Vascular dementia

Overview

Vascular dementia is a condition characterized by difficulties in reasoning, planning, judgment, memory, and other cognitive functions resulting from brain damage caused by reduced blood supply to the brain. Although strokes can be a contributing factor, vascular dementia can also occur due to other disorders that damage blood vessels and disrupt circulation, leading to a deprivation of oxygen and nutrients to the brain.

Various factors increase the risk of developing vascular dementia, which are similar to those associated with heart disease and stroke. These factors include smoking, high blood pressure, high cholesterol levels, and diabetes. By effectively managing and controlling these risk factors, it is possible to reduce the likelihood of developing vascular dementia.

Symptoms

The symptoms of vascular dementia differ according to the area of the brain where blood flow is compromised. The signs and symptoms of different forms of dementia, including Alzheimer’s disease dementia, frequently coincide. However, unlike Alzheimer’s disease, the most important symptoms of vascular dementia typically include thinking quickly and solving problems rather than memory loss.

Signs and symptoms of vascular dementia include:

• Confusion
• A diminished capacity to plan ideas or actions
• Problems in concentration and keeping attention
• Problems with memory, organization and decision making
• Slowed thinking
• A decline in the capacity to assess a situation, come up with an appropriate strategy, and convey that strategy to others.
• Urge to urinate suddenly or frequently or inability to control urinating
• One side of the body or face has numbness or paralysis 
• Indifference or depression 
• Unstable walk

The symptoms of vascular dementia can be most noticeable when they manifest rapidly following a stroke. In such cases, the condition is sometimes referred to as post–stroke dementia, as the changes in cognitive abilities and thinking processes are directly linked to the occurrence of a stroke.

Vascular dementia symptoms can occasionally manifest in a distinct pattern following a series of strokes or ministrokes. Unlike the gradual and continuous decline typically associated with Alzheimer’s disease dementia, cognitive changes in vascular dementia tend to occur in observable stages, gradually declining from the individual’s previous level of functioning.

However, similar to dementia caused by Alzheimer’s disease, vascular dementia can also manifest gradually over time. Furthermore, it is not uncommon for Alzheimer’s disease and vascular disease to coexist, with many individuals exhibiting signs symptoms of both conditions.

Research studies indicate that a significant number of individuals diagnosed with dementia and displaying signs and symptoms of brain vascular disease are affected by Alzheimer’s disease as well.

Causes

Vascular dementia is a disease that affects the blood arteries in your brain, making it less able to provide your brain with the nutrients and oxygen it requires to function properly.

Vascular dementia may be caused by a number of common conditions, including:

• Stroke which clogs the artery of the brain (infarction). Vascular dementia is typically one of a number of symptoms brought on by strokes that block a brain artery. However, not all strokes result in any obvious symptoms. The risk of dementia is nevertheless raised by these quiet strokes.

The likelihood of developing vascular dementia rises with time and the number of strokes, whether silent or obvious. Multi–infarct dementia is one form of vascular dementia in which there have been numerous strokes.

• Brain hemorrhage. Often brought on by a blood artery weakening due to high blood pressure, which causes damage–causing bleeding into the brain, or by an accumulation of protein in small blood vessels that weakens them over time as we age (cerebral amyloid angiopathy).
• Narrowed or persistently damaged blood vessels in the brain. Vascular dementia can also be brought on by illnesses that narrow your brain’s blood vessels or harm them permanently. These problems include the deterioration brought on by aging, high blood pressure, atherosclerosis, aberrant blood vessel aging, and diabetes.

Risk factors

The risk factors for heart disease, stroke, and vascular dementia are often the same. There are several risk factors for vascular dementia:

• Old age. As you age, your risk of developing vascular dementia increases. Prior to age 65, the disorder is uncommon, and by your 90s, the risk has significantly increased.
• Heart attacks, strokes or ministrokes medical history. You might be more likely to experience issues with the blood vessels in your brain if you’ve had a heart attack. Dementia risk may be impacted by the brain damage brought on by a stroke or ministroke (transient ischemic attack).
• Atherosclerosis. Plaques, which are accumulations of cholesterol and other chemicals, narrow your blood vessels and cause this illness. Atherosclerosis can raise your risk of developing vascular dementia by decreasing the blood supply to your brain.
• Elevated blood pressure. The blood arteries throughout your body, including those in your brain, are subjected to additional strain when your blood pressure is too high. This raises the possibility of cerebral vascular issues.
• Elevated cholesterol. Vascular dementia risk is raised by high levels of low–density lipoprotein (LDL), the “bad“ cholesterol.
• Diabetes. Your entire body suffers blood vessel damage from high glucose levels. Your risk of stroke and vascular dementia can increase if your brain blood arteries are damaged.
• Smoking. Smoking causes blood vessel damage, which raises your risk of vascular dementia, atherosclerosis, and other circulatory illnesses.
• Obesity. Being overweight raises your risk of developing vascular dementia because it is a known risk factor for vascular disorders in general.
• Atrial fibrillation. Your heart’s upper chambers start to beat quickly and erratically, out of sync with its lower chambers, during this abnormal heart rhythm. Because atrial fibrillation makes blood clots form in the heart that can separate and go to the blood arteries in the brain, it raises your risk of stroke.