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Vascular dementia, sometimes referred to as multi-infarct dementia (when caused by a series of mini-strokes), is the second most common type of dementia. Since vascular dementia is often the result of a stroke, symptoms may appear suddenly following a stroke. Vascular dementia results in a deterioration of thinking skills when the brain is deprived of nutrients and oxygen as the result of a blockage or a reduction in blood flow. This is often caused by a transient ischemic attack (TIA), otherwise known as a “mini-stroke.”
Vascular dementia is a broad term used to described cognitive problems that result from damage to the brain due to an insufficient blood supply to the brain. Vascular dementia symptoms vary, and different factors raise a person’s risk of developing vascular dementia.
A growing number of experts prefer to use “vascular cognitive impairment,” rather than “vascular dementia,” because they believe it better expresses the concept that vascular thinking changes can range from mild to severe.
Vascular dementia occurs with damage to the brain’s blood vessels, which results in a reduction in the amount of oxygen and nutrients that make it to the brain. Therefore, conditions that cause chronically damaged or narrowed blood vessels can also lead to vascular dementia. Conditions that can cause this damage include:
Strokes can also damage and block brain arteries which can lead to a range of symptoms, including vascular dementia. Silent strokes, those occurring without your knowledge, increase your chances of developing dementia as well. Strokes, both apparent and silent, incrementally increase your chances of developing vascular dementia, more so each time you experience one.
Risk factors for vascular dementia are nearly identical to those for stroke and heart disease:
Vascular dementia risks increase as you age and rise substantially by the age of 90. It rarely occurs before the age of 65. Older adults are recommended to schedule frequent checkups with a doctor to monitor their blood pressure, glucose levels and cholesterol.
High blood pressure puts extra stress on blood vessels throughout your body including the brain, thereby, increasing your risk of developing vascular dementia. High glucose levels associated with diabetes can cause damage to blood vessels throughout your body. Atherosclerosis (abnormal aging of blood vessels) happens when deposits of cholesterol and plaque build up in your arteries, causing a narrowing of the blood vessels, thereby increasing your risk of vascular dementia.
Having a history of heart attacks, mini-strokes or strokes can also increase your risk of having blood vessel problems in your brain, increasing your risk of developing vascular dementia. Atrial fibrillation increases your risk of stroke as it causes blood clots to form in the heart that can break off and travel to the brain, thus, increasing your risk of developing vascular dementia as a result of any stroke that occurs.
Lastly, smoking damages blood vessels, increasing your chance of developing atherosclerosis and other circulatory diseases, including vascular dementia.
Vascular dementia symptoms vary depending on what part of the brain has been affected. The severity of symptoms depends on how long the brain went without oxygen and blood and the resulting degree of damage to the brain. Vascular dementia symptoms may overlap those of other dementias, especially Alzheimer’s, and not all symptoms are easily detected. Symptoms may include:
Vascular dementia symptoms may be more readily diagnosed when they occur suddenly following a stroke. Cognitive changes clearly linked to a stroke are sometimes referred to as post-stroke dementia.
Vascular dementia symptoms may come on suddenly following a stroke; however, cognitive decline often occurs in characteristic steps of deterioration following a series of strokes or mini-strokes. With mini-strokes, the decline occurs in noticeable steps with periods of no change, unlike the gradual yet steady deterioration that typically happens with Alzheimer’s. But it can also develop gradually, just like Alzheimer’s. Additionally, Alzheimer’s and vascular dementia often occur simultaneously.
When vascular dementia develops as the result of disease of small blood vessels in the brain, it is referred to as subcortical vascular dementia. If it occurs after a major stroke or a series of TIAs, it is referred to as stroke-related dementia.
Stroke-related and subcortical vascular dementia share some symptoms but tend to progress differently. Vascular dementia caused by a stroke comes on suddenly with the severity of symptoms corresponding to the severity of the stroke; whereas, subcortical dementia develops gradually and progresses slowly, like Alzheimer’s.
Stroke related dementia generally then follows a “stepped” progression, with plateaus between strokes where symptoms remain the same. With each following stroke, symptoms worsen as each stroke further damages the brain.
It can be difficult to discern whether an individual has vascular dementia or Alzheimer’s. Although the symptoms can be similar, which can make it difficult, it’s not unusual for an individual to have mixed dementia (more than one type of dementia) and may actually be suffering from both types making the symptoms seem similar.
Heart health is closely linked to the health of your brain’s blood vessels; therefore, taking steps to keep your heart healthy reduces your risk of developing vascular dementia.
Cognitive changes caused by vascular dementia happen in noticeable stages. The initial stage is referred to as mild cognitive impairment (MCI). Individuals with MCI are aware that their cognitive capabilities and memory are not what they once were. MCI may happen immediately after a minor stroke or gradually after a series of mini-strokes. It can be difficult to diagnose vascular dementia at this stage.
A person in the early stage of vascular dementia is likely to experience mood swings, apathy and feeling unusually emotional. They also generally experience depression and anxiety, partly because they are more aware of their cognitive difficulties and aware of the fact that they have vascular dementia.
As vascular dementia progresses, the symptoms become similar to those experienced in the middle stages of Alzheimer’s moving eventually to the later stage. Problems with memory loss, communication, reasoning, disorientation and confusion all become worse. Behavioral changes such as irritability and agitation occur as well. Additionally, the individual may experience delusions and hallucinations (less often).
More severe strokes can cause advanced vascular dementia immediately, rather than the incremental stages of dementia caused by TIAs. Because the brain was without oxygen and blood for an extended period of time, a severe stroke can cause dramatic and easily noticed changes in cognitive and physical abilities.
The late stage of vascular dementia is basically much the same as that of late stage Alzheimer’s. The disease processes begin to considerably affect the parts of the brain that control bodily systems, such as bladder and bowel function, motor control and even breathing. Rigorous, around-the-clock care is required.
Each person will experience dementia differently, and vascular dementia is no different. Individuals with vascular dementia tend to live for an average of five years after symptoms commence. Many times, the actual cause of death will be a heart attack or stroke, not the dementia itself.
Doctors are usually able to determine that an individual has dementia, but there’s no test that can specifically confirm vascular dementia. Your doctor will make a judgment based on the information you provide, your medical history and the results of tests. When you visit the doctor, you can expect:
Using the information gathered and after ruling out other causes, the doctor may determine that the changes you are experiencing are indeed the result of vascular dementia.
Vascular dementia treatment often focuses on managing health conditions and risk factors that contribute to vascular dementia. Your doctor will encourage you to make healthier lifestyle choices – quit smoking, exercise regularly and eat a heart-healthy diet. Your doctor will treat any underlying conditions such as diabetes, high blood pressure and high cholesterol. Your doctor may also provide prescriptions for medications that have been found to boost memory and cognitive skills.
Unfortunately, there are no currently approved treatments that stop or reverse the changes already caused by vascular dementia; therefore, you and your doctor will work together to stop any further progression of the disease and do what you can to maintain the memory and cognitive skills you currently still possess.
Left untreated, vascular dementia usually ends in death from heart disease, heart attack, stroke or infection.
If you or a family member or friend have been diagnosed with vascular dementia, or any form of dementia for that matter, it’s important to understand you’re not alone. The Alzheimer’s Association, a trusted resource for all types of dementia, offers a 24/7 Helpline, support groups, an online community and a virtual library.
Best of all, however, Tessera is here to help you as well. In our secure ValeoTM memory care neighborhood in Westchase, FL, residents and their families enjoy a special sense of community in a comfortable and safe environment. Our memory care programming is specifically designed to foster social, intellectual, spiritual and physical well-being. Valeo (Latin for “to thrive”) is integrated into every aspect of care and service here. Customized care enables every resident to thrive and have meaningful interactions, build relationships and grow connections.
From our holistic approach to wellness to our gracious amenities and services to our secure and comfortable suites, life at Tessera of Westchase is fulfilling and inspiring. Contact us to discover all the ways we work hard to restore meaning in the life of someone with impaired memory.