What is Vascular Dementia?
Vascular dementia is the broad term for dementia associated with problems of circulation of blood to the brain. Inadequate blood flow can damage and eventually kill cells everywhere in the body, but the brain is especially vulnerable. Brain cells deprived of oxygen that the blood vessels carry will die overtime, impacting cognitive function and leading to dementia.
What causes Vascular Dementia?
Vascular dementia can occur gradually but is usually caused by a stroke. In care for the elderly, it is considered the second most common cause of dementia after Alzheimer’s disease. However, strokes are not always the cause of vascular dementia. It can also result from blood vessels in the brain that have been damaged by diabetes, high blood pressure, high cholesterol, smoking, and other health issues. These problems can all reduce the circulation of oxygen and nutrients to the brain, resulting in dementia leading to the need for in home care services or an aged care agency.
What are the risk factors for Vascular Dementia?
In general, the risk factors for vascular dementia are the same as those for heart disease and stroke. They include:
- Age. The risk of vascular dementia rises as we grow older and is more prevalent after the age of 65 and for those in aged care services.
- Heart attack and stroke. Heart attacks often trigger blood vessel damage in the brain as can 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 is impacted.
- Atherosclerosis. This condition refers to abnormal ageing of blood vessels. It is a condition which creates deposits of cholesterol and other substances (plaques) to build up in arteries and narrow blood vessels. This increases the risk of vascular dementia by reducing the flow of blood that nourishes 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 sugar levels damage blood vessels throughout your body increasing the risk of stroke and vascular dementia.
- Smoking. Since smoking damages blood vessels, it increases the risk of many kinds of health problems, such as atherosclerosis and other circulatory diseases, all 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 is broadly defined as a mental problem affecting reasoning, judgment, and memory. It shares many symptoms and characteristics with Alzheimer’s dementia but the two are different in some ways. Vascular dementia can develop gradually as does Alzheimer’s, but it is usually triggered by a stroke. Alzheimer’s is often genetic and may also be caused by health and lifestyle issues. Both increase the likelihood for home care assistance, especially if ageing in place, or aged care services.
The impact of vascular damage to our cognitive skills varies widely, depending on the severity of the blood vessel damage and the part of the brain it affects. In fact, 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 and include:
- Confusion and disorientation
- Trouble paying attention and concentrating
- Trouble speaking or understanding speech
- Inability to organise thoughts or actions and communicate them
- Decline in analytical ability
- Indecision
- 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 then steadily deteriorate requiring in home care or other aged care services support, if not addressed. Multiple minor strokes and damage to smaller blood vessels can increase the risk of vascular dementia. Studies also link vascular dementia with 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 a healthy blood pressure
- Prevent or control diabetes
- Don’t smoke
- Exercise
- Keep cholesterol in check
- Eat a healthy, balanced diet
- Maintain a healthy weight
- Limit alcohol consumption
Even while ageing in place, these lifestyle changes can be helpful, and the support of in home care services can make them even easier to achieve.
Vascular dementia often goes unrecognised, so those who have had a stroke, or some sort of heart disease should consider professional cognitive screening, which could start with a nurse at home or aged care agency. Experts in the aged care field also feel that those at risk should be screened and treated for depression as it can contribute to additional cognitive impairment. It all goes back to having a healthy body, and healthy brain. Controlling risk factors that may increase the likelihood of further damage to the brain’s blood vessels is an important treatment strategy. Research has proven that addressing risk factors in advance may help prevent a vascular event that leads to dementia. Following vascular damage, keeping your heart healthy may improve outcomes and help prevent further vascular decline.
References
Mayo Clinic Overview of Vascular Dementia
