Vascular dementia represents a challenge for those affected by it and their caretakers. But with an understanding of the condition, and a willingness to make important lifestyle changes, it may be possible to prevent further blockages and compensate for brain damage that has already occurred.
What is vascular dementia?
Vascular dementia refers to a subtle, progressive decline in memory and cognitive functioning. It occurs when the blood supply carrying oxygen and nutrients to the brain is interrupted by a blocked or diseased vascular system. If blood supply is blocked for longer than a few seconds, brain cells can die, causing damage to the cortex of the brain—the area associated with learning, memory, and language.Depending on the person, and the severity of the stroke or strokes, vascular dementia may come on gradually or suddenly. Currently, there is no known cure, but the good news is that making certain lifestyle changes and using practical strategies may help prevent strokes, compensate for cognitive loses, and slow its development.
Signs and symptoms of vascular dementia
Vascular dementia affects different people in different ways and the speed of the progression varies from person to person. Some symptoms may be similar to those of other types of dementia and usually reflect increasing difficulty to perform everyday activities like eating, dressing, or shopping.
Behavioral and physical symptoms can come on dramatically or very gradually, although it appears that a prolonged period of TIAs—the mini-strokes discussed above—leads to a gradual decline in memory, whereas a bigger stroke can produce profound symptoms immediately. Regardless of the rate of appearance, vascular dementia typically progresses in a stepwise fashion, where lapses in memory and reasoning abilities are followed by periods of stability, only to give way to further decline.
Causes of vascular dementia
Stroke, small vessel disease, or a mixture of the two can cause vascular dementia. Most commonly there is a blockage of small blood vessels somewhere in the vast system of arteries that feeds the brain and enters through the base of the skull. Blockages may be caused by plaque build up on the inside of the artery wall, or by blood clots which have broken loose and clogged a tributary further downstream. Clots can form as a result of abnormal heart rhythms, or other heart abnormalities. Also, a weak patch on an artery wall can balloon outward and form an aneurysm, which can burst and deprive the brain cells of oxygen. It is estimated that about 50 percent of the cases of vascular dementia result from hypertension, or high blood pressure. Less common causes of vascular dementia are associated with autoimmune inflammatory diseases of the arteries such as lupus and temporal arteritis, which are treatable with drugs that suppress the immune system.
Vascular dementia prevention and treatment
There is not yet a known cure for vascular dementia, so prevention is important. The best way to prevent vascular dementia is to lower the risk of stroke. This means getting high blood pressure under control, avoiding cigarettes, and controlling cholesterol levels and diabetes.But even if you or a loved one have already been diagnosed with vascular dementia, it’s not too late to do anything about it. If you treat the risk factors that led to vascular dementia, you may be able to slow the progression of the disease and possibly reverse some of the symptoms. The most important thing is minimizing your risk of having another stroke and making the dementia worse.
The FDA has not, as yet, approved any medications for the treatment of vascular dementia. However, a number of medications used to treat the cognitive symptoms of Alzheimer’s disease appear to work for vascular dementia, too.
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