Vascular Dementia Symptoms, Causes & Treatment Options

Vascular dementia occurs when the blood that carries oxygen and nutrients to your brain is interrupted. You may develop cognitive, psychiatric, or neurologic symptoms. [1]

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Contents

  1. Overview
  2. Symptoms
  3. Potential Causes
  4. Treatment, Prevention and Relief
  5. When to Seek Further Consultation
  6. References

What Is Vascular Dementia?

Summary

The diagnosis of vascular dementia involves a combination of symptoms, physical exam findings, and brain imaging. If you have a history of heart disease, vascular disease, or a stroke, you are at risk for developing vascular dementia. Your brain will be affected and you may experience cognitive problems such as memory loss and disorientation and neurologic symptoms such as urinary incontinence. Your cognitive and neurologic function will often decline in a stepwise fashion. Brain imaging may be able to detect brain abnormalities as a consequence of strokes or blood vessel diseases that can cause vascular dementia. Imaging will also help your doctor rule out other causes of your symptoms. Treatment often involves controlling the underlying chronic illnesses that you have such as heart and vascular disease to prevent your vascular dementia from worsening. [2]

Recommended care

Vascular Dementia Symptoms

Early symptoms

Your symptoms will depend on what part of your brain was affected by the decrease in blood flow. Symptoms can overlap with other types of dementia, but based on your history and the timing of your symptoms, your doctor may be able to attribute your symptoms to vascular dementia specifically. Early signs of dementia are often missed or mistaken for something else. They can include the following signs: [2]

  • Slowness of thought
  • Problems with decision making or planning
  • Finding it challenging to follow a series of steps
  • Problems concentrating
  • Short periods of confusion
  • Depression or apathy
  • Anxiety
  • Problems with memory
  • Problems with your language

Late symptoms

Your vascular dementia may worsen gradually or in sudden steps every few months or years. Similar to earlier on in your disease course, your symptoms will depend on what part of the brain is affected but may include the following: [2]

  • Increased slowness of thoughts
  • Loss of memories
  • Depression or mood swings
  • Confusion
  • Significant personality changes such as being aggressive
  • Increasing difficulty with your daily activities such as grocery shopping, doing laundry
  • Loss of bladder control leading to urinary incontinence
  • Loss of balance leading to falls

Vascular Dementia Causes

Vascular dementia occurs when the blood flow to your brain is interrupted. It is most commonly caused by a stroke which blocks your brain artery or a chronically damaged blood vessel in your brain that compromises oxygen delivery. [1] When blood flow to the brain is interrupted, brain cells will die, leading to problems with cognition and the neurologic system. There are several factors that can increase your risk of developing vascular dementia which are outlined below. [3]

Risk factors for vascular dementia

Risk factors that may predispose you to vascular dementia include:

  • Hypertension
  • High cholesterol
  • Diabetes
  • Smoking
  • Increased age
  • A history of heart attack, stroke, or a transient ischemic attack
  • Obesity
  • Atrial fibrillation
  • Heavy alcohol consumption
  • An unhealthy diet
  • Lack of exercise
  • Obesity

Vascular Dementia Symptom Checker

Take a quiz to find out if your symptoms point to vascular dementia

Treatment Options, Relief, and Prevention for Vascular Dementia

Treatment

If you have underlying heart or vascular disease, you should ensure that you are taking medications that treat your chronic illnesses to decrease the likelihood of recurrent interruptions of blood flow to your brain leading to worsening of your vascular dementia. Examples of these medications include drugs that manage your blood pressure, prevent the formation of blood clots, or decrease your cholesterol levels. Additionally, you should see your primary care physician regularly such that he or she can monitor your vitals and labs in order to make sure you are on the right medication regimen. [4]

As noted above, treatment of your chronic diseases can help prevent further damage to your brain and slow the progression of vascular dementia; however, there is no way to reverse damage that has already occurred in the setting of vascular dementia. If after you have had a vascular dementia event you need additional support to carry out your daily activities, you should discuss this with a family member, your doctor, or a social worker to ensure that you have the appropriate resources. [2]

Other resources that may be recommended based on your symptoms include occupational therapy, speech and language therapy, physiotherapy, psychological therapy, relaxation techniques, and home modifications such as removing trip hazards, ensuring good lighting, and adding handrails. [2]

If you are depressed on anxious as a result of your vascular dementia, you can also consider a type of psychotherapy called cognitive behavioral therapy or an anti-depressant medication to help manage your symptoms. [4]

Medications that are prescribed for individuals with Alzheimer’s disease such as donepezil (Aricept), galantamine (Reminyl), rivastigmine (Exelon), or memantine are not used if you suffer from vascular dementia alone. If you have both Alzheimer’s disease and vascular dementia, you should ask your doctor if you are a good candidate for any of these medications. [2]

Prevention

There are several actions you can take to reduce the likelihood of developing vascular dementia. You should take steps towards a healthy lifestyle such as eating a well-balanced diet including fruits and vegetables and exercising regularly. This will decrease your risk of developing Type 2 diabetes which can predispose you to vascular disease including vascular dementia. If you already have diabetes, be sure to check your sugars regularly and to seek out monitoring from your primary care physician. In addition to eating well and exercising, avoid smoking and drinking alcohol. Smoking, in particular, can cause significant damage to blood vessels throughout your body and can thus lead to vascular dementia in the long-term. [3]

You should additionally maintain a healthy blood pressure and if you are hypertensive, you should modify your diet to be low-sodium. You should additionally see your primary care physician regularly to monitor your blood pressures. [3]

If you have atrial fibrillation, a type of abnormal heart rhythm, be sure to see your doctor and ask if you should be on a type of medication that decreases your risk of forming clots. In individuals with atrial fibrillation, blood clots can form in the heart and then can later become displaced and travel to brain vessels causing vascular dementia. Your doctor will help to not only manage your heart condition, but also determine if you need a medication to decrease your clot formation risk. [3]

If you have a history of a stroke, you should ask your doctor if you should be on an anti-platelet medication. These medications can help prevent a recurrent stroke, and thus, they can also decrease your risk for new or worsening vascular dementia. [5]

When to Seek Further Consultation for Vascular Dementia

If you are suffering from cognitive or neurological symptoms and have a history of vascular or heart disease, you should see a doctor as soon as possible. Your doctor will help diagnose what is causing your symptoms and if your symptoms are attributable to heart or vascular disease, he or she will start you on a treatment plan to help reduce your risk of worsening vascular dementia.

You should also see your doctor regularly if you suffer from any of the chronic illnesses that predispose you to developing vascular dementia. Examples of these illnesses include diabetes, hypertension, hyperlipidemia, atrial fibrillation, transient ischemic attack, or stroke. Your doctor will help monitor your chronic disease to help prevent further damage to your blood vessels.

If you suffer from vascular dementia and have a change in your ability to live alone, carry out daily tasks, or avoid falls, you should seek out further help to connect you with resources that will ensure you are living in a safe environment.

Finally, if you suffer from signs concerning for a stroke such as sudden-onset weakness, numbness, trouble walking, trouble seeing, facial drooping, or slurring, you should go to an emergency department immediately for evaluation. [2] [5]