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Vascular Dementia

Definition


Disease: Vascular Dementia Vascular Dementia
Category: Neurological diseases

Disease Definition:

Problems in blood vessels that feed the brain cause vascular dementia, which is an umbrella term describing impairments in cognitive function. Sometimes, when a blood vessel is completely blocked, it may cause a stroke. Not all strokes cause vascular dementia; it depends on the severity of the stroke, the place of the stroke that occurred and the part of the brain that’s affected. When blood vessels in the brain narrow, reducing the number of blood flow to those parts of the brain, vascular dementia may also occur. 1 to 4% of people over the age of 65 experience a stroke. Prevention is crucial because few treatments are available for vascular dementia.
 

Work Group:


Symptoms, Causes

Symptoms:

Depending on the part of the brain that’s affected, symptoms of vascular dementia could vary. People suffering from vascular dementia could experience the following:

  • Urinary urgency, frequency or incontinence
  • Night wandering
  • Unsteady gait
  • Confusion and agitation
  • Depression
  • Problems with memory
  • Memory loss
  • Difficulty planning ahead
  •  Poor attention and concentration
  • Trouble communicating details sequentially
  • A decline in the ability to organize thoughts or actions

 

Symptoms of vascular dementia usually start abruptly and could get worse step by step, following a series of mini-strokes or strokes. Being confused with Alzheimer’s disease, some types of vascular dementia develop gradually. Yet another thing that may make people confuse between these two conditions is that vascular dementia usually occurs with Alzheimer’s disease. Some experts actually believe that it is more likely for these two conditions to occur together than each on its own.
 

Causes:

The two common causes of vascular dementia are:

 

Complete blockage of blood vessels in the brain: 

While some blockages don’t produce stroke symptoms, but the complete blockage of an artery in the brain often causes a stroke (infarction). A person’s risk of vascular dementia is increased by these “silent brain infarctions”. Depending on how many infarctions experienced over time, the risk might be increased. Multi-infarct dementia is one sort of vascular dementia. Risk of a stroke might be increased due to heart disease and irregular heart rhythms, such as atrial fibrillation.

 

Narrowing of the blood vessels in the brain: 

Parts of the brain could be starved for oxygen and food by reduced blood flow from arteries narrowed by vascular disease. So, vascular dementia could occur without a complete blockage of an artery. Some of the other things that may cause vascular dementia are:

  • Profoundly low blood pressure
  • Blood vessel damage from such disorders as lupus erythematosus or temporal arteritis
  • Brain damage resulting from brain hemorrhage

 

Some of the factors that may increase a person’s risk of vascular dementia are:

 

Increasing age: 

Before the age of 65, vascular dementia is quite rare. People in their 80s and 90s are much more likely to have vascular dementia than people in their 60s and 70s. One of the biggest risk factors for vascular dementia is increasing age.

 

History of stroke: 

The risk of developing dementia seems to be increased with the brain damage that occurs with strokes. 

 

Hardening of the arteries (atherosclerosis):

When plaque builds up in the arteries and narrows the blood vessels atherosclerosis occurs, increasing the risk of the disorder.

 

High blood pressure: 

Extra pressure is put on blood vessels throughout the body due to hypertension, increasing the risk of vascular problems in the brain.

 

Diabetes:

The risk of stroke and other vascular problems in the brain is increased due to diabetes because high glucose levels damage blood vessels.

 

Smoking: 

The risk of hardening of the arteries and other vascular diseases, including vascular dementia is increased due to smoking. 

 

High cholesterol:

High levels of bad cholesterol (LDL) are related to an increased risk of vascular dementia, and possibly with a higher risk of Alzheimer's disease.
 

Complications

Complications:

None

Treatments:

No cure is found for vascular dementia and no medications have been approved by the food and drug administration to treat it. Yet, people with vascular dementia seem to benefit from drugs that are designed to treat the symptoms of Alzheimer’s disease. Doctors can prescribe one or both kinds of the following medications:

 

Cholinesterase inhibitors: 

These are medications for Alzheimer’s disease; they work by boosting levels of a chemical messenger involved in memory and judgment. Nausea, muscle cramps, diarrhea and vomiting are some of the side effects. Examples include rivastigmine, donepezil and galantamine.

 

Memantine:

This medication has also shown to provide a modest benefit in people suffering from vascular dementia. Memantine regulates a chemical messenger involved in information processing, storage and retrieval. Headache, dizziness, confusion and constipation could be included in the side effects.

 

The progression of dementia may be slowed by treating the risk factors that may have contributed to vascular dementia. This implies controlling blood pressure, diabetes, cholesterol levels as well as quitting smoking. Doctors might also prescribe drugs to help the patient control these conditions, along with aspirin or an anti-platelet aggregator drugs, like ticlopidine and clopidogrel, to help keep the arteries clear. However, lost cognitive function cannot be restored by any of these medications.
 

Prognosis:

Not available

Expert's opinion

Expert's Name:
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Expert's opinion:

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Clinical Trials:

Not available

 

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