Vascular Dementia
What is Vascular Dementia?
Vascular dementia is a type of dementia that is caused by damage to the blood vessels in the brain, which can result in a gradual decline in cognitive function. It occurs when the brain does not receive enough blood or oxygen, leading to the death of brain cells.
Vascular dementia can occur as a result of several different conditions that affect the blood vessels in the brain. The most common cause of vascular dementia is stroke, which occurs when blood flow to the brain is interrupted, leading to the death of brain cells. Other conditions that can cause vascular dementia include high blood pressure, diabetes, and atherosclerosis, which is the hardening and narrowing of the arteries.
There is no cure for vascular dementia, but there are treatments available that can help manage the symptoms and slow the progression of the disease. These treatments include medications to manage high blood pressure or diabetes, as well as medications to manage the symptoms of dementia, such as cholinesterase inhibitors.
Brain cell damage due to lack of blood supply causes symptoms of dementia such as problems with executive brain function and memory, and interferes with the patient’s ability to perform everyday activities.
Depending upon the location of blockage in the brain, vascular dementia can present different symptoms and can mimic other dementias including Alzheimer’s disease dementia.
Symptoms
The symptoms of vascular dementia can vary depending on the location and severity of the damage to the brain. However, common symptoms include memory loss, difficulty with planning and decision-making, impaired judgment, and problems with language and communication. Some individuals with vascular dementia may also experience changes in mood or behavior, such as apathy or depression.
Signs and symptoms of vascular dementia may include:
- Memory loss or impairment, such as difficulty remembering names, dates, events, appointments and details of conversations.
- Difficulty concentrating, planning or developing an appropriate solution to a problem.
- Problems with completing tasks in a timely and efficient manner at home or at work.
- Confusion or disorientation with details of place, situation or the passage of time.
- Visuo-spatial difficulties, such as unsteady gait, geographical disorientation with driving, problems judging specific distances, or losing/misplacing items around the home.
- Language difficulties, such as word-finding problems, constricted/limited vocabulary or changes in the fluency of speech or writing.
- Demonstrating compromised reasoning or judgment in decision-making.
- Withdrawal from work or social activity, increased apathy and decreased interest in social engagements or events.
- Changes in mood , personality or behavior including signs of depression, apathy and anxiety.
- Difficulty controlling urination or increased need to pass urine.
Causes
Stroke: Vascular dementia due to stroke (also called post-stroke dementia) can occur because of a blood clot in an artery to the brain. This is not always the case but vascular dementia symptoms are immediately noticeable if they to develop after stroke. The onset of vascular dementia depends on the location and severity of the stroke in the brain and how long the brain was without oxygen due to lack of normal blood flow.
Patients experiencing a series of strokes or mini-strokes (transient ischemic attack or TIA) have increased risk of vascular dementia with each occurrence, and experience distinct declines in brain function, which is distinguishable from the gradual cognitive decline associated with Alzheimer’s disease dementia.
Hydrocephalus: Other conditions can also cause vascular dementia including normal pressure hydrocephalus. The increased pressure due to CSF fluid build up in the brain restricts blood circulation and can cause damage to blood vessels. Vascular dementia due to hydrocephalus is reversible with the drainage of excess fluid from the brain ventricles.
Blood vessel damage: Narrow or damaged blood vessels restricting oxygen and nutrient delivery to the brain can cause vascular dementia to develop. Conditions associated with blood vessel damage includes aging, high blood pressure, abnormal aging of blood vessels (atherosclerosis), diabetes, and brain hemorrhage.
Risk Factors
Vascular dementia is influenced by the same risk factors as heart disease and stroke. The risk of vascular dementia increases with several factors:
- Age. Risk increases from the age of 65 onwards
- Stroke and heart attack. Blood vessel damage due to history of stroke, TIA or heart attack increases the risk of developing vascular dementia
- Atrial fibrillation is a heart condition that has an increased risk of stroke
- Atherosclerosis involves the build up of deposits such as cholesterol on blood vessel walls and restricts blood flow to the brain
- High LDL cholesterol increases risk of vascular dementia
- High blood pressure causes increased pressure in blood vessels including in the brain leading to increased risk of vascular issues such as stroke
- Diabetes causes damage to brain blood vessels
- Smoking causes damage to brain blood vessels
- Obesity has an increased risk of vascular issues such as stroke
Prevention & Treatment
Preventing or managing the underlying conditions that can cause vascular dementia, such as high blood pressure and diabetes, can also help reduce the risk of developing this condition. It is important to work closely with a healthcare professional to develop an appropriate treatment plan for vascular dementia, as early detection and treatment can help individuals maintain their quality of life for as long as possible.
Incorporating changes in lifestyle for overall heart health substantially reduce the risk of vascular dementia.
- Quit smoking
- Eat a healthy diet that is low in salt and sugar
- Keep a healthy weight
- Exercise regularly
- Limit alcohol intake
- See your doctor regularly to keep the following in check:
- Blood pressure
- Cholesterol
- Diabetes
Treatment of vascular dementia varies widely and is entirely dependent on the underlying cause and co-existing medical conditions.
