What Is Vascular Dementia?

Vascular dementia is a general term describing problems with reasoning, planning, judgment, memory and other thought processes caused by brain damage from impaired blood flow to your brain.

Vascular dementia is a group of conditions that cause a decline in cognitive skills. People with vascular dementia experience problems with reasoning, judgment, and memory. These changes can occur suddenly, or they may be mild and go unnoticed at first.

Vascular dementia is caused by a blockage or lack of blood flow to the brain. Reduced blood flow to the brain deprives it of much-needed oxygen. Lack of oxygen and blood can damage the brain, even in a short period of time.

Vascular dementia, sometimes called vascular cognitive impairment, is the second most common cause of dementia after Alzheimer’s disease.

Symptoms

The symptoms of vascular dementia depend on which part of the brain is affected, and the severity of symptoms depends on how long the brain was without oxygen and blood. Many symptoms overlap with other types of dementia, and not all symptoms are easily noticed.

The most common symptoms of vascular dementia are:

• Confusion and memory problems

• Difficulty paying attention and focusing

• Being easily agitated or upset

• Unsteady gait

• Difficulty controlling urination or needing to urinate frequently

Stages

Changes caused by vascular dementia occur in noticeable stages, according to the Mayo Clinic. The first stage is called mild cognitive impairment. People with mild cognitive impairment are aware that their memory and mental capabilities are not what they once were. Mild impairment may occur after a minor stroke or after a series of mini strokes. It may be hard to diagnose vascular dementia at this stage.

More severe strokes may cause advanced vascular dementia. A severe stroke that leaves the brain without oxygen and blood for an extended period of time can cause dramatic changes in cognitive and physical capabilities. These symptoms are typically easily noticed.

Causes

Stroke is a common cause of vascular dementia. During a stroke, your brain goes without blood and oxygen for a period of time. This can damage or destroy portions of your brain. A heart attack can also leave your brain without adequate oxygen and blood for a period of time. An aneurysm or blood clot may prevent blood from flowing properly. This may cause part of your brain to go without oxygen and blood, too.

Other causes for vascular dementia include narrowed blood vessels or chronically damaged blood vessels.

Vascular dementia vs. Alzheimer’s

Alzheimer’s disease, like vascular dementia, is a form of dementia. In fact, it is the most common type. Some people use the terms interchangeably. However, Alzheimer’s is a type of dementia, not dementia itself.

Unlike vascular dementia, Alzheimer’s disease isn’t caused by stroke. There is no known cause of Alzheimer’s, and your risk of developing it increases with age. The Alzheimer’s Association estimates that it makes up 80 percent of all dementia diagnoses, which is why the two terms are often confused. Vascular problems, such as stroke, high cholesterol, and hypertension, aren’t related to Alzheimer’s disease, as they are with vascular dementia.

While Alzheimer’s can cause memory issues, some of the first signs are not memory related. Adults in the early stages of the disease might have vision, word finding, and spatial difficulties. It can also cause poor judgement in everyday tasks. This differs a bit with vascular dementia, which usually causes memory problems in the earliest stages.

Although vascular dementia and Alzheimer’s are not the same disease, it is possible to have both. In fact, according to the Alzheimer’s Society, about 10 percent of people who have dementia have a form called mixed dementia. Most of these cases include both vascular dementia and Alzheimer’s disease. A person in this situation could exhibit symptoms of both of these types of dementia.

Risk factors

Several conditions and factors can damage blood vessels. They include:

• Age. Older individuals, especially those over 65, are at an increased risk for developing vascular dementia.

• History of stroke or heart attack. Heart attacks and strokes can cut off blood flow to your brain. High blood pressure, smoking, and high cholesterol also increase your risk.

• Hardened arteries. Cholesterol and plaque deposits inside your arteries can build up and restrict blood flow through your body, increasing risk of heart attack or stroke.

• Contributing conditions. Diabetes, lupus, high blood pressure, and an abnormal heart rhythm all affect how blood flows through the body.

Diagnosis

If your doctor detects changes in your memory or reasoning, they may request a detailed assessment and screening that includes:

• a thorough physical with complete family history

• a consultation with friends and family members to see if they have detected changes in behavior

• a test to check the function of reflexes, nerves, coordination, and balance

• imaging and blood tests to check for other conditions that might be causing the cognitive changes

After ruling out other causes, your doctor may come to the conclusion that the changes in memory and cognition are the result of vascular dementia.

Treatment

The goal of vascular dementia treatment is to repair the underlying conditions that may be causing it. Your doctor will work with you to lower your blood pressure and cholesterol. They may also encourage you to adopt a healthier lifestyle with a better diet and more exercise in order to prevent clogged arteries, heart attack, and stroke.

Some medicines have been found to be useful in boosting memory and cognitive skills. These medicines alter how your brain’s cells communicate, process, store, and retrieve memories. However, there are currently no treatments approved to stop or reverse the changes caused by vascular dementia.

Prognosis

The brain is capable of repairing itself to a certain extent. It can regenerate blood vessels to help heal damaged areas, according to the Alzheimer’s Association. Still, vascular dementia shortens a person’s lifespan. Lifespan can be cut even shorter if another stroke or heart attack causes additional brain damage.

The severity of vascular dementia affects a person’s prognosis. The greater the damage to the brain, the more likely a person is to need assistance with everyday tasks.

Getting help for vascular dementia

Many symptoms of vascular dementia go unnoticed or are attributed to another condition, such as stress. Professional screenings should be able to detect the changes in memory and function commonly associated with vascular dementia. If you notice changes in yourself or in a loved one, make an appointment to speak with a doctor.

If you have a history of heart attack or stroke, these screenings are important. Doctors may notice very minor changes that might be easy to miss. Recognizing the changes and diagnosing them can speed up treatment. The sooner a person is treated, the better they will do in the future.