In the United States today, approximately 14% of adults aged 71 and above have dementia. There are many different types of dementia, all of which involve difficulty with memory and thinking. Most people are familiar with the most common type of dementia, Alzheimer’s disease. Less is known about the second most common type, vascular dementia.
Between 5% and 10% of people with dementia receive a vascular dementia diagnosis. Doctors believe that even some people who receive an Alzheimer’s diagnosis may also have vascular dementia.
What is Vascular Dementia?
Vascular dementia, also known as cerebrovascular disease, happens when there’s a lack of blood flow to the brain. The tissues and blood vessels in the brain don’t get enough nutrients, and that leads to tissue damage or death.
In some cases, this tissue damage can cause increasingly severe challenges with thinking and memory. These difficulties look and feel similar to the symptoms of Alzheimer’s disease, so it can be difficult to tell the two conditions apart.
The primary distinguishing factor is what happens within the brain itself. In some cases, however, doctors can tell whether a person has vascular dementia by analyzing what their symptoms are and how those symptoms developed.
Symptoms of Vascular Dementia
Vascular dementia symptoms can vary significantly from person to person. The biggest differences depend on what brain tissue has been damaged and how it happened.
Memory loss may occur, primarily if the damage affects the memory centers of the brain. If there has been damage to other brain areas responsible for higher-order thinking, other symptoms may appear. Potential signs include:
- Confusion
- Disorientation
- Difficulty speaking or processing speech
- Difficulty with planning and organizing
- Trouble with attention, focus and concentration
- Impaired judgment
- Difficulty functioning in social situations
- Difficulty communicating verbally
- Uncontrollable laughing or crying, or emotional numbness
People with vascular dementia are also more likely than those with Alzheimer’s to have trouble with balance and coordination in the early stages of the disease. If a person with early-stage dementia reports difficulty walking or numbness on a single side of the body, the cause is more likely to be vascular dementia than Alzheimer’s.
Stages and Progression
Progression is another factor that distinguishes vascular dementia from Alzheimer’s disease. The symptoms of Alzheimer’s disease tend to get worse gradually, often so much so that it’s difficult to pinpoint when someone transitions from the mild to moderate stage of the disease.
Vascular dementia progresses in a more stepwise fashion, but how fast that happens depends on what triggered the damage. Some people develop vascular dementia after a major stroke. In those cases, symptoms tend to come on with sudden intensity.
For other people, tissue and blood vessel damage happen slowly, sometimes as a result of multiple small strokes. Vascular dementia progresses more gradually in these individuals, though there is still a more distinct progression than a person with Alzheimer’s disease would experience. Symptoms may be very mild after someone’s first mini-stroke, then slightly more severe after the next one, and so on.
Causes and Risk Factors
The cause of vascular dementia is always an interruption of blood flow to the brain. There are two primary reasons why this happens.
Potential Cause: Artery Blockage Due to Stroke
About 80% of strokes involve a blockage of blood flow to the brain. Depending on where this blockage occurs in the brain, it may or may not cause vascular dementia.
The risk is higher if people have had more than one stroke. Scientists have calculated that among people who have had one stroke, about 10% will develop vascular dementia within a year. Among those that have had recurrent strokes, though, the risk of vascular dementia is between 29.6% and 53.1%. On the higher end, that’s more than half of all people with recurrent stroke.
Potential Cause: Narrowed or Damaged Blood Vessels
Stroke isn’t the only condition with the potential to damage brain tissue and cause vascular dementia. There are multiple medical conditions with that potential, including:
- High blood pressure
- Diabetes
- Hardening of the blood vessels (atherosclerosis)
- Brain hemorrhage
When these conditions cause vascular dementia, the progression of symptoms depends on how suddenly the blood flow to the brain gets interrupted. Slower-progressing conditions tend to cause more gradually progressing dementia, while hemorrhage and similar events may cause dementias that more closely resemble those following major strokes.
Risk Factors
Like other types of dementia, a person’s risk of developing vascular dementia increases as they age. Vascular dementia is rare in people under 65 years of age. Once a person reaches age 65, their risk for developing vascular dementia doubles every five years.
As mentioned earlier, a history of stroke also increases a person’s risk of developing vascular dementia, as does a history of any of the following:
- Heart attack
- High cholesterol
- High blood pressure
- Hardening or narrowing of the arteries (atherosclerosis)
- Chronic rapid and irregular heartbeat (atrial fibrillation)
There are also lifestyle and other medical risk factors for vascular dementia. They’re many of the same factors that increase your risk of heart and blood vessel diseases in general. Examples include:
- Smoking
- Poor diet
- Sedentary lifestyle
- Obesity
- Diabetes
Diagnosis and Treatment
Diagnosing vascular dementia usually involves cognitive testing, a physical and neurological exam, lab testing, and brain imaging. Key elements include:
- Blood pressure, cholesterol and blood sugar testing
- Coordination and balance tests
- Tests of strength and muscle tone, especially comparing one side of the body to the other
- Evaluation of a person’s ability to communicate, work with numbers, remember new information and develop solutions to problems
When testing for vascular dementia, in particular, doctors may focus particularly on whether a person can analyze a problem and develop a plan to solve it. These processes tend to be particularly difficult for people with vascular dementia, while people with other kinds of dementia may have more trouble with short-term memory.
Doctors who suspect vascular dementia may also be more inclined to suggest a CT scan or MRI (magnetic resonance imaging) test. These brain imaging techniques can help to identify blood vessel diseases or trauma that may cause vascular dementia symptoms. An MRI is usually preferred for detecting strokes and blood vessel damage since it produces more accurate pictures.
If doctors suspect a stroke, they may also suggest a carotid ultrasound, which uses sound waves to detect blockages in the carotid arteries. These arteries are located in the sides of the neck and supply blood to the brain.
Treating Vascular Dementia
In some cases, managing blood vessel health can help to slow the progression of vascular dementia. That means:
- Keeping blood pressure and cholesterol under control
- Controlling blood sugar, especially if the person has diabetes
- Avoiding saturated fats and eating plenty of fresh produce
- Exercising regularly
- Quitting or avoiding smoking
These lifestyle changes can help to keep the arteries clear and potentially prevent or slow down further damage.
Existing damage usually can’t be reversed, though there are exceptions. Some people who develop vascular dementia after a stroke can recover some cognitive abilities.
There are also some medications that can help to manage symptoms. Some medications prescribed for people with Alzheimer’s disease may help those whose vascular dementia causes memory problems. Depression and anxiety medications may also help to relieve those symptoms in people with vascular dementia.
For the most part, though, treatment for vascular dementia focuses on patient comfort and safety.
Vascular Dementia Care and Support Options
Like other forms of dementia, vascular dementia is a progressive disease. Most people with the disease find that their symptoms get worse over time, usually suddenly and sometimes after a long period of plateau.
In the early stages of the disease, which can last for years, many people manage at home with the help of family members or friends. A stable routine is important and can help the person with vascular dementia to feel safer and more in control.
It also helps to let the person with dementia be as independent as possible, for as long as possible. Doing things independently, as long as it’s safe, can help to keep the mind alert and preserve more cognitive function. Family members and friends should provide support and encouragement, as well as opportunities to participate in favorite leisure activities.
Eventually, most people with vascular dementia will need more help with the basic tasks of living. It’s important to talk ahead of time about what the person wants to happen and where they want to live when that time comes.
Finding a New Home
One of the best things that a family member or friend can do for someone with vascular dementia is to help them find a place to live where they’ll be safe, comfortable and happy, preferably long before they need to move.
The Cabana at Jensen Dunes is committed to being one of those places. Every person is welcomed into the community as a unique individual with plenty to contribute.
If you or someone you care about received a diagnosis of vascular dementia, or if you suspect a vascular dementia diagnosis, take the time to learn more about The Cabana. Knowing that this kind of community is in your future can be encouraging and reassuring — two things that everyone needs, no matter what their situation may be.
Complete our online information request form, and a member of our staff will get in touch with you to answer any questions you have about The Cabana. We look forward to talking with you.