Dementia can be caused by a number of factors. Sometimes, it can result from the interruption of blood flow into the brain. Vascular dementia is used to refer to these instances of cognitive decline.
While dementia can happen after a stroke blocks blood flow into the brain, not all strokes will lead to cognitive decline. Dementia can occur depending on the severity of the stroke. It also depends on other risk factors like high blood pressure or high cholesterol levels.
Which types of strokes lead to vascular dementia?
Interruption of blood flow into the brain causes a stroke. Without blood, neurons will begin to die, and this can lead to serious complications, or even death.
There are three main types of strokes.
- Hemorrhagic strokes are the least common, but the most fatal, happening after a blood vessel bursts.
- Ischemic strokes, on the other hand, account for 87% of occurrences. They are typically caused by atherosclerosis, that is, the buildup of fatty deposits on the walls of blood vessels.
- Transient ischemic attacks (TIAs) result from a brief interruption of blood flow into the brain. Physicians also refer to them as ministrokes.
Ischemic strokes and TIAs are associated with vascular dementia.
What are the types of vascular dementia?
While there are several types, Multi-infarct dementia and Binswanger’s disease (subcortical vascular dementia) are the most common.
Multi-infarct dementia
Multi-infarct dementia happens when more than one area of the brain is injured due to the interruption of blood flow. Strokes (infarctions) can sometimes happen without any symptoms. A number of these “silent” strokes experienced over time can result in multi-infarct dementia.
Binswanger’s disease (subcortical vascular dementia)
Damages to white matter found deep in the brain are the cause of Binswanger’s disease. These result from inadequate blood flow, thickening of the arteries, and high blood pressure. In fact, many people with Binswanger’s disease have a history of hypertension.
What are the symptoms of vascular or stroke-related dementia?
The changes in cognitive function following a stroke will depend on its severity. Another factor is the area within the brain where it occurred. Memory loss will not always be immediately obvious in the case of vascular dementia.
Symptoms of dementia after a stroke can include:
- Confusion
- Problems with focusing or paying attention
- Depression
- Difficulty with walking or finding balance
- Challenges with communication, comprehension, and analysis
- Lethargy or slowness
- Urinary incontinence
Symptoms typically become progressively more severe over time, but many factors can impact their speed of progression.
Diagnosis and treatment
If you suspect that you have vascular dementia, your general practitioner (GP) can help you understand what may be causing your symptoms. If possible, ask a close family member or friend to join you. They could share information on symptoms you may not have noticed yourself.
Your GP will then go through your medical history and current medications. They may also perform cognitive tests, ask questions about your mood, or run blood and urine tests.
If your GP suspects you might have dementia, they will refer you to a specialist, such as a geriatrician, neurologist, or psychiatrist. These specialists can assess next steps for your treatment.
Magnetic resonance imaging (MRI) test, or computerized tomography (CT) are used to diagnose vascular dementia. As it is with Alzheimer’s or Lewy body dementia, a firm vascular dementia diagnosis can only be ascertained by examining the brain after death.
The US Food and Drug Administration (FDA) has not approved any drugs to treat vascular dementia. Treatments that address underlying causes such as hypertension or diabetes mellitus are administered to prevent the worsening of its symptoms.
Several clinical trials have also determined that medication for Alzheimer’s disease may provide benefits to those living with vascular dementia.
What are the risk factors?
There are several factors that can cause vascular dementia. Most of them overlap with the risk factors that also cause heart disease and other conditions that affect blood vessels.
- Age. Vascular dementia is more common in people above the age of 65.
- High cholesterol. High levels of bad cholesterol can increase the risk of strokes. Furthermore, atherosclerosis or the buildup of cholesterol deposits can narrow your blood vessels.
- History of heart attacks or strokes. These can cause damage to blood vessels in the brain.
- Diabetes. High glucose levels can cause damage to blood vessels.
- Smoking. Smoking damages blood vessels, which can increase your risk of having a stroke and contracting vascular dementia
Your doctor can help you devise a plan of action to improve your health. You should also take immediate steps to improve your diet and lifestyle.
How can we reduce the risk of vascular dementia?
Developing habits that maintain good brain and heart health will significantly reduce the risk of strokes and vascular dementia.
- Avoid or quit smoking altogether.
- Maintain a healthy weight.
- Limit your consumption of alcohol and sugary foods.
- Stay physically active through regular exercise and movement.
- Adopt a healthy and balanced diet.
- Visit your GP / primary care physician on a predetermined schedule
- Manage and measure your cholesterol, blood pressure and blood sugar levels as suggested by your physician.
In conclusion
Though vascular dementia is a progressive disease, people who have been diagnosed should be encouraged to engage in normal activities as much as possible. They should also maintain a routine filled with activities that keep them physically and mentally stimulated.
By keeping themselves active, it is possible to preserve their quality of life and overall well-being. Overall, they must focus on maintaining healthy habits, staying actively engaged with doctors, and keeping informed about their condition.