What is vascular dementia?
Although it is often referred to as a singular condition, the term ‘dementia’ is actually a general term that describes a set of symptoms. The most common of these symptoms are memory loss, difficulties with thinking or problem solving, language difficulties, and behavioural issues.
In vascular dementia, these symptoms have been caused by problems with the blood supply to the brain. This results in degenerative damage which, over time, appears as the symptoms listed above.
Although you might not have heard of vascular dementia, it is the second most common type of dementia.
But what are the causes of vascular dementia?
In a nutshell, as vascular dementia is caused by problems with the supply of oxygen to the brain, individuals who have been diagnosed with the condition will usually have suffered some kind of stroke before the symptoms of dementia began to manifest.
Often the individual will have suffered a series of small strokes – known as ‘mini strokes’ – which might not have been noticed initially. Mini strokes restrict blood supply to the brain, which causes damage and often results in dementia.
Three important facts about dementia
- As the second most common form of dementia, around 20% of people who receive a diagnosis have vascular dementia. Many people will also receive a diagnosis for both Alzheimer’s and vascular dementia – called ‘mixed dementia’.
- Vascular dementia is also known as multi-infarct dementia (MID) or vascular cognitive impairment (VCI).
- In contrast to Alzheimer’s, which progresses comparatively slowly, vascular dementia is more aggressive. Once diagnosed with the condition, there will often be a sudden, rapid decline in an individual’s condition, because of the occurrence of subsequent mini strokes. However, slight improvement between strokes is also possible.
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What is the most common cause of vascular dementia?
In terms of how vascular dementia actually occurs, mini strokes cause small, but widespread damage to the brain through the restriction of blood supply.
To function properly, brain cells need a steady supply of oxygen and nutrient rich blood. This blood is delivered to the brain through a complex network of blood vessels called the ‘vascular system’, hence the name ‘vascular’ dementia.
If the supply of blood is disrupted or the vascular system is damaged, the flow of blood to the brain will become restricted, depriving the brain of the nutrients and oxygen contained in the blood. The damage is caused to the ‘cortex of the brain’, which is the area associated with memory, language, and learning. Vascular dementia affects the system of blood vessels in the brain known as ‘fotolia’.
This eventually causes brain cells to die, which causes problems with memory, thinking, and reasoning. It is these cognitive issues that often lead to the diagnosis of vascular dementia in affected individuals.
Vascular dementia risk factors
There are various risk factors that make an individual more likely to receive a diagnosis for vascular dementia. Whilst some of these risk factors can be controlled, others cannot.
The risk factors that cannot be controlled include both genetics and age. The unfortunate fact is that some people will simply be more susceptible to this form of dementia. Similarly, age is one of the strongest risk factors for developing vascular dementia. At age 65 and onwards, the risk of developing the condition will double every five years. Under the age of 65, however, the risk of vascular dementia is relatively low. Additionally, men are more at risk of developing it than women, as are people of Asian, Black, and Caribbean ethnicity.
The risk factors that can be controlled typically relate to lifestyle factors that increase an individual’s risk of experiencing a stroke. For this reason, you have a higher risk of developing vascular dementia if you have:
- Diabetes
- Heart disease
- Sleep apnoea
- Cardiovascular disease (including high blood pressure, high cholesterol or being overweight)
- Previously suffered a stroke
Controlling risk factors
Cardiovascular disease is one of the main risk factors in developing vascular dementia. A person can reduce their risk of cardiovascular disease – and the various conditions it covers – by having regular medical check-ups, not smoking, keeping physical fit, eating a healthy and balanced diet, and drinking alcohol in moderation.
Recent studies have also linked vascular dementia to people with a history of depression, so it is also recommended that medical advice be sought if this is something you suffer from. Moreover, there is strong evidence that keeping mentally, physically, and socially active throughout your life will reduce your risk of dementia.
What are the symptoms of vascular dementia?
Although the causes of the condition are clear, what are the signs and symptoms of vascular dementia?
There are many different signs and symptoms of vascular dementia and how advanced the condition is will dictate which of these you exhibit.
The early signs of vascular dementia include:
- Slowness of thought
- Difficulties with making plans
- Difficulties with comprehension and understanding
- Trouble with concentration and focus
- Sudden changes to mood or behaviour
- Problems with memory and language
The later signs of vascular dementia include:
- Significant slowness of thought
- Persistent feelings of disorientation and confusion
- Persistent memory loss
- Difficulty concentrating
- Difficulties finding the right words in conversation
- Extreme personality changes and mood swings
- Depressive tendencies and a lack of interest or enthusiasm
- Trouble with walking and balancing issues
- Incontinence
Treatment and looking to the future
Although there is no cure for the condition, early intervention and treatment can help to slow down the progression of vascular dementia.
In particular, lifestyle changes might be made to prevent further cardiovascular issues or to lessen your risk overall. In these circumstances, lifestyle changes can be combined with appropriate medicines.
It is particularly important to intervene as early as possible so that a care plan can be created. This will ensure that appropriate treatment can be received. A care plan might include carer support, lifestyle changes, financial assistance, and other alterations to your home environment. Where appropriate, this could also include occupational therapy, physiotherapy, and speech and language therapy.
A new drug treatment called Cerebrolysin has also been developed specifically to treat vascular dementia. Although it is still in the relatively early stages of clinical research, it has shown positive results in trials. Clinical trials are currently in progress in the UK, although the drug is yet to be licensed.
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