Vascular Dementia

The second most common type of dementia

 

Vascular dementia is the broad term for dementia associated with problems circulating blood to the brain. In this form of dementia, brain cells are deprived of oxygen and die. This can occur in distinct parts of the brain, leaving other areas relatively unaffected.

 

Vascular dementia is the second most common form of dementia and may appear similar to Alzheimer's disease. A mixture of Alzheimer's disease and vascular dementia can occur in some people.

 

Types of vascular dementia

 

There are a number of different types of vascular dementia. Two of the most common are:

 

  • Stroke related dementia
  • Subcortical dementia (Binswanger's disease)

 

Stroke related dementia
A stroke occurs when blood supply to the brain is disrupted suddenly, usually caused by a blood vessel narrowing and being blocked by a clot. In a major stroke, the blood flow is permanently cut off to a part of a brain. In a small stroke, the brain is damaged by a temporary disruption to blood flow. Multi-infarct dementia, the most common, is caused by multiple mini strokes which may not be noticeable until dementia symptoms start to present.

 

Subcortical dementia
Also known as Binswanger’s disease, subcortical dementia damages the layers of white matter deep in the brain. The arteries in the subcortical areas thicken, which impacts blood flow and causes the white brain matter to die. One of the most characteristic symptoms of subcortical dementia is the time required to turn a thought into an action.

 

Early symptoms

 

Symptoms of vascular dementia will depend on the part of the brain that has been affected by the reduced blood flow.

 

Symptoms may be most obvious directly after a stroke, or mini strokes, and be quite sudden. However it can also present in a more gradual decline, similar to Alzheimer’s disease.

 

Symptoms may include:

 

  • Memory problems, either gradual or sudden onset
  • Problems with concentration and attention
  • Slowed thinking
  • Difficulty retrieving words from memory

 

Progression

 

Each person with vascular dementia will have a different experience of the illness, as symptoms can vary from person to person, hour to hour.

 

Vascular dementia can progress in two ways:

 

  • Stepped (most common)
    Symptoms are stable for a time and then get suddenly worse, before stabilising again. The stable period can last months or years, and it is difficult to predict when the next step will occur. The step is usually caused by further strokes
  • Gradual
    The same as Alzheimer’s, where symptoms get progressively worse and new symptoms appear as different parts of the brain are affected

 

The symptoms will depend on the part of brain that has been damaged. They may include:

 

  • Severe problems with speed of thought
  • Increased disorientation and confusion
  • Changes in mood or behaviour, such as aggression, depression, irritability, or apathy
  • Hallucinations or delusions
  • Difficulties with movement and balance
  • Increased urination or incontinence

 

In the final stages of vascular dementia, the person may become much less aware of their surroundings, and require full time care for everyday personal care activities such as dressing, showering, eating, and moving around. Some people move into a special dementia wing at a residential aged care facility.

 

Causes

 

Vascular dementia is associated with strokes, but having a stroke does not mean you will develop dementia.

 

Other causes include damaged blood vessels and reduced circulation, both of which effect the amount of oxygen and nutrients reaching your brain.

 

High blood pressure, high cholesterol, obesity, high alcohol intake and smoking can raise your risk of developing heart disease, and therefore vascular dementia.

 

Like most forms of dementia, age is the biggest risk factor, with the risk doubling every five years after the age of 65. It is not common to develop the condition before the age of 65, but it can occur, and is known as younger onset dementia.

 

Treatment

 

Controlling the risk factors for heart disease and stroke can slow the progression of vascular dementia in some cases. Your doctor may consider prescribing medication to:

 

  • Reduce your cholesterol
  • Lower your blood pressure
  • Control your blood sugar (if you have diabetes)
  • Keep your arteries clear and your blood from clotting

 

There is no strong evidence to suggest that alternative medicines, including vitamins, herbal preparation, or other supplements, prevent or delay any form of dementia, even those that claim to.

 

There are many dementia strategies that can be introduced at home to help you manage your symptoms. These include:

 

  • Preparing your home
  • Regular exercise, such as a walk, exercise bike, or chair exercises with the aid of a DVD
  • Consulting a dietitian to review your meals

 

Support Services

 

A number of dementia support services are available to those living with dementia in Queensland, as well as their families, and carers. These include:

 

 


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