Vascular Dementia

Vascular Dementia: Causes, Symptoms and Treatments

Vascular dementia, also called multi-infarct dementia, is caused by reduced blood flow to the brain. Conditions like heart disease, stroke, and atherosclerosis (hardening of the arteries) can block significant blood vessels, eventually causing widespread damage that affects memory recall and learning.

According to the Alzheimer’s Association, vascular dementia is the second most common form of dementia, accounting for five to ten percent of dementia cases. However, many professionals believe this disease is grossly underdiagnosed. Thus, family members and friends must understand what causes vascular dementia, vascular dementia symptoms and stages, what treatments are available, and how to access dementia care.

What Is Vascular Dementia?

According to the Mayo Clinic, vascular dementia is a term applied to individuals who have issues remembering current and past situations, making decisions and plans, solving problems, and reasoning. These issues occur when the blood flow to a person’s brain is reduced. Individuals who suffer from a stroke, or a blockage in the arteries supplying blood to the brain, are at a very high risk of later developing vascular dementia. Approximately one in four stroke victims will go on to develop signs of dementia.

Other conditions, such as heart disease and atherosclerosis can also abruptly reduce the brain’s blood supply. Individuals with diabetes, high blood pressure, or high cholesterol are more likely to develop vascular dementia as well since these conditions can stiffen blood vessels or cause fatty build-up. The likelihood of developing vascular dementia only increases if these conditions are not treated and controlled.

Vascular brain changes often occur in tandem with other forms of dementia like Alzheimer’s disease and Lewy body dementia, a less common condition caused by microscopic deposits that slowly damage brain cells. Because of this, some individuals with vascular dementia are diagnosed with mixed dementia. Researchers believe having two or more types of dementia has a greater impact on the brain than one type alone.

Vascular Dementia Symptoms

Vascular dementia symptoms vary depending on how severely the brain’s vascular system has been damaged and which part of the brain has been affected. Symptoms may also mirror those of Alzheimer’s disease, which is why testing is vital in determining an accurate diagnosis.

Symptoms include:

• Problems with short-term memory and language
• Slowness of thought
• Mood changes
• Trouble concentrating
• Inability to follow instructions
• Loss of bladder or bowel control
• Hallucinations or delusions

Vascular Dementia Stages

There are seven vascular dementia stages. Of course, the disease’s progression will vary depending on the individual. Some see a slow decline that mirrors Alzheimer’s. Others experience   a “stepwise” pattern of progression: periods of decline followed by periods of stability. If an individual experiences rapid decline, this could suggest that a major stroke has occurred.

Generally, however, an individual with vascular dementia will experience the following stages:

1. No cognitive decline. Behavior is normal. There may be no identifiable symptoms in the earliest stage, although the brain may already be experiencing changes.
2. Very mild cognitive decline. Forgetting simple things or misplacing items may be seen as an age-related situation; however, it is a sign of memory loss.
3. Mild cognitive decline. During this period, more subtle changes become noticeable. The individual may have difficulty concentrating or finding the right words. They may get lost more often or be unable to perform at work. Stage three typically spans seven years.
4. Moderate cognitive decline. At this point, signs and symptoms will become more evident to others. The individual will be unable to manage finances, travel alone, or complete difficult tasks. This stage will last two years.
5. Moderately severe cognitive decline. During this stage, which typically lasts for 1.5 years, an individual will need assistance with daily tasks like bathing, using the restroom, and getting dressed. They will forget important details like their telephone number or where they are.
6. Severe cognitive decline. Constant supervision is now needed for those living at home. There may be noticable changes in their personality, such as anger and aggressiveness. They may become incontinent, delusional, and non-verbal. This stage can last for 2.5 years.
7. Very severe cognitive decline. The individual will lose all motor skills. Unable to walk, they will require constant supervision and assistance. This stage can last for 2.5 years.  

Causes and Risk Factors

Vascular dementia is caused by reduced blood flow to the brain. Various conditions can compromise the brain’s vascular system, stroke being the most common. A stroke occurs when an artery is blocked or a blood vessel leaks or bursts. Though it is possible for an individual to have a stroke and not experience any apparent symptoms, silent strokes still increase a person’s likelihood of developing vascular dementia. The more strokes a person experiences, the higher their chances of brain damage.

Blood clots can also cause vascular dementia by partially or completely limiting the flow of blood to brain tissue. Deposits of plaque and cholesterol in arteries, a brain hemorrhage, and the natural aging process can result in vascular dementia as well.

The risk factors associated with vascular dementia are:

• Blood clotting conditions
• Diabetes
• High blood pressure
• High levels of triglyceride and cholesterol
• High levels of homocysteine
• History of dementia in the family
• Increasing in age
• Little to no physical activity
• Metabolic syndrome
• Obesity

Vascular Dementia Diagnosis

There is no singular test to determine if a patient does or does not have vascular dementia. However, a doctor can still make a judgment call based on symptoms and medical history. He or she can also run a few tests to clarify the diagnosis.

Lab Tests

Lab tests are the first step. These tests will be used to gauge the health of a patient’s cardiovascular system. High blood pressure and high cholesterol, for example, are risk factors because they strain the cardiovascular system. Blood sugar is essential, as well because diabetes can stiffen blood vessels. The doctor will also be examining the patient’s overall health, ensuring that no underlying conditions like thyroid disease or vitamin deficiencies are causing memory loss.

Carotid Ultrasound

Among the same lines of lab testing, a carotid ultrasound evaluates the health of a patient’s cardiovascular system. Specifically, this test uses sound waves to determine if the carotid arteries (those supplying blood to the brain) are clogged by fatty deposits called plaque. To prevent stroke, a doctor may suggest surgery to remove the plaque or surgery to place a stent in the artery.

Brain Imaging

Brain imaging will reveal irregularities caused by strokes, blood vessel diseases, tumors, or trauma. Standard procedures include a computerized tomography (CT) scan, which will generate cross-sectional slices of a patient’s brain, and magnetic resonance imaging (MRI), producing detailed images of the brain. An electroencephalogram (EEG) may also be ordered to evaluate the brain’s activity.

Neuropsychological Assessment

A doctor may conduct a neuropsychological assessment to examine a patient’s reasoning and thinking skills. Since individuals with vascular dementia often struggle to analyze problems and present solutions, this qualitative test can be beneficial. The exam will test a person’s ability to speak, write, and understand language; learn and remember information; create solutions to problems, and work with numbers.

Vascular Dementia Treatment

Though vascular dementia treatment options cannot reverse brain damage, they can help reduce further damage. These options focus on minimizing risk factors and, in return, slowing the disease’s progression. A doctor will likely prescribe medications to control and manage conditions like diabetes, high blood pressure, and high cholesterol. For example, an individual with blood clotting conditions such as venous thromboembolism, or the tendency to develop blood clots in the legs’ deep veins, will be prescribed a blood thinner like Warfarin.

Lifestyle changes are also important. A doctor will suggest that patients with vascular dementia limit alcohol consumption, maintain a healthy diet, stop smoking, and incorporate more physical activity.

Vascular Dementia Care

Depending on the disease’s progression, an assisted living community with memory care services may be the next best step. Vascular dementia can make living alone impossible, if not dangerous. Even in the moderate stages of decline, an individual will struggle to manage finances and travel alone. In the later stages, they will need constant supervision and assistance with daily activities like bathing, getting dressed, and eating. An assisted living community can provide families and friends with peace of mind.

At The Brielle, our goal is to support, promote, and emphasize each resident’s needs on a spiritual, intellectual, physical, and social level. We do this by providing a safe and secure environment. Our trained team members assist residents with expert care and compassion at our ten acre assisted living and memory care campushelping each individual reach their own goals.

Our customized, one-on-one programs are designed to focus on and fulfill the needs of each resident. We do this by providing a variety of programs like:

• Cognitive games
• Social interaction
• Music therapy
• Travel times
• Wellness services
• Pet therapy

To learn more about our memory care community, download our brochure. For more information about The Brielle and what we have to offer, please give us a call or contact us using our online form.