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What is vascular dementia?
Vascular dementia is a general term describing problems with reasoning, planning, judgment, memory and other thought processes caused by brain damage from impaired blood flow to your brain.
There's no specific test that can confirm vascular dementia. Instead, health care professionals make a judgment based on any medical history for stroke or disorders of the heart and blood vessels, and results of tests that can clarify the diagnosis.
Vascular dementia symptoms vary, depending on the part of your brain where blood flow is impaired. Symptoms often overlap with those of other types of dementia, especially Alzheimer's disease. But unlike Alzheimer's disease, the most significant symptoms of vascular dementia tend to involve speed of thinking and problem-solving rather than memory loss.
Vascular dementia signs and symptoms include:
- Trouble paying attention and concentrating
- Reduced ability to organize thoughts or actions
- Decline in ability to analyze a situation, develop an effective plan and communicate that plan to others
- Slowed thinking
- Difficulty with organization
- Difficulty deciding what to do next
- Problems with memory
- Restlessness and agitation
- Unsteady gait
- Sudden or frequent urge to urinate or inability to control passing urine
- Depression or apathy
Vascular dementia results from conditions that damage your brain's blood vessels, reducing their ability to supply your brain with the amounts of nutrition and oxygen it needs to perform thought processes effectively.
Common conditions that may lead to vascular dementia include:
- Stroke blocking a brain artery: Strokes that block a brain artery usually cause a range of symptoms that may include vascular dementia. But some strokes don't cause any noticeable symptoms. These silent strokes still increase dementia risk. With both silent and apparent strokes, the risk of vascular dementia increases with the number of strokes that occur over time. One type of vascular dementia involving many strokes is called multi-infarct dementia.
- Brain hemorrhage: This condition often is caused by high blood pressure weakening a blood vessel, leading to bleeding into the brain and causing damage. Another cause can be buildup of protein in small blood vessels that occurs with aging and weakens them over time.
- Narrowed or chronically damaged brain blood vessels: Conditions that narrow or inflict long-term damage on your brain's blood vessels also can lead to vascular dementia. These conditions include the wear and tear associated with aging, high blood pressure, diabetes and abnormal aging of blood vessels.
In general, the risk factors for vascular dementia are the same as those for heart disease and stroke.
Risk factors for vascular dementia include:
- Increasing age: Your risk of vascular dementia rises as you grow older. The disorder is rare before 65, and the risk rises substantially by your 90s.
- History of heart attack, stroke or transient ischemia: If you've had a heart attack, you may be at increased risk of having blood vessel problems in your brain. The brain damage that occurs with a stroke or transient ischemia episode may increase your risk of developing dementia.
- Abnormal aging of blood vessels, or atherosclerosis: This condition occurs when deposits of cholesterol and other substances build up in your arteries and narrow your blood vessels. Atherosclerosis can increase your risk of vascular dementia by reducing the flow of blood that nourishes your brain.
- High cholesterol: Elevated levels of low-density lipoprotein, or LDL or "bad," cholesterol, are 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. This increases the risk of vascular problems in the brain.
- Diabetes: High glucose levels from diabetes can damage blood vessels throughout your body. Damage in brain blood vessels can increase your risk of stroke and vascular dementia.
- Smoking: Smoking directly damages your blood vessels, increasing your risk of atherosclerosis and other circulatory diseases, including vascular dementia.
- Obesity: Being overweight is a well-known risk factor for vascular diseases in general and so presumably increases your risk of vascular dementia.
- Atrial fibrillation: In this abnormal heart rhythm, the upper chambers of your heart begin to beat rapidly and irregularly, out of coordination with your heart's lower chambers. Atrial fibrillation increases your risk of stroke because it causes blood clots to form in the heart that can break off and go to the brain blood vessels.
Treatment often focuses on managing the health conditions and risk factors that contribute to vascular dementia. Controlling conditions that affect the underlying health of your heart and blood vessels can slow the rate at which vascular dementia worsens and prevent further decline.
Depending on your individual situation, your health care professional may prescribe medications to:
- Lower your blood pressure.
- Reduce your cholesterol level.
- Prevent your blood from clotting and keep your arteries clear.
- Help control your blood sugar if you have diabetes.
The health of your brain's blood vessels is closely linked to your overall heart health. Taking these steps to keep your heart healthy also can reduce your risk of vascular dementia:
- Maintain a healthy blood pressure.
- Prevent or control diabetes.
- Quit smoking.
- Get regular exercise.
- Keep your cholesterol in check.