What is Vascular Dementia

Vascular Dementia is a condition in which a person has problems with thinking, memory, and behavior that are severe enough to interfere with daily life. Vascular dementia is a type of dementia. It results from brain damage that is caused by the brain not getting enough blood. Vascular dementia usually begins between 60 and 75 years of age.

What are the causes?

Vascular dementia is caused by conditions that lessen blood flow to the brain. Common causes include:

• Multiple small strokes. These may happen without symptoms (silent stroke).
• Major stroke.
• Damage to small blood vessels in the brain (cerebral small vessel disease).

What increases the risk?

• Advancing age.
• Having had a stroke.
• Having high blood pressure (hypertension) or high cholesterol.
• Having a disease that affects the heart or blood vessels.
• Smoking.
• Having diabetes.
• Being male.
• Being obese.
• Not being active.
• Having depression.

What are the signs or symptoms?

Symptoms can vary a lot from one person to another. Symptoms may be mild or severe depending on the amount of damage and which parts of the brain have been affected. Symptoms may begin suddenly or may develop gradually.

Symptoms may remain stable, or they may get worse over time. Symptoms of vascular dementia may be similar to those of Alzheimer disease. The two conditions can occur together (mixed dementia).

Symptoms of vascular dementia may include:

Mental

• Confusion.
• Memory problems.
• Poor attention and concentration.
• Trouble understanding speech.
• Depression.
• Personality changes.
• Trouble recognizing familiar people.
• Agitation or aggression.
• Paranoia.
• Delusions or hallucinations.

Physical

• Weakness.
• Poor balance.
• Loss of bladder or bowel control (incontinence).
• Unsteady walking (gait).
• Speaking problems.

Behavioral

• Getting lost in familiar places.
• Problems with planning and judgment.
• Trouble following instructions.
• Social problems.
• Emotional outbursts.
• Trouble with daily activities and self-care.
• Problems handling money.

How is this diagnosed?

There is not a specific test to diagnose vascular dementia. The health care provider will consider the person’s medical history and symptoms or changes that are reported by friends and family. The health care provider will do a physical exam and may order lab tests or other tests that check brain and nervous system function. Tests that may be done include:

• Blood tests.
• Brain imaging tests.
• Tests of movement, speech, and other daily activities (neurological exam).
• Tests of memory, thinking, and problem-solving (neuropsychological or neurocognitive testing).

Diagnosis may involve several specialists. These may include a health care provider who specializes in the brain and nervous system (neurologist), a provider who specializes in disorders of the mind (psychiatrist), and a provider who focuses on speech and language changes (speech pathologist).

How is this treated?

There is no cure for vascular dementia. Brain damage that has already occurred cannot be reversed. Treatment depends on:

• How severe the condition is.
• Which parts of the brain have been affected.
• The person’s overall health.

Treatment measures aim to:

• Treat the underlying cause of vascular dementia and manage risk factors. This may include:
  • Controlling blood pressure.
  • Lowering cholesterol.
  • Treating diabetes.
  • Quitting smoking.
  • Losing weight.
• Manage symptoms.
• Prevent further brain damage.
• Improve the person’s health and quality of life.

Treatment for dementia may involve a team of health care providers, including:

• A neurologist.
• A psychiatrist.
• An occupational therapist.
• A speech pathologist.
• A cardiologist.
• An exercise physiologist or physical therapist.

Follow these instructions at home:

Home care for a person with vascular dementia depends on what caused the condition and how severe the symptoms are. General guidelines for care at home include:

• Following the health care provider’s instructions for treating the condition that caused the dementia.
• Using medicines only as told by the person’s health care provider.
• Creating a safe living space.
• Learning ways to help the person remember people, appointments, and daily activities.
• Finding a support group to help caregivers and family to cope with the effects of dementia.
• Helping family and friends learn about ways to communicate with a person who has dementia.
• Making sure the person keeps all follow-up visits and goes to all rehabilitation appointments as told by the health care team. This is important.

Contact a health care provider if:

• A fever develops.
• New behavioral problems develop.
• Problems with swallowing develop.
• Confusion gets worse.
• Sleepiness gets worse.

Get help right away if:

• Loss of consciousness occurs.
• There is a sudden loss of speech, balance, or thinking ability.
• New numbness or paralysis occurs.
• Sudden, severe headache occurs.
• Vision is lost or suddenly gets worse in one or both eyes.