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What is Vascular Dementia?  Types, Early Signs, etc.

Elderly Woman Being Cared For

Vascular dementia is caused by the deprivation of oxygen in the brain due to complications arising in the supply of blood.  This can occur either in permanent or acute damage to areas in the brain that help control activities such as planning, organizing, concentrating, following procedures such as cooking and concentrating.  Confusion, memory loss that is usually short-term, language, and visuospatial awareness are also areas affected in early stages of vascular dementia.  Vascular dementia affects the second most amount of people with dementia after Alzheimer’s. 

Types of Vascular Dementia

Stroke-Related Vascular Dementia

A stroke occurs when the blood to the brain is cut off.  This usually happens in the form of a clot.  The affected blood vessel either pops, or the afflicted area does not receive the nutrients and oxygen to stay alive.  Strokes vary in how severe they are depending on if the stoppage of blood flow to the brain is permanent or temporary and which parts of the brain are affected. 

Most major strokes occur when the blood flow to a major blood vessel in the brain is severed.  This occurs most commonly with a blood clot, though it can also occur with a blood vessel popping.  The deprivation of oxygen causes significant damage that can only be assessed on a subject to subject level.  While not every stroke victim will succumb to vascular dementia, it is common for close to 20% of stroke victims to develop symptoms within six months.  Sadly, those that have had a previous stroke are more inclined to have another, and thus the cycle progresses between strokes and vascular dementia.

Single and Multi- Infarct Vascular Dementia

These types of vascular dementia occur when there are either one small or multiple small strokes.  The size and area that the stroke affects can build and accumulate over time.  Sometimes though, the blocked or clotted areas clear fast enough that major brain damage is minimal, when regarding a stroke.  When the clot or blockage clears itself in less than one day is known as a mini-stroke or transient ischemic attack.  If the brain area is disconnected from blood supplies for more than a few moments the area is considered an infract.  If this only occurs in one specific area of the brain it is known as a single- infract area.  Unfortunately, this can occur in multiple parts of the brain over one or multiple strokes, which leads to the name of multi- infarct dementia.  

Subcortical Vascular Dementia

Subcortical Vascular Dementia occurs over an extended period of time and is actually caused by diseases that affect the small blood vessels located within the brain.  Over time the walls thicken, stiffen, and become twisted which reduces the blood flow that reaches the brain.  Small vessel damage, as it is often referred to, impacts the ability of nerve fibers to transmit signals to the brain.  Subcortical vascular dementia usually occurs much deeper in the brain than dementia caused by a stroke and the two can usually be differentiated.  Small vessel damage is the most common form of vascular dementia.

Mixed Dementia (Vascular Dementia and Alzheimer’s Disease)

Mixed dementia comprises roughly 10% of all people with memory loss or dementia.  The symptoms are difficult to diagnose because they can encompass the characteristics of either Alzheimer’s, dementia, or a combination of both.  Often, people with Alzheimer's Disease or dementia are best cared for in a dedicated Alzheimer's Care Unit at an assisted living facility.  

Early Symptoms

  • Difficulties with planning, organizing, decision making, and problem solving
  • Difficulties following procedures
  • Slower speed of thought or cognition
  • Problems recalling events, usually recent
  • Loss for words or fumbling over language
  • Depth perception

Stages and Life Expectancy

The stages of vascular dementia are difficult to determine.  Every person is different, and it does hit harder and faster for some people.  It is also important to remember that it will vary depending on if vascular dementia is caused by strokes, subcortical vascular dementia, or a combination of Alzheimer’s and one of these other forms.  As you can imagine, dementia caused by strokes versus subcortical, or the narrowing and clogging of blood vessels, affect the brain differently.  Subcortical vascular dementia is usually more steadily progressive and slowly grows worse with time.  Stroke related vascular dementia has a plateau or step pyramid tendency, where a stroke occurs and things drastically change, but usually level out.  It is difficult or impossible to determine when another stroke will occur, but usually after one happens, it is likely another will follow eventually.  Life expectancy estimates vary between most physicians, with some suggesting numbers as low as four and a half years, and others as high as ten years.  As we have discussed, it is difficult to gauge how vascular dementia will affect each individual.  

Treatment

Unfortunately, there is no treatment for vascular dementia.  That does not mean there is nothing one can do though.  While reversing the damage done is impossible, slowing it down starts with healthier habits.  Here are some suggestions:

  • Eating healthier
  • Stop smoking, drinking alcohol, and using other harmful substances
  • Exercise and weight loss
  • Medications that decrease cholesterol, thin blood and prevent blood clots, and reduce high blood pressure

 

Article written by Nick Schaller with Senior Directory

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