What is vascular dementia?
Similar to Alzheimer’s disease, vascular dementia is a type of dementia caused by reduced blood flow to the brain, which damages and eventually kills brain cells. It is generally considered the second most common subtype of dementia, which is an umbrella term used to describe a group of conditions characterized by memory loss and judgment. The most pronounced symptom identifying vascular dementia is when drastic changes occur immediately following a stroke, as stroke remains one of the highest risks for vascular dementia.
Vascular dementia can start suddenly or begin slowly over time, and possibly display short periods of improvement. Individuals affected show signs of slowness of thought, difficulty with planning and understanding, and changes in memory, thinking and behavior. Cognition and brain function can be significantly affected by the size, location and number of the vascular changes. This type of dementia can occur alone or be a part of a different diagnosis such as Alzheimer’s disease or other dementias.
Vascular dementia may follow several mini-strokes, or transient ischemic attacks, which create small patches of dead brain tissue, called an infarct, in the cortex. Early symptoms of vascular dementia can be very specific to where the tissue is lost, i.e., problems with episodic memory can be due to an infarct in the part of the brain known as the hippocampus, or problems with executive function caused by an infarct in the frontal lobe part of the brain.
The mild or middle stage of vascular dementia can last for several years before the early symptoms begin to worsen. Caregivers and family members may notice changes in their loved ones during this time such as confusion or difficulty concentrating, trouble organizing thoughts, problems making plans and communicating them to others, slowed thinking and memory loss.
The risk factors for vascular dementia are similar to stroke and heart disease. Age is a factor, especially those ages 65 and older, and other factors include high blood pressure, high cholesterol, diabetes, obesity, history of heart attack or stroke, smoking, abnormal aging of blood vessels, and abnormal heart rhythm (atrial fibrillation). Individuals with high risks of developing vascular dementia can help to reduce their risks by following a heart healthy lifestyle which includes regular exercise, good nutrition, maintaining a good weight, quitting smoking and working with the physician regularly to maintain any health issues. Alzheimer’s disease medications, such as donepezil (Aricept), rivastigmine (Exelon) or memantine (Namenda) are typically not used to treat vascular dementia, but may be used in people who have a combination of vascular dementia and Alzheimer’s disease. Medications may also be offered to treat the underlying causes of vascular dementia and prevent it from getting worse. These medications include those that treat high blood pressure, statins that treat high cholesterol, and low-dose aspirin and/or anticoagulant medications to reduce the risk of blood clots and further strokes.
Questions about Alzheimer’s Disease or related disorders can be sent to Dana Territo, author of “What My Grandchildren Taught Me About Alzheimer’s Disease,” at firstname.lastname@example.org.