

  • Ukuzwa nokuqonda

  • Ukuhlanganiswa

  • Ukulinganisela

  • Magnetic resonance imaging (MRI). I-Magnetic resonance imaging (MRI) isebenzisa amaza erediyo kanye nendlela enamandla ye-magnetic ukukhiqiza izithombe ezinemininingwane yengqondo yakho. Ulela etafuleni elilukhuni eliya etafuleni le-tube-shaped MRI machine, eliyenza imisindo emikhulu yokushaya ngenkathi likhiqiza izithombe.

    I-MRI ayinabhlungu, kodwa abanye abantu bazizwa bevaleleke ngaphakathi komshini futhi baphazanyiswa yimisindo. I-MRI ngokuvamile iyivivinyo elihehayo lokufana ngoba i-MRI inganikeza imininingwane engaphezulu kunokuhlola kwe-computed tomography (CT) mayelana ne-stroke, i-ministroke kanye nokungahambi kahle kwemiphunga futhi iyivivinyo lokukhetha lokuhlola i-dementia ye-vascular.

  • Computerized tomography (CT) scan. Nge-CT scan, uzolela etafuleni elilukhuni eliya ekhamera encane. I-X-rays idlula emzimbeni wakho ngezindlela ezahlukene, futhi ikhompyutha isebenzisa lolu lwazi ukudala izithombe ezinemininingwane eziqhelelene (izlice) zengqondo yakho.

    I-CT scan inganikeza ulwazi mayelana nesakhiwo sengqondo yakho; ukutshela ukuthi yiziphi izindawo ezibonisa ukunciphisa; nokubona ubufakazi be-stroke, i-ministroke (izimpawu ezithambekele ekuhlukaniseni), ukushintsha kwemiphunga noma isiphumu.

  • Ukukhuluma, ukubhala nokuqonda ulimi

  • Ukusebenza ngeminombolo

  • Ukufunda nokukhumbula ulwazi

  • Ukuthuthukisa uhlelo lokuhlaselwa nokuxazulula inkinga

  • Ukusebenza kahle ezimweni ezingacabangiwe

Ukwelashwa

Ukuphathwa kuvame ukugxila ekulawuleni izimo zezempilo nezingozi ezifaka isandla ekubeni yi-dementia ye-vascular.

Ukulawula izimo ezithinta impilo yomzimba yenhliziyo yakho nemiphunga yegazi kwangathi kungathomalalisa izinga lokuba yi-dementia ye-vascular ebiyelayo, futhi kwangathi kungavimbela nokwehla okwengeziwe. Ngokuya ngesimo sakho, udokotela wakho angase anikeze imithi yokwenza okulandelayo:

  • Ukuncipha kwegazi lakho
  • Ukuncipha kwezinga le-cholesterol yakho
  • Ukuvimbela igazi lakho ukuthi lingabambi futhi ugcine imithambo yakho ihlanzekile
  • Ukusiza ukulawula ushukela wakho wegazi uma une-diabetes
Ukuzinakekela

Nakuba lokhu kungabonakali ukuthi kushintsha inkambo yesifo se-vascular dementia, udokotela wakho cishe uzokuncoma ukuba u:

  • Uhlanganyele emisebenzini yomzimba eqondile njalo
  • Udla ukudla okunempilo
  • Uzama ukugcina isisindo sakho siqondile
  • Uhlanganyele emisebenzini yomphakathi
  • Uqeqeshe ubuchopho bakho ngemidlalo, ama-puzzle nemisebenzi emisha, njengokufunda amakilasi ezobuciko noma ukulalela umculo omusha
  • Ulinganise ukusetshenziswa kotshwala
Ukulungiselela ukuqokwa kwakho

Uma ungeneka isifo sokuqhaqhazela, ingxoxo yakho yokuqala ngezimpawu zakho nokubuyiselwa kwempilo cishe izoqala esibhedlela. Uma uqaphela izimpawu ezincane, ungase unqume ukuthi ufuna ukukhuluma nodokotela wakho ngezinguquko ekuqondeni kwakho, noma ungase ufune ukunakekelwa ngokucindezelwa kolwemi wakho oluhlela isikhathi sakho sokuhlangana futhi luhambe nawe.\n\nUngase uqale ukubona udokotela wakho oyinhloko, kodwa cishe uzokudlulisa kudockotela oqeqeshwe ezinkingeni zobuchopho nesistimu yezinzwa (neurologist).\n\nNgenxa yokuthi isikhathi sokuhlangana singaba mfushane, futhi kuvame ukuba khona okuningi okufanele kuhlanganiswe, kuyinto enhle ukulungiselela kahle isikhathi sakho sokuhlangana. Nansi imininingwane ezokusiza ukulungiselela nokubona ukuthi yini ongayilindela odokotela wakho.\n\nUkubhala uhlu lwemibuzo ngaphambi kwesikhathi kungakusiza ukukhumbula ukukhathazeka kwakho okukhulu futhi kukuvumele ukwenza okuningi ngesikhathi sakho sokuhlangana. Uma ubona udokotela wakho ngenxa yokukhathazeka ngokulahlekelwa kukhono lokucabanga ngenxa yezinkinga zegazi, ezinye zemibuzo okufanele uyibuze zifaka:\n\nNgaphezu kwemibuzo oyilungiselele ngaphambi kwesikhathi, ungangabazi ukubuza udokotela wakho ukucacisa noma yini ongayiqondi.\n\nUdokotela wakho cishe uzobuza nemibuzo kuwe. Ukulungela ukuphendula kungakhulula isikhathi sokuqondisa noma yimaphi amaphuzu ofuna ukukhuluma ngawo ngokujulile. Udokotela wakho angase abuze:\n\n* Qaphela noma yimaphi amazinga okulinganiselwe ngaphambi kokuthi uhlangane nodokotela. Uma wenza isikhathi sakho sokuhlangana, buza ukuthi udinga yini ukuzila ukudla ukuze wenze izivivinyo zegazi noma uma udinga ukwenza noma yini enye ukulungiselela izivivinyo zokuxilonga.\n* Bhala zonke izimpawu zakho. Udokotela wakho uzofuna ukwazi imininingwane mayelana nalokho okubangela ukukhathazeka kwakho ngekhono lakho lokuhumusha noma umsebenzi wengqondo. Yenza amaphuzu mayelana namanye ezinye izibonelo ezibalulekile zokukhohlwa, ukwahlulela okubi noma ezinye izinto ongafuni ukuzikhuluma. Zama ukukhumbula ukuthi uqale nini ukucela ukuthi kukhona okungahambi kahle. Uma ucabanga ukuthi ubunzima bakho buya bukhulu, lungela ukuchaza.\n* Thatha umuntu wasekhaya noma umngani, uma kungenzeka. Ukuqinisekiswa komuntu wasekhaya noma umngani othembekile kungadlala indima ebalulekile ekuqinisekiseni ukuthi ubunzima bakho bubonakala kwabanye. Ukuba nomuntu ongahamba nawe kungakusiza futhi ukukhumbula yonke imininingwane enikeziwe ngesikhathi sokuhlangana kwakho.\n* Yenza uhlu lwezinye izimo zakho zokwelapha. Udokotela wakho uzofuna ukwazi ukuthi ngokuqondene yini okwelashwa ngayo ngokugula kweswekile, igazi eliphezulu, isifo senhliziyo, ukuqhaqhazela kwangaphambili noma ezinye izimo.\n* Yenza uhlu lwawo wonke amaphilisi akho, kufaka phakathi amaphilisi athengiswa ngaphandle komthetho kanye neevithamini noma izongezelelo.\n\n* Ucabanga ukuthi nginamahloni ekukhumbula?\n* Ucabanga ukuthi izimpawu zami zibangelwa yizinkinga zokujikeleza ebuchophweni bami?\n* Yiziphi izivivinyo engizidingayo?\n* Uma ngina-vascular dementia, wena noma omunye udokotela uzophatha ukunakekelwa kwami okuqhubekayo? Ungangisiza ngithole uhlelo olubekwe ukuze ngisebenze nabadokotela bami bonke?\n* Yiziphi izindlela zokwelapha ezitholakalayo?\n* Ingabe kukhona engingakwenza okungasiza ukunciphisa ukwanda kwesifo sokulahlekelwa kukhono lokucabanga?\n* Ingabe kukhona ukuhlolwa kwezokwelapha kwezindlela zokwelapha ezilingwayo engingakufanele ngikuthathele?\n* Yini engingayilindela ukuba yenzeke esikhathini eside? Yiziphi izinyathelo engidinga ukuzithatha ukulungiselela?\n* Ingabe izimpawu zami zizothinta indlela engiphatha ngayo ezinye izimo zami zempilo?\n* Ingabe unamabhukwana noma ezinye izinto ezinyathelisiwe engingazithatha ekhaya nami? Yimaphi amawebhusayithi namathuluzi wokusekela oncomayo?\n\n* Yiziphi izinhlobo zezinkinga zokucabanga nokulahlekelwa kukhono lokuhumusha okunazo? Uqale nini ukuzazi?\n* Ingabe ziya ziba zimbi, noma ngezinye izikhathi zihamba kahle futhi ngezinye izikhathi zibe zimbi? Ingabe ziye zaba zimbi ngokuzumayo?\n* Ingabe kukhona osondelene nawe okubonise ukukhathazeka ngokucabanga kwakho nokuqonda kwakho?\n* Ingabe uqale ukuba nezinkinga nanoma yimiphi imisebenzi noma izinto ozithandayo isikhathi eside?\n* Ingabe uzizwa udabukile noma ukhathazekile kunokujwayelekile?\n* Ingabe ulahlekile muva nje endleleni yokushayela noma esimweni esivamile kuwe?\n* Ingabe uqaphele noma yiziphi izinguquko endleleni opendula ngayo kubantu noma izehlakalo?\n* Ingabe unenguquko ezingeni lakho lamandla?\n* Ingabe ngokuqondene yini okwelashwa ngayo ngegazi eliphezulu, ikholestrol eliphezulu, isifo sikashukela, isifo senhliziyo noma ukuqhaqhazela? Ingabe uke welashwa nganoma yikuphi kulawa ngaphambili?\n* Yiziphi izidakamizwa, amavithamini noma izongezelelo ozithathayo?\n* Ingabe uphuza utshwala noma ukhwetha? Zingakanani?\n* Ingabe uqaphele noma yikuphi ukuthuthumela noma ukungakwazi ukuhamba?\n* Ingabe unezinkinga zokukhumbula isikhathi sakho sokuhlangana nodokotela noma isikhathi sokuthatha amaphilisi akho?\n* Ingabe uke wahlolwa ukuzwa noku bona kwakho muva nje?\n* Ingabe kukhona omunye emndenini wakho okade enezinkinga zokucabanga noma ukukhumbula izinto njengoba bekhula? Ingabe kukhona okade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona 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owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ekhona owayekade ek

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