Vascular Dementia

ConditionsVascular Dementia

Vascular dementia is the condition that results from poor or impaired blood flow to the brain.

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 of vascular dementia may appear suddenly or develop slowly over time depending on the underlying cause and additional co-existing medical conditions, often Alzheimer’s disease.

Signs and symptoms of vascular dementia 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.

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.

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

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.