What Is Vascular Dementia?
Vascular dementia and Alzheimer’s have similar symptoms but different causes. That’s why understanding what vascular dementia is offers hope for prevention.
Dementia is marked by a loss of cognitive function — including problems with memory, reasoning, and thinking. The memory-damaging condition is often equated with Alzheimer’s disease. While it’s true Alzheimer’s is the most common type of dementia, there are other kinds, including vascular dementia.
Vascular dementia causes a progressive loss of cognitive functions, including difficulties with organization, attention, and problem solving. It also damages memory, although memory loss is often more prominent in Alzheimer’s, according to the National Institute on Aging (NIA).
Like Alzheimer’s, vascular dementia is more likely to occur in people 65 and older. But unlike Alzheimer’s, the cause of vascular dementia — vascular injury resulting in impaired blood flow to the brain — is known.
And because stroke can cause vascular dementia, avoiding stroke and vascular disease may prevent this mind-robbing disorder.
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What causes vascular dementia?
To understand vascular dementia, it’s important to recognize that inadequate or blocked blood flow can damage and eventually destroy cells anywhere in your body. Because the brain has one of the richest networks of blood vessels in your body, it is particularly vulnerable to damage from inadequate blood flow, the Alzheimer’s Association explains.
If a stroke blocks an artery in your brain, sudden changes in thinking abilities can sometimes occur. There are also transient ischemic attacks, or TIAs, sometimes called minor or mini strokes, that don't produce any lasting symptoms.
Over time, however, both obvious and minor strokes increase the risk of vascular dementia. Vascular dementia resulting from several strokes is known as multi-infarct dementia.
In addition to stroke, conditions including atherosclerosis, diabetes, and high blood pressure that narrow or inflict long-term damage on brain blood vessels can lead to vascular dementia.
Signs and symptoms of vascular dementia
The changes in thinking and memory that occur as symptoms of vascular dementia can vary from mild to severe, so some medical experts refer to the condition as vascular cognitive impairment, the Alzheimer’s Association notes.
After a major stroke, changes in thinking and perception suggesting vascular dementia may occur immediately, including confusion, disorientation, and trouble speaking or understanding speech. These symptoms may happen alongside stroke symptoms, such as a sudden headache, numbness on one side of the face or body, and difficulty walking.
Memory loss may or may not be a significant symptom of vascular dementia, depending on the severity of the blood vessel damage and the part of the brain affected, the NIA points out.
Other signs and symptoms of vascular dementia include:
- Reduced ability to organize thoughts and plans
- Difficulty deciding what to do
- Depression or apathy
- Restlessness and agitation
- An unsteady gait
Diagnosing and treating vascular dementia
Vascular dementia has symptoms similar to Alzheimer’s disease, which can sometimes cause confusion in diagnosing the brain problem, according to the NIA. In addition, a person may have both vascular dementia and Alzheimer’s or another form of dementia.
People at risk for vascular dementia can be screened for the condition with brief memory and reasoning tests.
Risk factors include those 65 and older with a history of:
- TIAs or stroke
- High blood pressure
- High cholesterol
- Other risk factors for heart or blood vessel disease
If the initial screening suggests changes in thinking or reasoning, a scientific statement issued by the American Heart Association and the American Stroke Association recommends doctors use more extensive neurocognitive testing to evaluate thinking skills and to check for a recent stroke or other blood vessel changes with brain imagining, usually a MRI. Patients should also have a physical exam and lab tests to make sure they have no other factors.
Vascular dementia treatment is primarily centered on managing the risk factors and health problems that caused or contributed to the vascular dementia. For example, medications can help keep arteries clear from clots and lower cholesterol levels and high blood pressure. Depending on the individual, controlling conditions affecting blood vessels and heart health may prevent further cognitive decline.
Brain and heart health are linked
Vascular dementia is preventable, according to the Centers for Disease Control and Prevention (CDC). When scientists studied vascular dementia, they found a strong link between heart and brain health.
That means what benefits your cardiovascular system can help keep your brain healthy, the CDC explains. Using these strategies can reduce your risk of vascular dementia, as well as heart attack and stroke:
- Control your blood pressure. Uncontrolled high blood pressure stresses your blood vessels and raises the risk for heart disease and stroke. Research has shown that uncontrolled high blood pressure raises your risk for both vascular dementia and Alzheimer’s in later life, too. Talk to your doctor about exercise, diet, and medication, if needed, to maintain a healthy blood pressure.
- Prevent or control diabetes. Avoid type 2 diabetes with regular exercise and keep your weight under control. If you already have diabetes, controlling your blood sugar can lower the risk of damaged brain blood vessels associated with vascular dementia.
- Stick to a healthy diet and curb alcohol. Eat a diet rich in vegetables, fruits, whole grains, low-fat dairy, and seafood rich in omega-3 fatty acids (such as salmon) each week to boost heart health and lower your stroke risk, the CDC recommends. Only drink alcohol in moderation. In excess, it raises blood pressure, increasing the risk of stroke.
- If you smoke, stop. Smoking makes blood more likely to clot and damages blood vessels, raising your risk of heart disease, stroke, and vascular dementia.
- Get moving. Commit to regular physical activity to keep high blood pressure and obesity at bay — lowering your risk of stroke and other vascular problems, including dementia. The CDC recommends at least 150 minutes of moderate intensity exercise each week.
March 21, 2023
Janet O’Dell, RN