A health condition caused by damage to the blood vessels and blocked blood flow to the brain is called vascular dementia. However, multiple conditions that lead to this type of dementia are manageable or treatable. For example, heart disease, diabetes, hypertension (high blood pressure), high cholesterol, and others. Generally, there is no direct treatment or cure for this type of dementia. That’s why preventing underlying diseases is very important. It also helps to prevent a severe form of vascular dementia.
Furthermore, this disorder is the most common type of dementia, which often occurs due to a lack of oxygen and other nutrients that cause damage to the brain. In some cases, vascular dementia may cause a serious decline in mental functions, which may interfere with daily living.
Additionally, this type of dementia is one of the most common causes of dementia among people over 65 years old in North America and Europe. More commonly, vascular dementia is present along with Alzheimer’s disease. In such cases, it is called mixed dementia.
Sometimes, this disorder is called vascular cognitive impairment (VCI) because it often represents multiple thinking changes. However, vascular dementia negatively affects people differently.
Symptoms
The symptoms of this condition often appear differently among people who develop it. Check below some examples:
- Walking or balance problems
- Memory loss
- Aphasia (difficulty understanding or using words)
- Difficulty concentrating, completing tasks, organizing, and others
- Mood swings (such as irritability)
- Depression
- Personality changes
- Apathy
- Sundown syndrome (confusion that often worsens during nighttime)
- Pseudobulbar affect (uncontrolled episodes of crying or laughing)
- Bladder or bowel incontinence
- Sleeping disturbances (insomnia)
- Tremors
If any of the previous symptoms occur, immediately contact your healthcare professional.
Causes and Risk Factors
This condition often occurs when other diseases cause damage to the blood vessels that supply blood to the brain. In some cases, vascular dementia occurs due to partially blocked blood flow. Check below the most common causes of vascular dementia:
- Atherosclerosis (narrowed blood vessels)
- Ischemic strokes (blockages in multiple blood vessels)
- Small vessel disease
However, doctors have identified some factors that put you at an increased risk of developing this type of dementia. These include:
- Diabetes
- Heart disease
- Atrial fibrillation (Afib)
- Hypertension (high blood pressure)
- Hyperlipidemia (high cholesterol)
- A medical history of stroke
- Smoking
- Aging (people over 60 years old are more likely to develop vascular dementia)
Types of Vascular Dementia
Physicians have divided this disorder into several types according to the number and type of damaged blood vessels. For example:
- Post-stroke dementia – In such cases, vascular dementia occurs after one stroke that causes damage to the brain tissue. To diagnose this condition, the symptoms should be present right away after or within 6 months of a stroke and do not improve.
- Multi-infarct dementia – Generally, the term “infarct” is another term for stroke. Therefore, multi-infarct dementia means dementia occurs after several strokes that negatively affect blood flow to multiple areas of the brain.
- Subcortical vascular dementia (also known as Binswanger disease) – It often occurs when small blood vessels in the white matter are blocked over time due to atherosclerosis. Usually, Binswanger disease occurs gradually over time.
- Mixed dementia – If vascular dementia happens along with Alzheimer’s disease (the most common combination), it is called mixed dementia. However, it may also occur along with other neurodegenerative disorders.
What Are The Possible Complications of Vascular Dementia?
People with this type of dementia may also experience some complications, especially without treatment. Check below some examples:
- Recurrent strokes
- Loss of function
- Cognitive decline
- Infections (such as pneumonia)
- Skin problems (such as pressure sores)
This document does not contain all possible complications of this disorder. Furthermore, you can talk with your doctor about ways to reduce the risk or prevent vascular dementia complications.
How to Prevent Vascular Dementia?
While some risk factors (such as age and genetics) cannot be changed, you can manage some health conditions that cause vascular dementia. Check below some tips that may help:
- Regularly manage blood pressure, cholesterol, and blood sugar levels
- Try to get and maintain a healthy weight
- It is recommended to aim for at least 30 minutes of physical exercise per day
- Adopt a healthy diet (such as DASH or Mediterranean diets)
- Stop smoking (if you are facing problems with smoking cessation, discuss it with your doctor)
- Manage stress
- Limit or avoid alcoholic drinks
- Take medications exactly as prescribed by your doctor
Diagnosis
In some cases, it may be difficult to diagnose this condition because there are other mental disorders that cause similar symptoms. Doctors often begin with a physical examination and questions about your medical history, symptoms, and family history. They may also perform multiple tests, including laboratory tests, imaging tests, and neurocognitive tests. For example:
Laboratory Tests
These tests are often done to exclude other conditions that cause similar symptoms to vascular dementia (including infections, inflammation, hypothyroidism, vitamin deficiency, and others). In some cases, physicians may perform a spinal tap to check for autoimmune and neurodegenerative diseases.
Brain Imaging Tests
These include:
- CT (computed tomography) and MRI (magnetic resonance imaging) scans – These imaging tests are often used to check for tumors, bleeding, stroke, and other abnormalities that may cause vascular dementia.
- Amyloid PET (positron emission tomography) scans – This imaging test is used to check for abnormal buildup of amyloid proteins in the brain. This protein buildup is often present in people with Alzheimer’s disease.
Neuropsychological Testing
During this testing, physicians use written and computerized tests to check mental abilities. These include:
- Judgment
- Memory
- Planning
- Language
- Reasoning
- Learning
- Problem solving
These tests may help get more clues about the disease.
Treatment
While this condition cannot be reversed or repaired completely, the treatment goal is to prevent or reduce further damage to the brain tissue.
Medicines
Generally, there are no medicines approved by the U.S. Food and Drug Administration (FDA) for vascular dementia. However, physicians usually prescribe cholinesterase inhibitors to treat symptoms of vascular dementia. These medications may also help improve blood flow to the brain and improve cognitive functions.
Another medicine that may be used for people with vascular dementia is Memantine. Moreover, it is approved by the FDA for Alzheimer’s disease, but may also help with this type of dementia.
Additionally, physicians may recommend other medicines to manage risk factors for stroke. For example, medicines for high cholesterol, diabetes, hypertension, and others.
Frequently Asked Questions
Is vascular dementia hereditary?
Generally, this is not a hereditary (genetic) condition, but there are some diseases that contribute to vascular dementia and may run in families (such as hypertension, heart disease, and others). However, two rare forms of vascular dementia are caused by multiple strokes that often happen due to gene mutations. For example:
- CADASIL – Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy occurs even with one abnormal gene that is passed from one biological parent.
- CARASIL – In such cases, the disorder occurs only when the baby receives two abnormal genes from both biological parents.
What is the life expectancy for someone with vascular dementia?
Usually, life expectancy for people with this disorder is different because it depends on the severity of the disease. Generally, vascular dementia affects each person differently.
What are the severe symptoms of vascular dementia?
- Severe memory loss
- Inability to eat
- Total loss of language skills
- Depression
- Hallucinations
- Restlessness
- Anger or agitation
If a loved one experiences any of the previous symptoms, immediately contact your physician. Ask your healthcare provider if you have additional questions.
