Vascular dementia

    Last updated date: 07-May-2023

    Originally Written in English

    Vascular Dementia 

    Vascular Dementia 

    The term "vascular dementia" refers to a group of disorders that result in a loss of cognitive abilities. Individuals who have vascular dementia have difficulty reasoning, making decisions, and remembering things. Such changes might happen quickly or gradually and may be overlooked at first. 

    A blockage or shortage of blood supply towards the brain causes vascular dementia. The brain is deprived of oxygen due to the limited flow of blood. Even a short period without oxygen or blood can cause severe brain damage. 

    After Alzheimer's disease, vascular dementia, also known as vascular cognitive impairment, is the second most frequent form of dementia. 

     

    Signs and Symptoms Vascular Dementia 

    The symptoms of vascular dementia differ based on which section of your brain has poor blood circulation. Symptoms of various types of dementia, including Alzheimer's disease dementia, frequently overlap. Unlike Alzheimer's disease, however, vascular dementia's most prominent symptoms are speed of thought and problem-solving instead of memory loss. 

    The following are signs and symptoms of vascular dementia:

    • Agitation and restlessness
    • Apathy or depression
    • Confusion
    • Deterioration of the capability to examine a situation, devise an effective plan, and convey that plan
    • Having trouble determining what to do next
    • Having trouble focusing and paying attention
    • Impaired ability to coordinate ideas or actions
    • Memory issues
    • Organizational difficulties
    • Slowing down of the thoughts
    • Unstable gait
    • Urge to urinate suddenly or frequently or difficulty controlling passing urine

     

    Stages of Vascular Dementia 

    Stages of Vascular Dementia

    The effects and changes of vascular dementia manifest themselves in stages. Mild cognitive impairment is the initial stage. It’s where people know that their memory and mental abilities have deteriorated. Mild disability can result from a single acute stroke or a sequence of minor strokes. At this point, diagnosing vascular dementia may be difficult. 

    More chronic strokes can cause advanced stages of vascular dementia. A major stroke, in which the brain is deprived of blood and oxygen for a long period, can significantly alter cognitive and physical ability. These signs and symptoms are usually obvious. 

     

    Causes of Vascular Dementia 

    When the blood vessels feeding the brain become narrow or block, vascular dementia develops. Strokes occur when the blood flow towards the brain that carries oxygen is abruptly cut off. Nonetheless, not everyone who has had a stroke gets vascular dementia. 

    While the "silent" strokes accumulate, vascular dementia can develop. Vascular dementia frequently comes to light only after a series of strokes has resulted in a considerable disability. 

    Early detection of vascular dementia helps to reduce the effects and the severity of the disease. Early detection necessitates a thorough understanding of risk factors, as well as attempts to maintain them under control. Any person who feels they are suffering from vascular dementia needs to consult their doctor right away. 

     

    Risk Factors of Vascular Dementia 

    Some of the risk factors that can contribute to the development of vascular dementia include; 

    • Age: Vascular dementia is more common in older people, particularly those above the age of 65.
    • Previous history of stroke or a heart attack: Blood supply towards the brain can be cut off by heart attacks and strokes. Smoking, high blood pressure, and high cholesterol all contribute to an increased risk of these conditions. 
    • Atherosclerosis (hardening of the arteries): Cholesterol and deposits of plaques can accumulate in your arteries. As a result, it limits blood flow and raises heart attack or stroke risks.
    • Atrial fibrillation: This is a condition in which the heart beats irregularly (abnormal heart rhythm). It occurs when the top chambers of the heart start beating fast and erratically, out of coordination with the lower chambers. Since atrial fibrillation triggers blood clots formations within the heart, which might break off and travel to the brain's arteries, it raises the risk of having a stroke.

     

    Vascular Dementia Diagnosis

    Vascular Dementia Diagnosis 

    Neurologists can almost always tell if you have dementia. However, there is no way to know for sure if you have vascular dementia. He or she will determine if vascular dementia is the possible reason for your symptoms depending on your information, including medical history for heart and blood vessel disorders or stroke, and the outcome of the tests that can assist in clarifying the diagnosis. 

    Your medical provider can recommend the following tests and procedures during vascular dementia diagnosis

    Laboratory tests:

    Sometimes, your medical record does not provide recent data for critical indications of heart and blood vessel health. In such cases, the doctor can order lab testing to determine blood pressure, levels of cholesterol, and blood sugar levels. 

    The provider can also conduct tests to help rule out other possible reasons for disorientation and memory loss. These causes can include thyroid problems and vitamins deficiency. 

    Neurological examination:

    Your provider may perform a neurological examination to assess your general neurological health. This could involve conducting tests on the following; 

    • Muscle tone and strength, as well as how one side's strength compares to the other
    • Reflexes
    • The capability to stand up and move across a room.
    • The sensation of sight and touch
    • Balance and coordination

    Brain imaging tests:

    Comprehensive brain images can detect visual anomalies in your thoughts and reasoning due to strokes, tumors, blood vessel illnesses, or trauma. A brain imaging examination enables your provider to narrow down and rule out other possible causes for the symptoms. 

    The following are some of the brain imaging tests the doctor can use to diagnoses vascular dementia; 

    • Magnetic resonance imaging (MRI): This imaging technique creates comprehensive images of the brain using radio waves and a powerful magnetic field. You will recline on a small table that glides into a tubal-shaped MRI scanner. It creates images while making loud pounding noises. 
    • Computerized tomography (CT) scan: You will lie down on a thin table that glides into a narrow chamber for a CT scan. X-rays are used to make comprehensive cross-sectional pictures (slices) of the brain by passing through it at different angles. 

     

    Vascular Dementia Treatment 

    Treatment for vascular dementia aims to address the underlying issues that might be causing the problem. You and your provider will work together to lower blood pressure and the levels of cholesterol. He or she may as well advise you to have a healthy lifestyle that includes an improved diet and additional exercise. This is to avoid heart attacks, clogged arteries, and even strokes.

    Some medications have been proven to help with memory as well as cognitive abilities. They influence the way the cells in the brain communicate, process, store, and regain memories. Currently, no medications have been approved to prevent or reverse the alterations due to vascular dementia. 

     

    Vascular Dementia Prevention 

    Your brain's blood vessels' health is related to the general health of your heart. Taking the following steps to maintain your heart's health might as well help you avoid vascular dementia or reduce the risk: 

    • Maintain a normal blood pressure level: Maintaining healthy blood pressure can help avoid both Alzheimer's disease as well as vascular dementia. 
    • Stop smoking: Tobacco use affects the blood vessels throughout the body.
    • Control or prevention of diabetes: Another strategy to reduce your risk of getting dementia is to prevent the development of type 2 diabetes through dieting and exercising. If you already have the condition, managing your glucose levels might help avoid damages to the brain blood vessels. 
    • Maintain a healthy cholesterol level: A healthy and low-fat diet, as well as cholesterol-reducing drugs if necessary, can help minimize your heart attacks and strokes risks. This is by lowering plaque deposits accumulation in the brain's arteries. 
    • Get more physical activity: Every person's wellness schedule should include regular physical activity. Exercise, in addition to its many other advantages, might help in preventing vascular dementia. 

     

    The prognosis for Vascular Dementia Patients 

    The prognosis for vascular dementia is usually not good if the underlying causes are not treated. For a certain period, an individual with vascular dementia might appear to be improving till another stroke occurs. As a result, it diminishes more brain function, independence, and memory. Vascular dementia that goes untreated frequently leads to death due to heart disease, stroke, or infection. 

    Generally, vascular dementia is a dangerous disorder. However, the best medication is to discover it early to avoid more damages. Patients with vascular dementia can easily recognize and control the disease by collaborating with their providers and family members. 

    Most of the symptoms of vascular dementia might go undetected or be mistaken for something else (stress or depression). Specialized screenings should help detect the memory and cognitive impairments that are frequent in vascular dementia. Make an appointment with your doctor if you detect any changes. 

     

    Conclusion 

    Vascular dementia is a broad term that refers to issues with reasoning, judgment, planning, thinking, and other memory processes. These could occur following brain damage due to reduced blood supply to the brain. A stroke can induce vascular dementia if an artery in the brain is blocked. However, strokes do not always result in vascular dementia.

    Identifying the underlying reason for the condition can assist in determining the best course of action. On the other hand, certain lifestyle adjustments could help avoid additional damage if you have vascular dementia.