Vascular dementia ranks among the four most common types of dementia, along with Alzheimer’s disease, Lewy Body dementia (LBD), and frontotemporal dementia. It’s possible for several of these diseases to occur simultaneously. In fact, a blend of Alzheimer’s disease in addition to vascular damage to the brain is the most common cause of dementia. When various dementia types work together, understanding the signs and symptoms to determine an appropriate treatment becomes even more important.
We spoke with Jeremy Pruzin, MD, a neurologist at the Banner Alzheimer’s Institute, to learn more about what makes vascular dementia unique.
What is vascular dementia?
Vascular dementia occurs when blood flow to the brain is limited. “A reliable, consistent, and robust supply of oxygen-carrying blood is crucial to the health of any organ, including the brain,” commented Dr. Pruzin. “If blood supply is limited, the tissue in your brain will become damaged or die completely.” This can happen all at once or over a period of years, even decades. The condition effects cognition, memory, and behavior.
What causes vascular dementia?
There are three common ways that blood flow to the brain can be limited, leading to vascular dementia.
- Stroke: A stroke is caused when blood supply to the brain is suddenly cut off. This is often caused by a blockage inside the artery which has broken loose and created a clog. Damage begins to appear within minutes and brain tissue may never recover.
- Transient Ischemic Attack (TIA): A minor or temporary decrease in blood supply to an area of the brain, often referred to as a “mini stroke” or transient ischemic attack (TIA). These have varying degrees of severity. In some cases, you may not realize it’s happening. Symptoms from a TIA can be minor at first and come and go, often over the period of months and even years. Typically, these attacks are a sign that a full stroke is not far away.
- Small vessels: The most common cause of vascular dementia is hardening and narrowing of small vessels deep in the brain. This usually appears as a result of underlying health issues like high blood pressure and diabetes. In these cases, oxygen-rich blood is restricted and the damage to brain cells happens over a long period.
What are the risk factors for vascular dementia?
Not surprising, the risk factors for vascular dementia are very similar to those for stroke. Activities and lifestyles that damage the heart and block blood flow will lead to an increased risk of vascular dementia, as well as many other dangerous conditions. Risk factors include:
- Cardiovascular disease
- High cholesterol
- Smoking
- Diabetes
- Sleep apnea
- High blood pressure
- Age
- Family history of stroke and heart disease
- Lack of exercise
- Obesity
- Excessive alcohol consumption
Most of these risk factors are within your power to control. Lowering your risk for dementia and other health concerns becomes more and more important as we age. In fact, a person’s risk of developing vascular dementia doubles approximately every five years after the age of 65. But, you shouldn’t wait to take preventive action. Prevention is a lifelong effort.
What are the symptoms?
The symptoms of vascular dementia can vary wildly. It all depends on what part of the brain has been damaged. But there are a few common signs of vascular dementia. “People with vascular dementia tend to have more problems with executive function,” Dr. Pruzin explained. This refers to issues with planning, organizing, and following instructions. The Alzheimer’s Association lists a few other signs related to vascular dementia.
- Confusion
- Disorientation
- Trouble speaking or understanding speech
- Physical stroke symptoms, weakness on one side of the body or trouble speaking
- Difficulty walking
- Agitation
- Hallucination
- Poor balance
How is vascular dementia diagnosed?
There are several ways to diagnose vascular dementia. A diagnosis will typically rely on multiple perspectives. “In addition to reviewing the behavioral symptoms, we look at risk factors for vascular disease such as hypertension, diabetes, high cholesterol, family history of stroke or heart attack,” explained Dr. Pruzin. “Another way to identify the impact of vascular disease is by looking at an MRI of the brain.” The scan will show damage in the brain, exposing strokes and blood flow deficiencies that can cause damage to the deep wiring in the brain, known as the white matter, that patients may not have known about. Understanding where brain damage is located may also influence treatments.
Distinguishing between Alzheimer’s disease, vascular dementia and others
There are a lot of shared symptoms among dementias, and in some cases, people may be feeling the effects of more than one type. But determining the type of dementia will go a long way in determining proper treatment. The symptoms of each common type of dementia can vary in significant ways. People with Alzheimer’s may tend to wander or get lost and have problems recognizing friends and family. Those with frontotemporal dementia are more likely to have behavioral and personality changes. Lewy body dementia will sometimes cause movement symptoms like stiffness or certain types of tremors. While those with vascular dementia may have problems following instructions or learning new things. The differences between these and vascular dementia are summed up well in this infographic from the National Institute on Aging (NIA).
Treatment options
Like all dementias, there is currently no cure for vascular dementia. The damage done to the brain cannot be reversed. However, treatments exist to make life more comfortable for those showing symptoms.
“First of all, if there is a cardiovascular issue linked to the vascular dementia, we must do what we can to control it,” said Dr. Pruzin. “It’s vital that we slow or cease further vascular damage to the brain and thus dementia.” Many patients will be prescribed medication and lifestyle changes to lower cholesterol, decrease the likelihood of blood clots and control blood pressure. Treatments for conditions resulting from dementia, such as depression, may be treated with counseling and sometimes medication.
The specifics of each case will help determine what’s necessary for treatment. To identify the best course of treatment for you or your loved one, contact your physician or find a doctor by visiting www.bannerhealth.com. Additionally, creating a support group of professionals and caring friends and family will help to maintain as much independence as possible.
