Vascular Dementia

Vascular dementia is a type of dementia and is caused by an interruption to the blood supply to the brain, usually caused by a number of small strokes, not by Alzheimer’s disease.

What is vascular dementia?

Many people use the terms dementia and Alzheimer’s Disease interchangeably, but Alzheimer’s is not the only cause of dementia. As many as one in five people affected have vascular dementia, and if you’ve never heard of it, it’s not surprising.

It’s also known as multi-infarct dementia (MID) or vascular cognitive impairment (VCI) and it is actually the second most common cause of the condition.

In vascular dementia, the brain is damaged by an interruption to the blood supply, usually by a number of small strokes. When the blood flow is interrupted, the brain cells do not receive the nutrients and oxygen essential for life. These so-called ‘mini’ strokes can be so minor that they’re unnoticeable, but together they damage the cortex of the brain, leading to the increasing memory loss, confusion and communication problems characteristic of the disease.

Steady or stepwise?

Whereas Alzheimer’s disease progresses slowly and steadily, the deterioration in vascular dementia can be much more dramatic. With each new stroke, there can be a sudden functional decline. After the initial brain injury, their condition can stabilise or improve a little until the next stroke strikes.

This means that vascular dementia tends to have a much more stepped and uneven progression.

Signs and symptoms of vascular dementia

The impact of each tiny stroke will depend on the area of the brain affected. Individuals may initially struggle to think clearly, to remember familiar words or to plan and carry out complex tasks. In some people, the memory loss may be minor, with the predominant problems being with communication. There may be issues finding the right words, following conversations and understanding others. Many people present with problems including:

1. Feeling less sharp, with thoughts coming slower and with more difficulty
2. Problems with planning and understanding instructions
3. Struggling to concentrate
4. Changes in mood, personality or behaviour
5. Feeling confused, lost or disorientated in time or place
6. Having problems with balance and normal mobility

With time and increasing numbers of strokes, the symptoms can escalate and the level of function will fall, until it can affect all aspects of life.

Who is at risk?

The risk of vascular dementia increases with age, with those under sixty-five rarely affected. Men tend to be at higher risk than women and those of certain pre-disposed ethnicities, or who have already had a stroke, have pre-existing heart disease or are at increased risk of cardiovascular disease are particularly vulnerable. This includes:

• People of Asian, Black and Caribbean descent
• People with diabetes
• People who smoke
• People with high blood pressure
• People with high cholesterol
• People who are overweight

Is there anything that can be done?

There is no cure for vascular dementia, but the good news is that if it is identified early, then the risk factors can be modified and the rate of decline significantly slowed. Losing weight, stopping smoking, and controlling diabetes through diet and activity can all make a difference.

Changing your eating habits to the MIND diet may help improve brain function and reduce dementia. It focuses on ten ‘brain-healthy’ foods, including berries, leafy green vegetables, nuts, whole grains, pulses all washed down with just a little red wine.

It’s important that the doctor reviews all medication so that hypertension and any irregular heartbeats are controlled. Anyone at risk of small clots breaking off may be given mini-aspirin or other anti-clotting medication to decrease the danger.

Looking forward, a new drug called Cerebrolysin has been shown to improve concentration, improve mood and boost memory in individuals affected by vascular dementia. Trials are still ongoing and it is still not available in the UK, but there is reason to be hopeful for the future.

Any dementia diagnosis can be devastating, and an early diagnosis of vascular dementia can be a warning sign to change your lifestyle and get treatment in place to help maintain health and preserve function.

Finding care

As the condition progresses, it may be sensible to find a carer. Acknowledging this early can help you to receive the care you need, prolonging your independence and ability to stay in your own home.

There are lots of different care options, and the Hometouch team is happy to help. We can provide you with advice and support, and help you to find a top quality carer in your local area. You can speak to a Hometouch Care Advisor to get more advice.

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• Living With Someone With Dementia
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• How to Cope With Denial in Dementia
• How are Parkinson’s and Dementia Related?
• The Later Stages of Dementia
• Dementia Care: How to Find the Right Carer