What are the other Names for this Condition? (Also known as/Synonyms)

• Cortical Vascular Dementia (CVD)
• Multi-Infarct Dementia (MID)
• Vascular Cognitive Impairment (VCI)

What is Vascular Dementia? (Definition/Background Information)

• Vascular Dementia is a condition that involves a decline in thought processes due to decreased blood supply to the brain, causing trouble with reasoning, planning, judgment, and memory. Vascular Dementia is one of the most common types of dementia
• Dementia is a term used to describe symptoms that affect thought processes to the point of disrupting a person’s ability to perform everyday activities. It may be caused by a wide variety of factors
• Vascular Dementia develops primarily due to conditions that harm the brain’s blood vessels. This prevents the brain from receiving the necessary nutrients and oxygen for normal thought and other processes
• Individuals with this condition may experience abnormal changes in thinking and reasoning. Those diagnosed with Vascular Dementia are likely to also have Alzheimer’s disease, a mental disorder that causes the most common form of dementia
• The treatment focuses on controlling risk factors that may produce further damage to the brain, and helping affected individuals to cope with lost mental abilities. However, there is no treatment to reverse the brain damage that has already occurred. Vascular Dementia is progressive in nature and the prognosis is generally poor

Who gets Vascular Dementia? (Age and Sex Distribution)

• Vascular Dementia occurs in approximately 1% to 4% of individuals aged 65 years and older
• Although both genders may be affected, males are more likely to be diagnosed with Vascular Dementia
• It is observed worldwide across all racial and ethnic groups

What are the Risk Factors for Vascular Dementia? (Predisposing Factors)

The risk factors for the development of Vascular Dementia are as follows:

• Advancing age: Most individuals display symptoms beyond the age of 65 years
• History of heart attack or brain stroke
  • Heart attacks increase likelihood of blood vessel problems in the brain
  • Strokes can cause brain damage that may lead to dementia
• Atherosclerosis: This is a condition in which plaque builds up in the arteries, thereby reducing the flow of blood to brain
• High cholesterol levels
• High blood pressure: This may result in excess stress on the blood vessels everywhere in the body, including within the brain
• Uncontrolled diabetes: High glucose levels may damage the blood vessels in the brain
• Smoking: Smoking may damage the blood vessels, leading to circulatory disorders such as atherosclerosis and Vascular Dementia
• Obesity: Being obese or overweight may lead to many vascular diseases, including Vascular Dementia 
• Excessive alcohol consumption that may damage blood vessels in the brain
• Atrial fibrillation: This is a condition in which the upper chambers of the heartbeat abnormally faster than the lower chambers, resulting in blood clots that may travel to the brain and cause a stroke

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Vascular Dementia? (Etiology)

Vascular Dementia is caused by certain conditions that damage the blood vessels of the brain. These damaged blood vessels prevent the brain from receiving important nutrients and oxygen that is required for it to be healthy and perform regular thought processes and other functions.

The following conditions may result in damaged blood vessels in the brain:

• Brain stroke:
  • A stroke may block brain arteries depriving the brain of blood supply
  • Some strokes, commonly known as mini strokes or “silent strokes”, do not display any symptoms, but may still increase the risk for Vascular Dementia
  • As the number of strokes increase over time, there is a higher risk for the development of Vascular Dementia 
• Some conditions can narrow or damage blood vessels (of the brain) over time. These include:
  • High blood pressure
  • Atherosclerosis (aging of blood vessels)
  • Uncontrolled diabetes
  • Brain hemorrhage

What are the Signs and Symptoms of Vascular Dementia?

The signs and symptoms of Vascular Dementia may vary depending on which part of the brain is deprived of blood, and how severe the damage is. Many symptoms may also be difficult to recognize. Individuals may exhibit any or a combination of the following signs and symptoms:

• Slow thinking
• Difficulty with organizing thoughts and actions
• Trouble with understanding
• Forgetfulness
• Changes in mood and behavior
• Changes in sleep patterns
• Restlessness, agitation, and violent behavior
• Problems with memory and language
• Loss of control over urination
  • Sudden and frequent need to urinate
  • Unable to control urine leaking
• Depression or apathy
• Social isolation

How is Vascular Dementia Diagnosed?

Most healthcare professionals are able to easily determine if an individual has dementia. However, it is generally difficult to determine if one has Vascular Dementia. The following tests may assist with the diagnosis:

• Comprehensive medical history assessment and complete physical examination
• Laboratory tests to diagnose an underlying condition
• Neurological exam
• Brain imaging
• Carotid ultrasound 
• Neuropsychological tests

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Vascular Dementia?

The complications of Vascular Dementia may include the following:

• Higher likelihood of brain strokes (again, and in future)
• Heart disease
• Inability to function or take care of oneself
• Inability to socially interact with others
• Physical health problems such as:
  • Pneumonia
  • Urinary tract infections
  • Skin infections

How is Vascular Dementia Treated?

The treatment for Vascular Dementia is focused on managing underlying health conditions that caused the dementia, and the options may vary based on each individual’s symptoms and complications, if any. Some methods of treatment are as follows:

• Bringing about lifestyle changes:
  • Eating healthy
  • Losing weight
  • Reducing and quitting alcohol and tobacco use (if any)
• Use of medications that:
  • Help reduce high blood pressure
  • Treat high cholesterol
  • Reduce the risk of blood clots
  • Treat diabetes for good glycemic control
  • Aid with behavioral issues such as aggression and distress (such as by administering the drug lorazepam)
• Psychotherapy that may involve:
  • Occupational therapy to help identify problems in daily functioning and work out a practical solution
  • Cognitive stimulation can improve memory, problem solving skills, and language 
• Meditation and relaxation methods

Although treatment may slow progression of the condition, it may not reverse any existing brain damage that was earlier caused by Vascular Dementia.

How can Vascular Dementia be Prevented?

• In some cases, Vascular Dementia may be preventable by eliminating certain habits and behaviors that may cause the condition, or be a risk factor. Some preventative measures include the following:
  • Controlling blood pressure
  • Controlling weight
  • Healthy eating
  • Reducing and stopping tobacco and alcohol use
• Regular physical check-ups to assess any heart problem that may need to be treated early
• Active research is currently being performed to explore the possibilities for treatment and prevention of disorders such as Vascular Dementia
• Regular medical screening at periodic intervals with tests and physical examinations are highly recommended

What is the Prognosis of Vascular Dementia? (Outcomes/Resolutions)

Due to the severity of Vascular Dementia, the prognosis is generally poor for this condition. 

• With early diagnosis, individuals can learn to manage their condition, and show some improvement in their symptoms; however, slow mental deterioration may be still observed
• If left untreated, the affected individuals may continue to lose significant brain function, eventually succumbing to the disorder
• On an average, individuals with Vascular Dementia have a shortened lifespan and live for approximately 5 years following the onset of symptoms

Additions and Relevant Useful Information for Vascular Dementia:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/emotional-well-being/