Vascular Dementia – Causes, Symptoms, Diagnosis, And Treatment
What is vascular dementia?
Vascular dementia refers to brain damage caused by a series of small strokes over an extended period. It is also called multi-infarct dementia. Dementia is a gradual and permanent loss of brain function. It affects memory, thinking, language, judgment, and behavior.
Vascular dementia is the second most common cause of dementia after Alzheimer disease in people over age 65.
What causes vascular dementia?
A series of small strokes cause vascular dementia. A stroke occurs when the blood supply to any part of the brain is stopped.
- A stroke is also called an infarct. Multi-infarct means that more than 1 area in the brain has been injured due to a lack of blood.
- If blood flow is stopped for longer than a few seconds, the brain cannot get oxygen. Brain cells can die, causing permanent damage.
- When strokes affect a small area, there may be no symptoms. These are called silent strokes. Over time, as more areas of the brain are damaged, the symptoms of dementia appear.
- Not all strokes are silent. Larger strokes that affect strength, sensation, or other brain and nervous system (neurologic) function can also lead to dementia.
The following are the risk factors for vascular dementia:
- Atherosclerosis (hardening of the arteries)
- Hypertension (high blood pressure)
What are the symptoms of vascular dementia?
Symptoms of vascular dementia may develop gradually or may progress after each small stroke. Symptoms may begin suddenly after each stroke. Some people with vascular dementia may improve for short periods, but decline after having more silent strokes.
The following are the early symptoms of dementia:
- Getting lost on familiar routes
- Language problems, such as trouble finding the name of familiar objects
- Losing interest in things you previously enjoyed, flat mood
- Misplacing items
- Difficulty performing tasks that used to be easily done, such as balancing a checkbook, playing games (such as bridge), and learning new information or routines
- Personality changes and loss of social skills
As dementia worsens, symptoms become more visible, and the ability for self-care declines. The following symptoms may occur as dementia progresses:
- Forgetting details about current events
- Remembering events in your own life history, losing awareness of who you are
- Difficulty in doing basic tasks, such as preparing meals, choosing proper clothing, or driving
- Having delusions, depression, or agitation
- Having hallucinations, arguments, striking out, or violent behavior
- Having more difficulty reading or writing
- Having poor judgment and loss of ability to recognize a danger
- Using the wrong word, not pronouncing words correctly, or speaking in confusing sentences
- Withdrawing from social contact
- Change in sleep patterns, often waking up at night
How is vascular dementia diagnosed?
The doctor will perform a physical exam and review your symptoms and medical history. The doctor may order some tests to help determine whether other medical problems could be causing dementia or making it worse, such as:
- Brain tumor
- Chronic infection
- Drug and medicine intoxication (overdose)
- Severe depression
- Thyroid disease
- Vitamin deficiency
The doctor may do the following tests that can show evidence of previous strokes in the brain:
- CT scan of the head
- MRI of the brain
How is vascular dementia treated?
Brain damage caused by small strokes cannot be cured or reversed. The goal of the treatment would be to control symptoms and correct the risk factors.
The doctor may recommend the following treatment or measures to prevent future strokes:
- Avoid fatty foods. Follow a healthy, low-fat diet.
- Don’t drink more than 1 to 2 alcoholic drinks a day.
- Keep blood pressure lower than 130/80 mm/Hg.
- Keep LDL “bad” cholesterol lower than 70 mg/dL.
- Don’t smoke.
- The doctor may suggest blood thinners, such as aspirin, to help prevent blood clots from forming in the arteries.
The goals of helping someone with dementia in the home are to:
- Manage behavior problems, confusion, sleep problems, and agitation
- Remove safety hazards in the house
- Support family members and other caregivers
The doctor may prescribe medicines to control aggressive, agitated, or dangerous behaviors.
This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.