Dementia impacts millions of individuals and families each year. Despite its prevalence, many aren’t aware there are different types of dementia, with distinct outward signs and symptoms.
Vascular dementia is what this article will be exploring, in the hopes of spreading knowledge and awareness about this unique type of dementia.
If your family has been impacted by vascular dementia, or you’re concerned it may be affecting someone you love, learning more about this condition can be a powerful tool in your toolbox. It can help you better understand the nature of this issue, its prognosis and treatment options, and to effectively advocate for those who may be experiencing it.
Let’s start by reviewing the brain science that underpins this issue.
What is Vascular Dementia?
In order to understand the nature of vascular dementia, it’s vital to be aware of what it means to have a stroke.
What is a Stroke?
You may not realize it, but your brain depends on a constant supply of oxygen-rich blood in order to do everything it does for you—all day, everyday.
Any disruption of this supply can cause issues even bigger than what we collectively experienced during the pandemic, when crucial goods like lumber, toilet paper, and household cleaners suddenly became as scarce as hen’s teeth.
While you’re likely familiar with stroke as a medical term, you may not be clear on what this condition entails.
A stroke is medically known as a cerebrovascular accident, or CVA.
Put more simply—a stroke is an accident that happens in the blood vessels of the brain.
Since the brain relies on a steady supply of blood from the many vessels that feed it, a stroke acts like a traffic jam—stopping the flow of blood to the areas of the brain that depend upon it.
Depending on the location and severity of a stroke, the accident portion of the term can range from a fender bender to a 40-car pile up.
When parts of the brain go without blood, it cuts off their air supply. Your neurons (the cells that make up your brain’s communication network) start to get sick and die off, the longer they’re deprived of what they need to thrive.
With prompt, targeted treatment, some neurons can be restored. That’s why the common saying in stroke treatment is—time lost is brain lost.
If you or a loved one experience a stroke and survive the event, time is of the essence to treat its effects in the hopes of reversing their severity and lasting impact.
Medical experts refer to this crucial post-stroke time frame as the three-hour window.
Your brain has specific areas that are tasked with crucial functions.
For example, the majority of people are left lateralized for language. This simply means that several of your critical language centers are located in the left hemisphere of your brain.
There’s an area in the left frontal lobe of the brain, known as Broca’s Area, that’s vital for organizing and producing coherent speech. If this area is impacted by a stroke, people lose their ability to speak fluently and coherently.
So, the outward effects of a stroke depend upon the location and the severity of the damage to your brain. This damage is caused by an interruption of blood flow.
Ok, let’s circle back to the main theme—vascular dementia.
What is Vascular Dementia?
Vascular dementia is a condition caused by issues impacting the blood vessels of the brain.
Some define it as a series of strokes.
While it can result from any issues that damage blood vessels and impact circulation—strokes are the most common underlying cause of vascular dementia.
Anything that deprives the brain from its necessary dose of blood-delivered oxygen and nutrients can cause the cognitive changes that are characteristic of vascular dementia.
Some dementia scientists prefer to refer to vascular dementia as vascular cognitive impairment (VCI), as they feel it better conceptualizes the condition’s impact on thinking skills. Others prefer the term, multi-infarct dementia, as it speaks to its stroke-related clinical origin.
The brain abnormalities seen in vascular dementia are almost always evident on brain scans such as MRIs.
While a history of stroke doesn’t guarantee a person will develop vascular dementia, stroke survivors are at increased risk for this condition.
Vascular dementia can occur by itself, and can also co-occur with other types of dementia. Referred to as mixed dementia, or mixed-picture dementia, this means more than one type of dementia is present at the same time.
It’s estimated that vascular dementia alone accounts for 5-10% of total dementia cases.
Now that you know what vascular dementia is, let’s take a look at how it typically shows up in those who experience it.
What are the Symptoms of Vascular Dementia?
In general, vascular dementia is characterized by issues with reasoning, judgment, and memory.
Crucial executive function skills include—decision making, planning, thought organization, inhibition, and insight.
But, the outward signs and symptoms of vascular dementia are also largely dependent upon the underlying areas of the brain that are impacted. As is the case with any stroke, the impairments seen are contingent on the location and severity of the damage to the brain.
People with vascular dementia often present with symptoms including—
- Difficulty concentrating
- Problems with thought organization
- Memory issues
- Difficulty communicating
- Slow processing of information
- Unsteady gait
- Problems with analyzing and understanding situations
- Troubles with decision making
In some cases, people with vascular dementia also experience restlessness and agitation, depression, anxiety, and apathy. They may present with personality changes that can be concerning and even upsetting to loved ones.
Some people with vascular dementia also experience difficulties with urination. This can involve increased frequency in the need to urinate, or difficulty controlling the passage of urine.
Some Ways Vascular Dementia Shows Up In Real Life
Your loved one with vascular dementia may experience issues with—
- Misplacing things
- Struggling to perform daily tasks as they once did, like paying bills or keeping a calendar
- Forgetting current or past events, or mixing up details
- Finding the right words to express themselves
- Getting lost, even in familiar surroundings
- Changes in sleep patterns
- Changes in reading and writing skills
- Changes in personality and behavior
- Difficulties with judgment and insight, such as failing to recognize potential danger
- Changes in mood, which can include depression, agitation, and anger
- Hallucinations or delusions (seeing things that aren’t there, believing things are true that aren’t)
- Trouble understanding and following directions
It’s understandable how any of these issues can cause family members and loved ones to feel worried and even upset. It can be very difficult to witness someone you care for experiencing cognitive changes.
One powerful, positive strategy for supporting both your loved one and yourself in this situation is seeking out the knowledge and community you need to understand dementia and realize that you’re not alone.
But, it’s also important to seek out quality sources of information. While the internet is a marvelous thing, it can also be rife with misinformation.
Here are some sources of high-quality information on vascular dementia—
The American Heart Association maintains the Stroke.org website, which is a wonderful resource about all things stroke-related.
The U.S. Department of Health and Human Services released this in-depth article on their Alzheimers.gov site about vascular dementia, to help spread awareness about this condition.
The National Institute of Neurological Disorders and Stroke (NINDS) created this wide-ranging overview of multi-infarct dementia, which also reviews current research efforts.
This article from the National Heart, Lung, and Blood Institute provides another helpful overview of vascular dementia, and also includes a link to this infographic handout about dementia from the National Institute on Aging.
You may also be interested in learning about prevention and treatment options for vascular dementia. Let’s explore some.
How Can I Prevent and Treat Vascular Dementia?
One silver lining to vascular dementia is that it has more known preventable risk factors than other types of dementia.
Whenever major risk factors for a disorder are within your control to manage—you have an opportunity to invest in preventative measures, to reduce risks for developing the condition.
Many of the major risks for vascular dementia are the same as those for stroke.
Lifestyle factors that contribute to risks for stroke and vascular dementia include—
- Poor diet
- Lack of exercise
- Moderate to heavy alcohol consumption
The good news? All these risk factors are within your control to change.
Making lifestyle changes that address these issues will decrease your risk for stroke and vascular dementia.
Several medical conditions are also associated with an increased risk of stroke and vascular dementia. These include—
- Cardiovascular issues (such as high blood pressure and atrial fibrillation)
- Circulation issues (like atherosclerosis)
- High cholesterol
More good news? Most of these conditions can be effectively managed with a combination of a doctor’s help, lifestyle changes, and medications.
Because vascular dementia’s presence can be difficult to pinpoint, it’s a good idea to pursue professional cognitive screening if you’re concerned your loved one may have this condition.
People considered at increased for vascular dementia include those who have suffered a stroke or transient ischemic attack (TIA) (also commonly referred to as a mini-stroke), and those who have medical issues impacting their heart or blood vessels.
If your loved one falls into one of these groups and you have concerns about their risks for vascular dementia, you can discuss it with their doctor and request in-depth cognitive testing.
At this time, the treatments for vascular dementia primarily target the medical issues that are known to impact this condition. This includes managing and treating conditions like diabetes, high cholesterol, high blood pressure, and cardiac issues.
While the FDA has yet to approve a medication specific to the treatment of vascular dementia, clinical trials have shown some promise in the use of Alzheimer’s medications to treat its symptoms.
Currently, the main goal of vascular dementia treatment is to slow its progression and manage symptom severity.
While there’s not yet a cure, researchers are actively investigating and conducting clinical trials, in the hopes of finding a cure for all types of dementia.
If your family has been touched by this condition, there is help and support available—for everyone involved.
Here’s a link to the Alzheimer’s Association site’s search page for support groups by location. Many support groups exist both for individuals with dementia and their loved ones and caregivers.
This article from the Alzheimer’s Society offers caregivers ideas and advice about treatments and daily support strategies for loved ones with vascular dementia.
Assistance from rehabilitation professionals such as speech-language pathologists (SLPs), occupational therapists (OTs), and physical therapists (PTs) can also help individuals and families address the challenges of vascular dementia with effective strategies and supports.
If your life or the life of a loved one has been impacted by vascular dementia, it’s important to know—there are many resources available to help you navigate life with this condition. You don’t have to face the challenges of vascular dementia alone.
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