Vascular dementia is a decline in memory and thinking skills caused by problems that reduce blood flow to the brain. A stroke or a series of ministrokes can cause vascular dementia. It can also stem from gradual damage to your blood vessels from other health conditions, such as diabetes or high blood pressure. Or vascular dementia can be caused by a combination of factors.
UPMC neurology experts provide advanced care for people with vascular dementia, including medications and lifestyle changes to help manage symptoms.
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What Is Vascular Dementia?
Vascular dementia is a decline in memory and thinking skills caused by problems that reduce blood flow to the brain. A stroke or a series of ministrokes can cause vascular dementia. It can also stem from gradual damage to your blood vessels from other health conditions, such as diabetes or high blood pressure. Or vascular dementia can be caused by a combination of factors.
How serious is vascular dementia?
Vascular dementia is a serious condition caused by damage to your brain. It causes memory and cognitive problems that worsen over time and may eventually lead to loss of independence.
What are the types of vascular dementia?
There are several types of vascular dementia, including:
- Mixed dementia — A condition in which a person has more than one type of dementia at the same time, affecting at least 1 in 10 people with dementia. It is diagnosed when doctors see clear signs of two or more dementia types, including Alzheimer's, which happens mainly in older adults.
- Multi-infarct dementia — Happens when someone has a series of small strokes. If the strokes affect both sides of the brain, the risk for dementia is higher. Sometimes people don't even realize they've had mini-strokes.
- Post-stroke dementia — Occurs in the weeks or months after having a major stroke. Not everyone who has a stroke will get this type of dementia.
- Subcortical vascular dementia — Involves damage to the small blood vessels and nerves that make up white matter in the brain. People who have this type often have high blood pressure, a history of stroke, or blood vessel disease that affects the carotid arteries in the neck.
How common is vascular dementia?
According to the National Institute on Aging, vascular dementia is the second most common type of dementia after Alzheimer’s disease.
However, only about 5% to 10% of people with dementia have vascular dementia alone. It's more likely that you will develop vascular dementia along with Alzheimer's disease. Both diseases share many symptoms.
What causes vascular dementia?
Vascular dementia happens when blocked or narrowed blood vessels cause reduced blood flow to your brain. Whether from a stroke, ministrokes, blood vessel damage, or a combination of issues, blocked or narrowed blood vessels rob your brain of oxygen-rich blood. When your brain doesn’t get enough oxygen-rich blood, brain cells die, causing permanent damage to your brain cells over time.
What can trigger vascular dementia?
Conditions that may trigger vascular dementia include:
- A single stroke — Happens when the blood supply to your brain suddenly becomes blocked.
- A series of small, sometimes undetected ministrokes — Transient ischemic attacks (TIAs) can cause widespread damage to your brain.
- Chronic conditions, such as diabetes and high blood pressure — Chronic conditions can damage blood vessels and reduce blood flow to the brain.
Vascular dementia risk factors
Risk factors for vascular dementia include:
- Age — Most people with vascular dementia are over 65.
- Cardiovascular disease — Hardening of the arteries, known as atherosclerosis, high cholesterol, and high blood pressure can cause narrowing and damage to arteries that reduces blood flow.
- Diabetes — Uncontrolled diabetes damages blood vessels, which may reduce blood supply to the brain.
- Obesity — Being overweight leads to heart and blood vessel problems, including high blood pressure.
- Smoking and heavy alcohol use — Increases your risk of cardiovascular disease and stroke.
Complications of vascular dementia
Complications of vascular dementia may include:
- Heart disease.
- Loss of ability to care for oneself.
- Loss of ability to communicate.
- Pneumonia.
- Pressure sores.
- Skin infections.
- Strokes.
- Urinary tract infections.
How can I prevent vascular dementia?
It's not possible to prevent every type of dementia, but your lifestyle can play a role in whether you'll get vascular dementia. Keeping your heart and blood vessels as healthy as possible may help prevent conditions that cause vascular dementia.
To reduce your risk of vascular dementia:
- Control your blood pressure.
- Eat a well-balanced, heart-healthy diet.
- Keep diabetes under control.
- Maintain a healthy weight.
- Quit smoking.
What Are the Signs and Symptoms of Vascular Dementia?
Many symptoms of vascular dementia, including memory loss, mimic the symptoms of Alzheimer's disease. Memory loss may depend on what part of the brain was damaged.
Symptoms of vascular dementia may come on more quickly than symptoms of Alzheimer's, especially if someone had a major stroke. The first signs of vascular dementia may include problems with memory, decision-making, and thinking.
Common symptoms of vascular dementia include:
- Behavior (aggression or agitation) that seems out of character.
- Depression or apathy.
- Disturbed sleep patterns.
- Feeling anxious.
- Feeling lost or confused.
- Inability to follow instructions.
- Issues with balance and walking.
- Lack of facial expression.
- Loss of bladder control.
- Numbness or paralysis on one side of the face or body.
- Personality changes.
- Problems concentrating.
- Problems with language and memory.
- Rapid mood swings.
- Slowness of thought.
- Stroke symptoms, such as a sudden headache.
- Trouble making decisions.
When should I see a doctor about my vascular dementia symptoms?
If you have symptoms of any type of dementia, you should schedule an appointment with your doctor right away. Your doctor may refer you to a neurologist who specializes in diagnosing and managing different types of dementia.
How Do You Diagnose Vascular Dementia?
It's crucial to have an expert diagnosis for any type of dementia. Diagnosing vascular dementiais complex because symptoms may be similar to other types of dementia. Sometimes, a person will have more than one type of dementia at a time (mixed dementia).
To diagnose vascular dementia, your doctor will perform physical and neurological examinations and review your symptoms and medical history — including any history of stroke, high blood pressure, or other cardiovascular diseases. Your doctor may also order tests to confirm your diagnosis or rule out other problems.
What to expect during your visit
During your visit, your doctor will:
- Ask you about your symptoms.
- Order tests.
- Perform a physical and neurological exam.
- Review your medical history.
Tests to diagnose vascular dementia
There's no conclusive test to diagnose vascular dementia.
However, your doctor may order tests to provide information or rule out other problems, including:
- Blood tests — Checks for abnormalities and rules out other conditions.
- Cerebral spinal fluid analysis (spinal tap or lumbar puncture) — Involves inserting a needle into your lower back to collect a sample of cerebrospinal fluid (CSF) for analysis in a lab. Done most to confirm a mixed dementia diagnosis.
- Magnetic resonance imaging (MRI) — Creates images of your brain using contrast dye to look for damaged or abnormal areas.
- Neurological examination — A noninvasive test to check your reflexes, balance, movement, memory, and ability to think.
- Neuropsychological examination — Checks your ability to think, reason, and remember.
Vascular dementia prognosis
There is no cure for vascular dementia, and there is no way to reverse brain cell damage that has already occurred. Symptoms of vascular dementia get worse over time, but some people may experience short periods of temporary improvement. The rate at which the disease progresses varies from person to person.
How long does someone usually live with vascular dementia?
On average, a person lives about five years after symptoms start. Someone with vascular dementia is most likely to die from a stroke or heart attack.
How Do You Treat Vascular Dementia?
Although vascular dementia on its own is not considered to be neurodegenerative (gets progressively worse), there's no cure for it and no way to reverse brain cell damage once it has already occurred. Because vascular dementia is due to underlying medical conditions, care for it focuses on treating and managing the underlying cause(s).
Treatment options for managing the underlying causes of vascular dementia and slowing its progression may include:
Medication
Medication to treat high blood pressure, cholesterol, and diabetes may help slow down brain cell damage.
Doctors may prescribe aspirin or blood thinners to reduce the chances of blood clots. Do not take aspirin without checking with your doctor.
Doctors don't use Alzheimer's medicines to treat vascular dementia, but they may use these drugs for people who have mixed dementia diagnoses.
Lifestyle changes
Lifestyle changes may reduce your risk of a second stroke or stabilize your vascular dementia.
Your doctor may recommend:
- Cutting out or limiting alcohol.
- Eating a heart-healthy diet.
- Losing weight.
- Quitting smoking.
- Removing safety hazards in your home.
- Starting a mild exercise routine (like walking).
- Sticking to a daily routine.
Other treatments for vascular dementia
Occupational and physical therapy may help manage the symptoms of vascular dementia. They can also help you stay active and mobile as long as possible.
Why Choose UPMC for Vascular Dementia Care?
When you choose UPMC for vascular dementia care, you will receive:
- Multidisciplinary care — Our team of dementia experts will work with you and your loved ones to develop a customized treatment plan that optimizes your quality of life and reduces your risk of complications.
- Access to advanced clinical trials — Our team participates in national, multicenter clinical trials evaluating new treatment options, giving you the opportunity to contribute to research advancing dementia care.
- Seamless, ongoing treatment — If you are diagnosed with vascular dementia, our team will develop a plan for your follow-up care, including ongoing symptom management and long-term care planning, as needed.
