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What is vascular dementia?
Vascular dementia is a degenerative cerebrovascular disease that leads to a 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. Vascular dementia generally affects people between the ages of 60 and 75, and affects more men than women.
The most common type of vascular dementia is multi-infarct dementia (MID), which is caused by a series of small strokes, or “mini-strokes,” that often go unnoticed and cause damage to the cortex of the brain—the area associated with learning, memory, and language. These mini-strokes are sometimes referred to as transient ischemic attacks (TIAs), which result in only temporary, partial blockages of blood supply and brief impairments in consciousness or sight. Over time, however, the damage caused to brain tissue interferes with basic cognitive functions and disrupts everyday functioning.
Multi-infarct dementia causes loss of functioning to specific areas of the brain, impairing some neurological and mental functions and not others. When vascular dementia occurs with other types of dementia, such as Alzheimer’s disease, it is known as “mixed dementia.”
Signs and symptoms of vascular dementia
Signs and symptoms are varied and usually reflect increasing difficulty to perform everyday activities, such as eating, dressing, shopping, etc. Possible signs and symptoms of vascular dementia include:
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Onset can be gradual or dramatic. It appears that a prolonged period of TIAs leads to a gradual decline in memory, whereas a 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.
Brief episodes of numbness and temporary loss of vision, speech, or strength may indicate a mini-stroke (TIA), or be a warning sign of a stroke. If you ever experience these symptoms it is advisable to be proactive and seek medical help.
Causes of vascular dementia
Vascular dementia can be caused in several different ways. 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.
The risk factors associated with vascular dementia, therefore, are those associated with cardiovascular disease. These include: high blood pressure, diabetes, high cholesterol, a family history of heart problems, disease in arteries elsewhere in the body, and heart rhythm abnormalities. Lifestyle factors like being overweight or smoking can contribute to the risk, as well.
It is estimated that about 50 percent of the cases of vascular dementia result from hypertension, or high blood pressure. Rarer causes of vascular dementia are associated with auto-immune inflammatory diseases of the arteries such as Lupus and Temporal Arteritis, which are treatable with drugs that suppress the immune system.
Causes of memory problems other than dementia
It is important to know that memory loss and cognitive problems can have many causes, of which dementia is only one. You should consult a doctor for a proper diagnosis if you are experiencing dementia-like symptoms, as many can be treated relatively simply. Causes of memory problems other than dementia include:
- Malnutrition
- Dehydration
- Fatigue
- Depression
- Adverse reaction to medication
- Thyroid disease
- Metabolic disorder
- Head injuries
- Benign brain tumors
- Viral or bacterial infections
- Parkinson’s disease
Managing symptoms of vascular dementia
Although there are claims that the symptoms of vascular dementia can be reduced in some cases, there is no known, scientifically documented way to restore the normal functioning of brain tissue due to stroke or TIAs. The good news is that further damage can be prevented. Medications may be taken that improve blood circulation to the brain and reduce the probability of future strokes. There are also different therapies such as physiotherapy, occupational therapy, and speech therapy that help stimulate normal movement and speech patterns.
Recovery tips for vascular dementia
Recovery involves learning practical ways to manage memory loss. The Heart and Stroke Foundation of Canada offers suggestions on how to better cope with memory deficits:
- Carry a notepad to write down names, dates, appointment times, and errands that need to be completed. This take the pressure off yourself.
- Inform the people you’re working with that you’ve had a stroke and ask them to speak slowly or repeat information when necessary. That way they know what to expect and you can alleviate any misunderstandings.
- Exercise your brain! At the end of the day, you can set aside time to recall the day’s events, which builds memory capacity.
- Remove distractions such as t.v. or radio when attempting to understanding long messages or instructions,. You can ask the person to break the message into smaller parts, and repeat what you heard back to them.
- Avoid rushing into new tasks; be deliberate and stop to think and plan before beginning.
- Be patient with yourself. Getting angry only makes it more difficult to remember. See if you can learn some relaxation techniques and use them.
- Allow those close to you to help you.
Vascular dementia prevention and support
The best way to prevent vascular dementia is to lower the risk of stroke. Studies have shown that the rate of prevalence for vascular dementia is 9 times higher following a stroke than the rate of prevalence in control groups. There are ways you can reduce your risk of high blood pressure, stroke, and vascular dementia.
Make a commitment to a healthier lifestyle
Not smoking, exercising regularly, and eating a healthy diet (limiting your intake of alcohol, salt and saturated fat) is a great way to reduce your risk of heart disease and many other diseases. Stress is a major contributor to high blood pressure and heart disease, so it’s helpful to learn to manage your stress through relaxation techniques or meditation. Try to get your blood pressure checked at least once a year, as well as your body fat levels measured periodically, especially if you are over 65 or have a history of heart disease.
Ask your physicians about medications
Medications can control high blood pressure and heart disease. Blood thinners, for example, are commonly used to correct an irregular heart beat. In more advanced cases of arteriosclerosis, or hardening of the arteries, surgery may be necessary to restore the blood flow to the brain.
Education, lifestyle changes, and adequate medical advice are the best safeguards. Know the warning signs and start making the necessary life adjustments. The most important thing is to begin! Seek support and encouragement from friends, family, support groups (see References and resources), and health care experts. And remember that even if you have already been diagnosed with vascular dementia, it is not too late to do anything about it.
How can I help someone with vascular dementia?
Individuals with vascular dementia or any other type of dementia should be encouraged to participate in their daily routine, and engage in physical and social activities for as long as possible. Fortunately, there are support groups for caregivers, research studies evaluating medication for improving mental function, and Day Centers that provide activities and socialization for patients.
Related links for vascular dementia
Facts About Dementia – This site from the UK gives clear definitions of the causes, diagnosis, and treatments of the many aspects of vascular dementia. (Alzheimer’s Society)
Multi-Infarct Dementia Fact Sheet – Helpful information on symptoms, treatment options, and how to help a loved one with the disease. A service of the National Institute on Aging. (Alzheimer's Disease Education & Referral Center (ADEAR))
Medicine Plus: Multi-Infarct Dementia – Includes an overview, symptoms, treatment, and prevention, as well as a glossary of terms. (National Library of Medicine / National Institutes of Health)
Aging and Memory: Vascular Dementia – Article from the Newsletter of the Memory Disorders Project at Rutgers University, Summer 2000. (Memory Loss and the Brain)
Memory Fitness for Life – Information about the work of Cynthia Green, Ph.D., a clinical psychologist who founded the Memory Enhancement program at Mt. Sinai Hospital in New York. Looks at memory fitness as the result of attending to multiple lifestyle factors, such as exercise, nutrition, and healthy sleep patterns. (Memory Loss and the Brain)
Heart Disease Support Groups List – An international listing of support groups related to heart disease. (Open Directory Project)
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