Vascular dementia often occurs gradually but is most commonly caused by stroke. It is considered the second most common cause of dementia after Alzheimer's disease. While symptoms can vary from mild to severe, they often include confusion and disorientation, trouble speaking, and a decline in analytical abilities. Getting your risk factors under control and taking care of your heart health is the first step of prevention!
What is Vascular Dementia?
Vascular dementia refers to the specific condition where blood vessels or arteries connected to the brain are damaged. Inadequate blood flow can eventually kill cells everywhere in the body, but the brain is especially vulnerable. Brain cells deprived of oxygen will die over time, impacting cognitive function, eventually leading to dementia.
In general, the risk factors for vascular dementia are similar to those for heart disease and stroke. They can include:
- Age. The risk of vascular dementia rises as we grow older and is more prevalent after the age of 65.
- Heart attack and stroke. Heart attacks often trigger blood vessel damage in the brain. Likewise, a stroke or a mini-stroke (transient ischemic attack or TIA). These events may increase a person’s risk of developing dementia because blood flow to the brain has been impacted.
- Atherosclerosis. This condition refers to the abnormal aging of blood vessels. This condition causes deposits of cholesterol and other plaque to build up in arteries, reducing blood flow to the brain.
- High cholesterol. Elevated levels of low-density lipoprotein (LDL), the "bad" cholesterol, are also associated with an increased risk of vascular dementia.
- High blood pressure. High blood pressure puts extra stress on blood vessels everywhere in your body, including your brain.
- Diabetes. High glucose/sugar levels damage blood vessels throughout your body increases the risk of stroke and vascular dementia.
- Smoking. Since smoking damages blood vessels, it increases the risk of atherosclerosis and other circulatory diseases - leading to vascular dementia.
- Obesity. Being overweight is a proven risk factor for all vascular diseases, including vascular dementia.
- Atrial fibrillation. This abnormal, rapid and irregular heartbeat in the upper chambers of your heart can increase the risk of stroke by causing blood clots to form.
The Symptoms and Stages of Vascular Dementia
Vascular dementia can develop gradually similar to Alzheimer’s dementia, but it is often triggered by a stroke. The impact of vascular damage on our cognitive skills varies widely, depending on the severity of the blood vessel damage and the part of the brain it affects.
Many experts prefer the term “vascular cognitive impairment” (VCI) to “vascular dementia”. Since vascular changes in the brain can range from mild to severe, they feel VCI better describes the wide range of cognitive impact. Vascular dementia symptoms are most obvious following a stroke. These symptoms can include:
- Confusion and disorientation
- Trouble paying attention and concentrating
- Trouble speaking or understanding speech
- Inability to organize thoughts or actions and communicate them
- A decline in analytical ability
- Memory loss
- Balance and walking issues
- Restlessness and agitation
- Depression or apathy
The stages of vascular dementia vary in every instance. It can begin gradually and steadily deteriorate if not addressed. Multiple minor strokes and damage to smaller blood vessels can increase the risk of vascular dementia. Studies also link vascular dementia to Alzheimer's disease, indicating that the two conditions are often concurrent.
Prevention and Treatment of Vascular Dementia
The health of our brains and all our blood vessels has long been linked to overall heart health. A healthy heart can help reduce the risk of a vascular incident that can lead to vascular dementia. Here’s how to keep your heart healthy and prevent vascular damage and dementia:
- Maintain healthy blood pressure
- Actively prevent or control diabetes
- Don’t smoke
- Keep cholesterol in check
- Eat a healthy, balanced diet
- Maintain a healthy weight
- Limit alcohol consumption
It all goes back to a healthy body, healthy brain. Controlling risk factors that may increase the likelihood of further damage to the brain’s blood vessels is an important prevention strategy. Research has proven that addressing risk factors in advance may help prevent a vascular event that can lead to dementia. Following vascular damage, treatment includes managing the health conditions and risk factors that caused it. Maintaining a healthy heart may improve outcomes and help prevent further vascular decline.
Doctors may prescribe medications to:
- Lower blood pressure
- Reduce cholesterol level
- Prevent blood from clotting
- Control blood sugar if diabetes is an issue
Non-pharmaceutical, lifestyle adjustments can also help with treatment such as:
- Regular physical activity
- A healthy diet
- Maintaining normal weight
- Social interaction and other brain-stimulating activities like crossword puzzles, card games, learning a new skill
Vascular dementia often goes unrecognized, so those who have had a stroke or some sort of heart disease should consider professional cognitive screening.
Caring for Someone with Vascular Dementia
Living with and caring for someone with Vascular Dementia can become frustrating as symptoms develop. Providing care for a person with dementia is physically and emotionally demanding so, if possible, don’t do it alone. Here are a few tips for caring for a loved one living with Vascular Dementia.
- Seek out support. Enlist family and friends. Connect with local organizations and support groups that can provide resources and referrals as well as information about home care agencies and residential care facilities. Your healthcare provider as well as your local Alzheimer's Association affiliate can help.
- Listen, encourage, reassure and be patient. Being there is the most important thing you can do for a loved one with vascular dementia. Be aware that they are probably struggling to maintain their self-respect and dignity. It may be frustrating for you, it is even more so for them.
- Create a predictable and calm environment. This will help minimize worry, confusion, and agitation. Daily routines help manage expectations. Try to incorporate enjoyable activities such as listening to music or reading out loud to the patient. Sitting in a garden can be calming and peaceful.
- Engage in exercise and projects. As a person’s physical condition allows, encourage walks through a park or creative projects like putting together a photo album or scrapbook. These activities can help jump-start cognitive functions, as well as help decrease stress as a caregiver.
- Learn as much as you can about vascular dementia. There is a lot of literature available today online, from libraries, medical resources, and other professionals on living with or caring for someone with dementia. The more you know, the better!
- Take care of yourself. As I always say, if you don’t take care of yourself, you aren’t going to be able to take care of anyone else. Exercise, watch your diet, manage stress. Take a break every day and indulge in what you want to do. Even though you don’t think you have time, make time for friends. You’ll be glad you did.