Vascular Dementia

Dementia is when someone loses brain function a little at a time. Damage to the brain from dementia is permanent and often gets worse over time. It affects thinking, decision-making, memory, emotion, and many other things controlled by the brain.

With vascular dementia or vascular cognitive impairment, this happens because the brain is not getting enough blood. The blood vessels in the brain are too blocked or damaged to carry enough blood and oxygen to the brain. Without enough oxygen, brain cells die.

This is what happens when someone has a stroke. With a major stroke, the loss of brain function is often noticeable right away. But a person can have smaller, “silent” strokes that don’t seem to cause problems at first. With these strokes, the damage adds up over time and the person gradually loses brain function.

Vascular is the second most-common type of dementia. Only Alzheimer’s disease is more common.

People with vascular dementia will have the same symptoms as people with other types of dementia. Early symptoms include:

• Trouble remembering words or the names for everyday people and things
• Trouble with thinking tasks that used to be easy, like learning new information, solving a problem, or playing a game
• Losing things
• Personality changes

As time goes on, a person with vascular dementia could also have these symptoms:

• Not able to do tasks that used to be easy, like getting dressed or preparing food
• Trouble with reading, writing, and speaking
• Forgetting what day or year it is or what is happening in the news
• Forgetting your past or who you are
• Avoiding others
• Trouble with telling the difference between a safe and a dangerous situation (may either be agitated for no reason or unaware of danger)
• Violent outbursts and trouble with self-control

People with vascular dementia may also have some of the typical neurological (nerve) symptoms from a stroke:

• Numbness or weakness, usually on one side of the body
• Dizziness and trouble with coordination and balance
• Sudden difficulty with walking or seeing

Call 911 immediately if there are signs of a stroke, including:

• Sudden severe headache
• Numbness or weakness on one side of the body
• Sudden blurry vision
• Sudden inability to walk, talk, or do other everyday activities

See a doctor as soon as you notice any of the early stage symptoms of dementia. You may also want to the see doctor if you are older than 65 years old and have risk factors for vascular dementia. These risk factors include high blood pressure, heart disease, and past stroke or mini-stroke (also called a transient ischemic attack, or TIA).

Vascular dementia is caused by blood vessel disease, which can also cause high blood pressure, heart attacks, and strokes. It also seems that blood vessels problems can lead to changes in the brain related to other types dementia, like Alzheimer’s disease.

To diagnose vascular dementia, the doctor may do several things, including:

• A physical examination. The doctor will do a brief screening to see if you are having problems with thinking or memory. The doctor may also check your balance and reflexes. The doctor will ask you about any changes you have noticed in your ability to do daily activities. If possible, the doctor will ask a family member or close friend about any changes they have noticed.
• A CT scan of the head. This scan uses x-rays to see if you have had a stroke or have other problems with your blood vessels.
• An MRI scan of the brain. An MRI uses a magnetic field and radio waves to create a picture of your brain. It shows if you have bleeding or other problems in your brain and where the problems are.
• Lab tests. Your doctor may do a blood test to see if there is an infection, vitamin deficiency, or other problem causing the dementia or adding to it.

There is no treatment to fix parts of the brain that have been damaged by stroke.

You may be able to prevent further damage by doing the things that prevent heart disease and stroke. It is important to take the medicines your doctor tells you to take to control blood pressure, prevent blood clots, and control cholesterol.

In the early stages of vascular dementia, you may be able to take medicines that have been used to slow the progress of other types of dementia, like Alzheimer’s disease.

You can prevent vascular dementia throughout your life by preventing diseases of your heart and blood vessels. Take these prevention steps:

• Do not smoke.
• Eat a healthy low-fat diet with fruits and vegetables and whole grains.
• Move your body every day by walking or doing other activities.
• Stay at a healthy weight.
• If you have high blood pressure or high cholesterol, take the medicines your doctor tells you to take.

• Alzheimer’s Association
• MedlinePlus