Is my husband's behavior due to vascular dementia or bi-polar disorder?

Barbara1 asked...

How do I know when my husband is having a bi-polar moment or if it's vascular dementia? Is it paranoia from his bi-polar that is popping up with new endings to previous senerios (of years past) or if it's vascular dementia from his diabetes, stroke two yrs ago and his heart attack from six years ago?

He lives in a state of depression and is on bi-polar medcations that help. His diabetes is under control, but this new thing of his is confusing me. He seems to live in his head, creating new senerios and it's me he is verbally accusing. This has happen three times now and it's mind boggling.
It's an unfair fight and I can't fight with him (as his wife) on this new level of his. Last night when he was thinking straight, I was able to get him to understand that what goes on in his head is him making himself a victim of his own mental creations and he only hurts others when he speaks these new perceptions to me or anyone else. But in the heat of his anger and self-righteousness, I can't get him to understand.

He isn't diagnosed with vascular dementia, but our daughter who is a nurse wants me to contact his VA doctor and discuss it. He has taken to changing past memories endings to what he believes really happen. 1+1 now equals a different 2.

What I have read today, online, sure helps in thinking this new thing he is doing, as in changing endings and demanding I admit to them, is vascular dementia. I really need help with this. So any input is welcomed.

Expert Answer

Ladislav Volicer, M.D., Ph.D., is recognized as an international expert on advanced dementia care. He is a courtesy full professor at the School of Aging Studies, University of South Florida, Tampa, and visiting professor at the Third Medical Faculty, Charles University, Prague, Czech Republic. Twenty-five years ago, he established one of the first dementia special care units.

It is not possible to tell apart bipolar disorder and vascular dementia on the basis of information that your provided. If your husband had vascular dementia, he would most likely have other deficits of cognitive function (short term memory, orientation, judgement) in addition to some delusions. You definitely need to take him to his VA doctor for examination and possible medication adjustments.