Stroke and Dementia

Dr Jane Gilbert Apr 20, 2019 3 min

For an average of 1 in 3 people, stroke and dementia are linked. The symptoms of dementia are caused by the injury to the brain, which happens during a stroke.

Many people instantly think of Alzheimer’s disease when they consider dementia, but Alzheimer’s is not the only cause of the condition. In around 20% of people, stroke and dementia are linked.

Vascular (or multi-infarct) dementia, where successive strokes lead to gradual cognitive decline, is actually the second most common cause of dementia symptoms. Although both types of dementia are characterised by cognitive decline, they can have differing progression as well as varying symptoms and signs.

Patterns of disease

Vascular dementia tends to get worse in stages. People affected may notice that their symptoms get worse in a stepped pattern, with function declining suddenly after each new stroke. They may then gradually improve or stabilise until they suffer the next stroke. The specific symptoms will depend on the area of the brain affected, but commonly include difficulties with:

Communication
Following a conversation
Mood changes
Unsteadiness and falls
Incontinence
Weakness on one side of the body

In contrast, as Alzheimer’s develops there is usually steady disease progression and a corresponding deterioration in function. Problems with memory loss, problem solving, communication and behaviour are all common. Although these changes may be completely insignificant in the beginning, they gradually increase to affect all aspects of daily life.

Different strokes

A stroke could be called a ‘brain attack’. There is an interruption to the essential blood supply to part of the brain, leading to damage and death of the brain cells. They are caused by a clot (ischaemic stroke) or a bleed (haemorrhagic stroke) in one of the narrow blood vessels in the brain. This can cause weakness or paralysis in part of the body but it can also cause a type of dementia.

Post-stroke dementia may affect one in three stroke survivors within 5 years of the initial brain injury.

Vascular dementia is caused by progressive damage to the brain by a number of the small or ‘mini’ strokes caused by a blockage in the blood flow. Although there may be a significant stroke which requires hospital admission, for many people these strokes may not even be noticeable. Despite this, the brain cells do not get the nutrients and oxygen they need to function and there is increasing confusion as well as communication problems and declining function.

If you would like to learn more about stroke; the history, causes, and the various treatments, see Stroke: A Deeper Dive

Medical management

The thought of being diagnosed with dementia can be devastating, but it is important to realise that not everyone who has a stroke will develop the condition. If you are worried that you or a loved one has vascular dementia, it’s important to see your doctor.

Although sadly there is no treatments available that can cure the condition, medication can reduce the chance of further strokes happening. Controlling blood pressure, lowering cholesterol levels and taking blood-thinning medications like aspirin or warfarin can all reduce the risk of clots. Lifestyle measures like stopping smoking and getting to a healthy BMI may also help protect against further deterioration.

By preventing ongoing brain injury, symptoms may stay stable or even gradually start to improve.

Looking to the future

Dealing with a diagnosis of dementia can be distressing and difficult for the individual affected and for their family. Many people feel sad, angry and frightened about the future. However, it’s important to realise that there is support and rehabilitation available. Physiotherapy, occupational therapy and speech therapy can all help improve communication and function.

Social services can perform a care assessment to identify needs. With the right support, care and treatment it is possible to continue to live in safety, comfort and dignity.

If you’re caring for someone who has had a stroke, HomeTouch can help. Whether it’s a day off to run errands and catch-up with friends, or a week or two for a well-earned holiday, we have highly qualified carers available on a live in or hourly basis, who can help you through this time.

If you’re unsure about the prospect of care, that’s ok. You can download our impartial guide to elderly care (which is applicable no matter the age of your loved one) and get to know the many options available. There’s no harm in knowing more, and a carer might be able to provide you and your loved one with the support you need.

Find out more about strokes and dementia:

Dr Jane Gilbert

Jane has over 20 years’ experience as a health writer and TV presenter. Jane writes on a wide variety of clinical and care topics – from explaining the latest studies and research to unpacking conditions and discussing treatment options. Jane holds a MBBS degree from Imperial College, London and spent seven years working in the NHS.