Vascular Dementia
Overview
A stroke causes impaired blood flow to the brain, resulting in nerve cell death and disrupted cell connections. Depending on which part of the brain is affected, stroke damage can cause physical symptoms and/or result in vascular dementia. Vascular dementia symptoms occur gradually in those who have had multiple small strokes or abruptly with larger strokes. Vascular dementia is the second most common dementia after Alzheimer’s disease (AD) and can occur alone or in conjunction with AD or other dementias.
Types
- Post-stroke dementia, which develops after a stroke occurs
- Mixed dementia, a combination of vascular and other dementias, that is often progressive
Symptoms
- Apathy, depression, anxiety or mood swings
- Confusion and/or memory loss
- Difficulty solving problems, processing, interpreting or understanding information
- Speech and language problems
Prevention
The best way to prevent vascular dementia is to reduce the risk of strokes by staying physically active with regular exercise and following a healthy diet. You should also:
- Avoid smoking.
- Limit alcohol use.
- Get screened and treated for medical conditions associated with vascular dementia.
Risk Factors
- Aging
- Obesity
- Smoking
Other risk factors include medical conditions associated with increased vascular dementia risk, such as:
- Depression (linked to vascular dementia in some studies)
- Diabetes
- Heart disease
- High blood pressure (risk factor for heart disease and stroke)
- High cholesterol (risk factor for heart disease and stroke)
- Sleep apnea
- Stroke
Diagnosis
- Medical history and symptom review. The provider will review your symptoms and ask about your ability to perform daily tasks.
- Physical examination. The doctor will perform a neurologic exam and may perform cognitive assessment testing or neuropsychological evaluation.
- Diagnostic tests. Neuroimaging (MRI or CT scans) of the brain may show stroke. EEG (a test that detects electrical activity) may show slowing of certain areas of the brain.
Treatment
While no treatment can reverse vascular dementia, certain measures may reduce its chances of progressing. You should also manage conditions and risk factors to prevent having another stroke with:
- Medications to prevent blood clots
- Alzheimer’s medications may help those with mixed dementia (AD and vascular dementia) but are otherwise not recommended.
- Antihypertensives for high blood pressure
- CPAP use for sleep apnea
- Lifestyle modification
- Medications to lower blood sugar for those with diabetes
- Physical therapy or occupational therapy may be ordered to help improve mobility and daily function.
- Speech therapy may be ordered for speech or swallowing issues.
- Statins to lower cholesterol
- Treatment of depression (counseling and/or medications)
Follow-up Care
- Periodic office visits and blood work allow your physician to assess your need for medication changes or referrals.
- Follow up with your physician for abrupt changes in symptoms to evaluate for infection, stroke, medication effect or other causes.