Vascular Dementia

A person with vascular dementia is likely to have difficulty thinking. Sometimes, a stroke can cause this to occur. In other cases, it can occur when the blood supply to the brain is lesser than normal. Since the brain requires a large amount of oxygen-rich blood to function properly, any instance in which this is cut off limits the brain from functioning properly.

In all forms of dementia, Alzheimer’s disease is the most common, according to the Alzheimer’s Association. However, vascular dementia is the second most common form. It accounts for about five to ten percent of all new cases.

What Is Vascular Dementia?

The term vascular dementia is used to describe a situation in which a person has difficulty with planning, reasoning and judgment. It also impacts a person’s ability to remember things. This type of limitation occurs as a result of a lack of blood flow to the brain.

Vascular dementia can occur after a stroke, but there are other factors that can impact it as well. It can occur in any situation, in which reduced circulation of blood or damage to blood vessels leaves the brain without enough oxygen and nutrients to support its function. This causes the cells in the brain to suffer damage and die.

Symptoms of Vascular Dementia

The symptoms a person experiences will depend on the area of the brain that was deprived of oxygen. For example, they can be very mild in some cases and more severe in others. The following are the most common signs and symptoms of vascular dementia:

  • Confusion, either ongoing or for short periods of time
  • Difficulty concentrating, unable to pay attention to activities
  • A reduced ability to organize thoughts, complete a sentence or complete tasks they once could do
  • Trouble deciding what to do
  • Difficulties associated with memory
  • Struggle to communicate a plan or analyze a situation
  • Restlessness
  • Unsteady gait, leading to an increase in trips and falls
  • A sudden need to go to the bathroom or inability to control urine flow
  • Apathy
  • Depression

It is very important to follow up any stroke with careful examination for these types of symptoms. Though vascular dementia can occur for other reasons, strokes are very common causes. When changes in a person’s ability to reason, communicate or make decisions occurs after a stroke, vascular dementia may be the cause.

Stages of Vascular Dementia

Like many other forms of dementia, vascular dementia progresses through stages. These occur at various intervals for a person, and a person’s progression through the stages often depends on their health and the severity of the oxygen deprivation to the brain. Vascular dementia has three main stages:

Mild Impairment: A person with mild cognitive impairment is likely to notice their memory problems and changes in their mental abilities. They notice that they are not able to do the things they are used to.

Moderate Impairment: Over time, this worsens. People with a moderate level of cognitive impairment may see symptoms that develop more readily and, in some cases, become more severe. Confusion and disorientation are more likely to occur as well.  The moderate level of decline tends to last the longest, yet the amount of time varies greatly.

Severe Impairment: In severe situations, or after a significant stroke, severe cognitive impairment can occur. In this case, a person has a significant amount of oxygen deprivation, and the damage to the brain is significant.

A person can reach any stage at any point in time. For example, someone with vascular dementia can slowly progress from mild to severe impairment, or a person can suffer from a serious stroke and be diagnosed with severe impairment immediately.

Causes of Vascular Dementia

There are two main causes of vascular dementia:

Strokes: The most common cause of vascular dementia, according to the Mayo Clinic, is a stroke. When a stroke occurs, it blocks an artery in the brain from receiving blood flow. This cuts off all tissue beyond that point from access to oxygen-rich blood. Strokes are very dangerous and can cause death themselves. Silent strokes, though, which are a common cause of vascular dementia, are not easy to pinpoint. Yet, they increase the risk for developing dementia. The more times that a stroke occurs, the more likely it is for a person to develop vascular dementia.

Changes in the Blood Vessels: Another common cause is a narrowing or damage to the blood vessels that supply oxygen to the brain. Any condition in which a narrowing of the blood vessels occurs makes it difficult for an adequate blood supply to get to these areas. In addition, any condition that causes long-term damage to the blood vessels in the brain can do the same thing. There are some conditions more likely to cause this, including atherosclerosis, abnormal aging of the vessels. However, more common causes include having high blood pressure or diabetes. A hemorrhage in the brain can also cause it.

Risk Factors for Vascular Dementia

A number of conditions and lifestyle choices can make it more likely for a person to develop vascular dementia. Every situation is different, but the following are some of the most common risk factors.

  • Age – Those who are over the age of 65 are more likely to develop vascular dementia than those who are younger. The risk rises as a person matures.
  • A History of Strokes – Those who have had a stroke in the past, including mini-strokes, are more likely to have this condition.
  • A History of  Heart Attacks – If a person has had a heart attack, especially due to blood vessel-related problems, it is more likely that this condition will develop.
  • High Blood Pressure – High blood pressure indicates that there is a lot of stress on the blood vessels throughout the body. This increases the risk of one bursting, causing a stroke.
  • High Cholesterol – Cholesterol can build up on the interior linings of the blood vessels. This can increase the narrowing of the blood vessel and can lead to dementia development due to a lack of adequate blood supply.
  • Smoking – Smoking is known to cause damage to the blood vessels. This is a common cause for early-onset dementia related to blood vessel damage.
  • Diabetes – Those who have high blood glucose numbers, especially over a long period of time, are also likely to develop this condition without management. Diabetes increases your risk of strokes and damages the blood vessels.
  • Atrial Fibrillation – A person who has a heartbeat that is not normal is also at a higher risk because it can include the risk of damage to the blood vessels over time. This can specifically impact the vessels found in the brain.

Diagnosis for Vascular Dementia

In some forms of vascular dementia, doctors can diagnose the condition based on immediately evident symptoms. After a severe stroke, for example, any of the above symptoms are likely. In milder forms of the condition, this becomes harder to do. They use several methods to understand the damage to the brain. This may include:

Lab Tests: Monitoring for high blood pressure, high cholesterol and high blood glucose levels is common. Thyroid disorders and vitamin deficiencies can also provide some insight.

Neurological Exams: The goal here is to determine the outward signs of the condition, such as a person’s ability to communicate, balance, coordinate movement and reflexes.

Brain Imaging: Doctors can use CT and MRI scans to get a clear picture of the brain. This can be done as a non-invasive way of seeing the movement of blood through the brain as well as areas that may indicate a sign of a stroke or blood vessel changes.

Treatment for Vascular Dementia

The initial treatment for those who have vascular dementia will be to slow the progression of the condition. This means getting underlying causes, such as high blood pressure and cholesterol, under control. It also means preventing the risk of a blood clot from forming, as this is the most common cause of a stroke. Blood-thinning medications can help minimize this risk.

There is no cure for vascular dementia. Though there are numerous interventions and clinical trials currently underway, it is typically difficult for doctors to stop the progression of this condition. However, in some mild cases, patients can learn to live the highest quality of life with it through coping skills.

It is also important to maintain routine doctor appointments. New symptoms or changes should  be addressed properly to minimize any ongoing risks to the person. Doctors can generally offer access to more advanced care needs as they become necessary.

What Are the Care Needs of a Person with Vascular Dementia?

The amount and type of memory care a person needs depend on the severity of their symptoms. Every situation is very different. However, as this condition worsens, it may become necessary to seek out more advanced memory care, including 24/7 support and guidance.

Many people who have vascular dementia will need supportive services to help with overcoming limitations, such as help with walking, hygiene needs and movement. Others may need support for minimizing the risk of causing self-injury due to miscommunications or misjudgments.

There is evidence that shows a person may do well if the surrounding environment is encouraging and calm. This can help to minimize the amount of agitation a person feels while also encouraging a higher quality of life. For an individual facing a diagnosis of vascular dementia, there is no specific timeline that indicates how severe the condition will become or how long it can occur. That is why ongoing support and encouragement are so important at all stages.

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