Brief Answer:
part of the Classic presentation

Detailed Answer:
Thank you for asking!
I want you to know that lack of energy, apathy and always sleepy is a part of its classic presentation. here is how it presents
Vascular dementia is the second most common form of dementia after Alzheimer disease (AD). The condition is not a single disease; it is a group of syndromes relating to different vascular mechanisms. Vascular dementia is preventable; therefore, early detection and an accurate diagnosis are important.Risk factors for vascular dementia include hypertension, smoking, hypercholesterolemia, diabetes mellitus, and cardiovascular and cerebrovascular disease.Vascular dementia development after stroke can be influenced by many factors. Some of the important factors that can lead to the development of dementia are older age, lower education level, family history of dementia, left-sided lesions, larger lesions, larger periventricular white matter ischemic lesions, and strokes in thalamic artery territory, inferomedian temporal lobes, hippocampus, and watershed infarcts involving superior frontal and parietal regions

Patients who have had a stroke are at increased risk for vascular dementia. Recently, vascular lesions have been thought to play a role in AD.

Your husband needs management for this vascular dementia.The mainstay of management of vascular dementia is the prevention of new strokes. This includes administering antiplatelet drugs and controlling major vascular risk factors. Aspirin has also been found to slow the progression of vascular dementia.

Drug treatment is primarily used to prevent further worsening of vascular dementia by treating the underlying disease such as hypertension, hyperlipidemia, and diabetes mellitus. Antiplatelet agents are indicated.

Pentoxifylline and, to a more limited extent, ergoloid mesylates (Hydergine), may be useful for increasing cerebral blood flow. It has been proved useful.

Neuroprotective drugs such as nimodipine, propentofylline, and posatirelin are currently shown to be useful for vascular dementia. Nicardipine has been shown to decrease in cognitive deterioration in patients with cerebrovascular disease.

The general management of dementia includes appropriate referral to community services, judgment and decision-making regarding legal and ethical issues (eg, driving, competency, advance directives), and consideration of caregiver stress.

Agitation and psychosis are common in older adults with dementia and are challenging to manage. use of antidepressants for the treatment of agitation and psychosis in dementia; like the selective serotonin reuptake inhibitors (SSRIs) sertraline and citalopram are proved helpful.

In the Rotterdam study, an increased risk of vascular dementia was associated with total fat intake, whereas fish consumption was inversely related to dementia.
Low levels of folate, vitamin B-6, and vitamin B-12 are associated with increased homocysteine levels, a risk factor for stroke.

I hope you get the essence of care here. You need to consult his neurologist and stay in touch with them for the better management.

Take good care of your husband.Don't forget to close the discussion please.
May the odds be ever in your favour.
Regards
S Khan

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