What Is Vascular Dementia?
Vascular dementia is a form of dementia caused by damage from impaired blood flow to the brain—either a partial or complete blockage from a blood clot. Vascular dementia often develops after a stroke blocks an artery to the brain or a series of minor, asymptomatic strokes. Vascular dementia can also occur after major surgery, like a heart bypass, or caused by damaged blood vessels and reduced circulation—even for a short time—that deprives the brain of much-needed oxygen and nutrients.
Symptoms are often described as memory loss, problem-solving issues, inability to plan, or poor judgment and reasoning. Symptoms and changes in behavior often depend on the size and location within the brain that is damaged. If a large area of the brain is affected, symptoms may occur suddenly. An individual can experience more significant gaps in memory or, in some cases, are unable to function normally. But for other individuals, vascular dementia may go unnoticed at first because symptoms may gradually appear over time.
What is the Difference between Vascular Dementia and Alzheimer’s?
Alzheimer’s is the number one cause of dementia by far, affecting more than 5.5 million people in the United States. Vascular dementia is the second most prevalent form of dementia, affecting approximately 50% of all dementia cases in older adults.
Many medical professionals describe the cognitive decline in those with vascular dementia as step-like, where brain function may hold steady between steps, or symptoms can come on suddenly after an event like a major stroke. In contrast, Alzheimer’s is a more steady downward decline over time in stages. Typically, symptoms do not come on suddenly for those with Alzheimer’s but can change significantly from day to day as symptoms progress.
Although some symptoms may overlap in brain functioning between the two forms of dementia, the causes are different. The specific cause of Alzheimer’s isn’t fully understood, but factors like genetics, age, lifestyle, and the environment can contribute to the cause. In comparison, vascular dementia is often caused by a specific event like a stroke or an interruption in blood flow to the brain. Heart disease, diabetes, high blood pressure, and high cholesterol can put a person at higher risk of vascular dementia.
One other unique note about vascular dementia is that it can occur at the same time as Alzheimer’s—called mixed dementia. One of the two types is typically more dominant during the diagnosis process, and the more apparent dementia will determine the treatment course.
What is the Difference between Vascular Dementia and Other Forms of Dementia?
A common difference between some forms of dementia and vascular disease is the stages and progression of the disease. Most forms of dementia follow seven stages of progression—moving from mild and early stages through middle stages and then late stages. Vascular dementia can happen suddenly after a stroke or interruption in blood flow to the brain, and many people’s symptoms stabilize for more extended periods before progressing.
Prevention may be the key difference between vascular dementia and other forms of dementia because vascular dementia is often linked to a stroke or damaged brain tissue. The cause of many types of dementia is largely unknown. But in the case of vascular dementia, precautionary steps can be taken to prevent a heart attack or stroke. Quitting smoking, reducing alcohol consumption, lowering one’s blood pressure, and reducing stress can all be helpful preventative measures.
What are the Common Symptoms of Vascular Dementia?
Depending on the area of the brain where blood flow has been impaired, vascular dementia symptoms can vary. Symptoms often overlap with other forms of dementia, especially Alzheimer’s. But the most prominent symptoms of vascular dementia involve problem-solving and reaction time rather than long-term memory loss. Clear-cut symptoms may occur suddenly after a stroke with changes in behavior, thinking, or reasoning.
Vascular dementia symptoms include:
- Trouble concentrating
- Unable to organize thoughts or plans
- Slowed thinking
- Issues with regulating moods
- Hallucinations and delusion
- Unsteady gait
- Memory loss
- Restlessness or lack of interest
- Frequent headaches
- Difficulty speaking
- Lack of bladder control
How are People Diagnosed with Vascular Dementia?
If you or someone you love has concerns that they may have any type of dementia or vascular dementia, make an appointment with the individual’s general practitioner. An early diagnosis of dementia of any kind can be beneficial to the individual. A diagnosis can help clarify a person’s symptoms, provide access to early treatment and support, and allow them to prepare for changes in the future. Lifestyle changes and treatment can slow down the progression of symptoms for some individuals who are diagnosed with vascular dementia.
The physician will review a patient’s medical history, including questions about high blood pressure, diabetes, and dementia or cardiovascular disease in family members. A physical exam will help determine if a person’s symptoms are impeding their life. Labs can also help to assess blood glucose, cholesterol, and homocysteine levels, as well as testing blood pressure. And a test of mental abilities will help find subtle changes or struggles. A general practitioner may refer their patient to a specialist who can run a broader range of tests to assess their symptoms in more detail.
If a patient is suspected of having vascular dementia, a brain scan can find changes in the brain. A CT or MRI can rule out issues, such as a brain tumor or build-up of fluids. A brain scan can also show brain tissue damage due to a stroke or series of smaller strokes, which can help to diagnose vascular dementia.
What are the Common Causes & Risk Factors for Vascular Dementia?
The most substantial risk factor for vascular dementia is beyond our control—it’s age. After the age of 65, a person’s risk factor for vascular dementia nearly doubles every five years. And men are at a slightly higher risk of getting vascular dementia than females.
Since you cannot turn back time, reducing the risk of vascular dementia starts with controlling one’s risk of heart disease, stroke, and diabetes with prescription medications and a lifestyle change. If you have a family history of stroke, heart disease, or diabetes, you should be extra vigilant. Reduce high blood pressure, control cholesterol, keep a healthy weight, reduce stress, and get regular check-ups to reduce cardiovascular disease risk. Stop smoking, stay physically active, eat a balanced diet, and consume alcohol in moderation are simple steps to ensure a healthy lifestyle and to lower your risk of vascular dementia.
What is the Typical Prognosis for Someone with Vascular Dementia?
If the underlying health issues can be controlled, it may be possible to slow down the progression of vascular dementia. For example, the treatment of high blood pressure can reduce the risk of another stroke and further damage. For stroke-related vascular dementia, treatment and medication can prolong symptoms from getting worse for extended periods.
Vascular dementia has no cure. The typical prognosis for vascular dementia most often results in around-the-clock care due to mental and physical decline. Family members may be able to care for a loved one early in their diagnosis. But as your loved one’s symptoms progress, professional care in a long-term senior living community that specializes in memory care will be needed.
In the early stages, family members can help support a loved one’s independence by breaking tasks down into smaller bite-sized steps to accomplish a goal. Creating a quiet and calm space can help someone with vascular dementia concentrate easier and cope with their cognitive symptoms. And if your loved one is experiencing memory loss, a scheduled routine can help alleviate frustration and maintain independence.
How Does Vascular Dementia Affect Life Expectancy?
If the underlying health conditions that cause vascular dementia are untreated, the long-term prognosis is not favorable. If another stroke happens, further damage can affect more brain function, memory, and independence or cause severe deterioration. Eventually, untreated vascular dementia can end in death from a stroke, heart disease, or infection.
Because vascular dementia is often linked to a stroke, a patient’s health may be complicated and worse overall. Research suggests that even with treatment, life expectancy is between three to five years.
What are the Typical Phases of Vascular Dementia?
Vascular dementia does not always follow typical stages, as you see with other forms of dementia. A person may experience a stroke that leaves them physically weaker, along with cognitive issues that happen suddenly. Medical professionals often describe the changes in behavior and health of an individual with vascular dementia as “steps.” An individual may stay in one phase or “step” for an extended amount of time with relative stability. Often these steps are broken into three steps: early, middle, and late.
In the early phase of vascular dementia, individuals often have trouble finding the right words, following simple directions, paying attention, and lack the ability to organize, plan, and perform a task. Walking may be more difficult. Emotionally, they may experience some mood swings and depression, but it’s often manageable at this stage.
Through the middle stages of vascular dementia, symptoms will worsen. A person with dementia may not be aware of their condition, so life can become frustrating, stressful, and disorienting. Their emotions may be running high as they deal with changes which can cause anger, paranoia, irritability, and greater mood swings. Most likely, if not already, they cannot care for themselves alone. At this stage, it’s best to make living arrangements so they are safe 24/7, like an assisted living – memory care community, where they can get assistance with day-to-day activities (ADLs).
At the final point where your loved one is experiencing the late stage of vascular dementia, they will need increased levels of professional support to care for their unique needs. They will be experiencing significant confusion and disorientation. They will need constant guidance and direction for their health and safety. The late stage of vascular dementia significantly impacts communication, logical thinking, physical strength, ability to eat, and both short-term and long-term memory.
Other significant factors that can impact the decline in a person with vascular dementia are the location, size, and extent of damage within the brain. Depending on where the damage occurs, changes can mimic the gradual declining stages of Alzheimer’s, happen suddenly, or triggers for the decline may be less clear. Also, vascular dementia can be complicated when signs of Alzheimer’s are present which can affect the rate of decline.
It’s important to understand that vascular dementia affects everyone differently. There is no single path or predictable pattern for this dementia. And as a person goes through the different steps, they can still live a full and joyful life.
What is the Most Effective Treatment for Vascular Dementia?
Vascular dementia is progressive with no cure or effective drug treatment. But progression can be slowed down by reducing the risk and treating comorbidities. Medications can manage cholesterol, diabetes, high blood pressure, and triglycerides that can affect blood flow to the brain. The symptoms of dementia can be treated with treatments like cholinesterase inhibitors.
Lifestyle changes can significantly affect the overall health of an individual with regular exercise and a healthy diet along with quitting smoking and consuming alcohol in moderation. In some cases, surgical procedures can improve blood flow to the brain, such as a stent, angioplasty, or carotid endarterectomy.
In addition to medical care, your loved one can benefit from moving to a memory care community with around-the-clock staff who can care for and manage the unique behaviors that come with dementia. A memory care community is purpose-built to address the unique needs of people living with dementia with safety measures and design features to ensure residents are secure and comfortable. Staff members are specially trained to handle the behaviors that can happen with dementia with gentle redirection and daily support to alleviate agitation and frustration. Staff cater memory care activities and programs to the cognitive level and interests of the residents. Stimulating activities, physical movement, brain exercises, group activities, music therapy, and strength training help residents stay active and moving.
If your loved one with vascular dementia or any form of dementia needs assistance, visit one of our local Aegis Living communities to speak with our expert caregivers. A memory care community can keep your loved one active, engaged, and thriving.