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Vascular Dementia

What is Vascular Dementia?

Vascular dementia is a decline in memory and thinking skills caused by reduced blood flow to the brain.

It often occurs after a stroke but may also happen after several mini-strokes. It can also stem from gradual damage to the blood vessels from diabetes or high blood pressure.

Only about 5% to 10% of people with dementia have vascular dementia alone. It's more likely that someone has vascular dementia with Alzheimer's. Both diseases share many symptoms.

Types of vascular dementia

Vascular dementia (also called “vascular cognitive impairment") can take several forms.

  • Post-stroke dementia occurs in the weeks or months after having a major stroke. But not everyone who has a stroke will get this type.
  • 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 realize they've had mini-strokes.
  • 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 of the neck.

Vascular dementia causes

Vascular dementia happens when something hinders blood flow to the brain. The blood vessels get blocked or become narrow.

When the brain cells don't have blood, there is permanent damage.

Causes of vascular dementia include:

  • A single stroke, where there's a sudden block of blood supply to the brain.
  • A series of small, sometimes undetected “mini-strokes." Transient ischemic attacks (TIA) can cause widespread damage to the brain.
  • Chronic conditions, such as diabetes and high blood pressure. These ailments can damage blood vessels and reduce blood flow to the brain.

Vascular dementia risk factors and complications

Some risk factors for vascular dementia are:

  • Age. Most people are over 65.
  • Ethnicity. African-Americans and Hispanics have a higher rate of all types of dementia.
  • Diabetes. Chronic diabetes damages blood vessels, cutting off blood supply to the brain.
  • Hardening of the arteries.
  • High blood pressure.
  • Obesity. Being overweight leads to heart and blood vessel problems, including high blood pressure.
  • High cholesterol.
  • Smoking.
  • Heavy alcohol use.

Complications of vascular dementia include:

  • Loss of ability to communicate.
  • Loss of ability to care for oneself.
  • Strokes.
  • Heart disease.
  • Pneumonia.
  • Urinary tract infections.
  • Skin infections.
  • Pressure sores.

How to 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 is a good start.

To reduce your risk of vascular dementia:

  • Stay at a healthy weight.
  • Quit smoking.
  • Control your blood pressure.
  • Keep diabetes under control.
  • Eat a well-balanced, heart-healthy diet.

Vascular Dementia Symptoms and Diagnosis

Many symptoms of vascular dementia, including memory loss, mimic Alzheimer's disease. Memory loss may depend on what part of the brain suffered damage.

Symptoms of vascular dementia may come on more quickly than those of Alzheimer's. That's especially true if someone had a major stroke.

Common symptoms of vascular dementia include:

  • Problems with language and memory.
  • Trouble making decisions.
  • Slowness of thought.
  • Problems concentrating.
  • Rapid mood swings.
  • Personality changes.
  • Inability to follow instructions.
  • Feeling lost or confused.
  • Issues with balance and walking.
  • Lack of facial expression.
  • Stroke symptoms, such as a sudden headache.
  • Numbness or paralysis on one side of the face or body.
  • Depression, apathy.
  • Feeling anxious.
  • Loss of bladder control.
  • Behavior (aggression, agitation) that seems out of character.
  • Disturbed sleep patterns.

Diagnosing vascular dementia

There isn't one single test to diagnose vascular dementia.

To narrow down a diagnosis, you or your loved one's doctor may:

  • Take a full medical history.
  • Conduct a complete physical exam.
  • Note history of strokes, high blood pressure, or other signs of heart or vein disease.
  • Assess mental sharpness with written and digital questions and tests.
  • Order brain scans (MRI, CT) to look for changes in the brain.

Vascular Dementia Treatment

There's no cure for vascular dementia. Any destruction of brain cells is permanent.

Treatment aims at the underlying cause of vascular dementia. At best, treatment can slow down the progression of the disease.

Medicine

Medicine 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 them for people who have both diseases.

Lifestyle changes

Preventing having another stroke may help slow down the progression of vascular dementia.

Your doctor may suggest that you or your loved one:

  • Quit smoking.
  • Start a mild exercise routine (like walking).
  • Lose weight.
  • Eat a heart-healthy diet.
  • Cut out or cut down on alcohol.
  • Remove safety hazards in the home.
  • Stick to a 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.

Vascular dementia prognosis/survival rate

There's no cure for vascular dementia at the current time.

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.