While Alzheimer’s disease is the most common cause of dementia and receives much attention from the public, vascular dementia is the second most common cause of dementia, occurring in between 5% and 10% of all cases of dementia. Vascular dementia is characterized by a decline in cognitive abilities caused by health conditions that either block or reduce blood flow to various regions of the brain, thereby depriving them of needed oxygen and nutrients. Poor blood flow damages and eventually kills brain cells. Some experts prefer using the term “Vascular Cognitive Impairment” rather than vascular dementia, because the cognitive changes that occur can range from mild to severe.
Symptoms
Signs and symptoms of vascular dementia may appear suddenly after an individual has a stroke, which blocks major blood vessels in the brain. They too, can appear from multiple mini strokes. Vascular changes in the brain can also coexist with changes associated with other types of dementia including Alzheimer’s disease and Lewy Body Dementia, making the clinical picture more complex and diagnosis more difficult.
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Symptoms depend largely on the severity of blood vessel damage and the area(s) of the brain affected. Memory loss may or may not be a sign of vascular dementia depending on where the damage is located in the brain. Some symptoms may be obvious after and individual has had a stroke. Post-stroke changes in thinking and perception include confusion and disorientation, difficulty speaking and understanding speech, sudden headache, difficulty walking, poor balance and numbness or paralysis on one side of the face or body.
When mini strokes are involved, symptoms may not be as noticeable at first. Over time, thinking changes may gradually deteriorate as damage in the brain accumulates. Small vessel disease, which is associated with multiple mini strokes, is characterized by impaired planning, poor judgement, uncontrolled laughing or crying, a decrease in attention, inability to perform socially, and language difficulties.
Diagnosing Vascular Dementia
According to guidelines presented by the American Heart Association, American Stroke Association, and the Alzheimer’s Association, the following criteria suggest the likelihood of dementia caused by vascular changes. Neurocognitive testing which involves hours of written and computerized tests is performed to evaluate judgment, problem-solving, planning, memory or reasoning skills. Brain imaging is used, for example magnetic resonance imaging or MRI to confirm a recent stroke or other vascular changes that have caused cognitive impairment to some degree. Finally, a diagnosis rules out the possibility that no other non-vascular factors are causing the decline in cognitive abilities.
Causes and Risks of Vascular Dementia
Any health-associated condition that causes damage to blood vessels in the body can lead to changes in the brain associated with vascular dementia. Many risk factors for vascular dementia are associated with those of heart disease, stroke, and other conditions that affect blood vessels. These risks are also associated with Alzheimer’s disease.
Prevention
There is a strong connection between physical health and brain health. For example, what is good for your heart is healthy for your brain and what is bad for your heart is equally as bad for the brain. It is not wise to smoke tobacco products. Maintaining healthy blood pressure, cholesterol and blood sugar can help to prevent or delay the onset of vascular dementia. eating a healthy, balanced diet high in antioxidants is also recommended. Getting moderate exercise and maintaining a healthy weight can all be effective in the prevention of vascular dementia.
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