Vascular dementia is a general term that describes problems with reasoning, planning, judgment, memory and other thought processes caused by damage to the brain due to poor blood flow.
Vascular dementia, which is characterized by blockage of an artery in the brain, can develop after a stroke, but stroke is not always the cause of vascular dementia. Whether a stroke affects thinking and reasoning depends on the severity and location of the stroke. Vascular dementia can also result from other diseases that damage blood vessels and reduce blood flow, depriving the brain of vital oxygen and nutrients.
Factors that increase the risk of heart disease or stroke - such as diabetes, high blood pressure, high cholesterol and smoking - also increase the risk of developing vascular dementia. Controlling these factors can help reduce the risk of developing vascular dementia.
Vascular Dementia Symptoms
Symptoms of vascular dementia vary depending on the area of the brain where blood flow is affected. Symptoms often overlap with those of other forms of dementia, including Alzheimer's disease.
Vascular dementia includes signs and symptoms:
- Attention and concentration problems
- Decreased ability to organize thoughts or actions
- Reduced ability to analyze a situation, develop an effective plan and communicate it to others.
- It is difficult to decide what to do next.
- Memory problems
- Anxiety and excitement
- Sudden or frequent need to urinate or inability to control urination.
- Depression or apathy
Symptoms of vascular dementia may be more pronounced when they occur suddenly after a stroke. When changes in thinking and reasoning appear to be clearly related to the stroke, it is sometimes referred to as post-stroke dementia.
Sometimes the characteristic pattern of vascular dementia symptoms follows a series of strokes or mini-strokes. Changes in thought processes occur in sharp steps down from the previous level of functioning, in contrast to the gradual, steady decline that usually occurs with dementia in Alzheimer's disease.
However, vascular dementia can also develop quite gradually, as is the case with dementia due to Alzheimer's disease. In addition, vascular disease and Alzheimer's disease are often associated.
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Studies show that many people with dementia and vascular brain disease also have Alzheimer's disease.
Vascular Dementia Causes
Vascular dementia is the result of diseases that damage the brain's blood vessels, limiting their ability to supply the brain with the nutrients and oxygen it needs to carry out its thought processes.
Among the most common conditions that can lead to vascular dementia are:
- A stroke (heart attack) blocks an artery in the brain. Strokes that block a cerebral artery often cause a range of symptoms that may include vascular dementia. However, some strokes cause no noticeable symptoms. These silent strokes still increase the risk of dementia.
In cases of silent or overt stroke, the risk of vascular dementia increases with the number of strokes that occur over time. One form of vascular dementia associated with multiple strokes is called multiple stroke dementia.
- Narrowed or chronically damaged blood vessels in the brain. Vascular dementia can also be caused by conditions that narrow or cause long-term damage to blood vessels in the brain. These include age-related wear and tear, high blood pressure, abnormal aging of blood vessels (atherosclerosis), diabetes, and cerebral hemorrhage.
Vascular Dementia Risk Factors
In general, the risk factors for vascular dementia are the same as those for heart disease and stroke. Risk factors for vascular dementia include:
- With age. The risk of vascular dementia increases with age. Before the age of 65, the disease is rare, but after the age of 90, the risk increases considerably.
- History of myocardial infarction, stroke or mini-stroke. If you have had a heart attack, you may be at increased risk for problems in the blood vessels of the brain. Brain damage that occurs during a stroke or mini-stroke (transient ischemic attack) may increase the risk of developing dementia.
- Abnormal aging of blood vessels (atherosclerosis). This disease occurs when deposits of cholesterol and other substances (plaques) form in the arteries and narrow the blood vessels. Atherosclerosis can increase the risk of vascular dementia by reducing blood flow to the brain.
- High cholesterol levels. Elevated levels of low-density lipoprotein (LDL), the "bad" cholesterol, are associated with an increased risk of vascular dementia.
- High blood pressure. When blood pressure is too high, it puts pressure on blood vessels throughout the body, including the brain. This increases the risk of vascular problems in the brain.
- Diabetes. High blood sugar levels damage blood vessels throughout the body. Damage to blood vessels in the brain can increase the risk of stroke and vascular dementia.
- Smoking. Smoking directly damages blood vessels and increases the risk of atherosclerosis and other circulatory diseases, including vascular dementia.
- Obesity. Obesity is a known risk factor for vascular disease in general and is therefore believed to increase the risk of vascular dementia.
- Atrial fibrillation. In this abnormal heart rhythm, the upper chambers of the heart begin to beat rapidly and irregularly and are not synchronized with the lower chambers of the heart. Atrial fibrillation increases the risk of stroke because blood clots form in the heart, which can break off and enter the blood vessels of the brain.
Vascular Dementia Prevention
The health of the brain's blood vessels is closely related to the overall health of the heart. By taking these steps to keep your heart healthy, you can also reduce your risk of developing vascular dementia:
- Maintain healthy blood pressure. Maintaining normal blood pressure can help prevent vascular dementia and Alzheimer's disease.
- Prevent or control diabetes. Diet and exercise are another way to reduce your risk of developing type 2 diabetes. If you already have diabetes, controlling blood sugar can help protect brain vessels from damage.
- Stop smoking. Smoking tobacco damages blood vessels throughout the body.
- Physical activity. Regular physical activity should be an important part of everyone's wellness plan. In addition to all the other benefits, exercise can help you avoid vascular dementia.
- Keep your cholesterol under control. A healthy, low-fat diet and cholesterol-lowering medications, if you need them, can reduce the risk of stroke and myocardial infarction that can lead to vascular dementia, probably by reducing plaque buildup in the arteries of the brain.