Vascular Dementia: Symptoms, Treatment, and Care
Dementia includes several different forms. While Alzheimer’s disease tends to be the most familiar type of dementia, other versions of the condition also exist. Vascular dementia, for example, can occur in response to reduced blood flow to the brain, often as the result of a stroke. According to the Centers for Disease Control, this is responsible for up to ten percent of all dementia cases. Some experts believe that it is underdiagnosed, however.
Because vascular dementia is poorly understood, many people fail to recognize the early signs. The lack of a prompt diagnosis or treatment can allow the condition to worsen quickly. With more awareness, however, it’s possible to spot the signs soon enough to manage the symptoms. Proper treatment – combined with the support of a life plan community – can help those diagnosed with the condition maintain a fulfilling way of life.
What is Vascular Dementia?
Vascular dementia results from impaired blood vessels and a reduced supply of oxygen to the brain. It can occur in response to major strokes, silent strokes or as a result of narrow or aging blood vessels. Like other forms of dementia, it is linked to mental impairments and emotional trauma. It can occur in combination with other conditions, such as Alzheimer’s.
Symptoms of Vascular Dementia
The symptoms of vascular dementia present themselves differently based on whether the condition happens in response to a major stroke or a series of mini-strokes. Some people experience a gradual onset of symptoms, while others see a rapid decline in physical and cognitive functioning.
Regardless of how quickly vascular dementia symptoms arrive, it’s important to recognize them as quickly as possible. The sooner they’re addressed, the more successful treatments and therapies may be.
The following are among the most common signs and symptoms associated with vascular dementia:
- Diminished executive function: People with vascular dementia may struggle to stay organized. Issues with attention also appear early on, with focus becoming more of an issue as the disease progresses. Executive function deficiencies impact problem-solving skills, with some people unable to analyze situations and develop effective plans based on their observations.
- Trouble walking: The physical manifestations of vascular dementia tend to be downplayed as compared to Lewy body or other forms of dementia. However, some patients develop an unsteady gait, making them more vulnerable to falls when navigating settings with obstructions.
- Incontinence: People with dementia may experience, without warning, the urgent need to urinate. Many also struggle to maintain control while urinating.
- Emotional distress: Some people with vascular dementia develop depression. They may feel sad, helpless or angry about their condition. Others express apathy, even during activities and events they’ve previously enjoyed.
Vascular dementia differs from similar conditions such as Alzheimer’s in that it often appears suddenly. Symptom severity can accelerate rapidly following a stroke. In some cases, however, the condition may take years to develop. This slow progression typically occurs in patients who experience mini-strokes but who are unaware of the issue.
In many cases, vascular dementia follows a step-like progression. This may involve an extended period of stability, followed by a sudden flare-up of symptoms. While some level of recovery may occur after a stroke or other damaging event, each step in the pattern of progression is typically followed by a plateau at a lower level of cognitive ability. While step-like declines are often linked to strokes, triggers are sometimes less obvious.
Because the progression of vascular dementia differs so significantly from one person to the next, the condition is not typically divided into strict stages. Symptoms can, however, be classified as falling under early, mid, or late stages.
In the earliest stage of vascular dementia, people may be entirely unaware that they’ve experienced strokes or have otherwise sustained damage to the blood vessels that travel to the brain. They may deal with mild memory impairments or inattention, but not enough to keep them from participating in most programs or events they enjoyed prior to the disease’s onset.
During the middle and later stages, memory and problem-solving concerns become more severe. This can happen gradually, although many people see sudden declines in response to major strokes. Once the disease reaches its latest stages, it may become difficult to communicate or perform basic tasks. Emotional distress is also common.
Causes and Risk Factors
Vascular dementia is caused by reduced blood flow to the brain. This condition is marked by a limited ability to supply the brain with necessary oxygen. As a result, the brain becomes less effective at handling typical thought processes.
While a variety of issues can harm the performance of the brain’s blood vessels, strokes are often to blame. Vascular dementia is easiest to diagnose after major strokes, as the symptoms come on quickly and may accompany other stroke-related issues. In other cases, the condition develops over time alongside a series of silent strokes. Medical professionals commonly refer to this problem as multi-infarct dementia.
While vascular dementia is often related to strokes, a variety of other issues can lead to blood vessel damage and prompt mental impairment. Chronic conditions such as diabetes are linked to vascular dementia, as is a buildup of plaque known as atherosclerosis.
Atrial fibrillation can increase the likelihood of stroke-related vascular dementia, as abnormal heart rhythms may lead to clots that eventually travel to the brain’s blood vessels.
Other common risk factors include:
- High cholesterol
- High blood pressure
- Illicit drug use
- History of heart attack
In some cases, vascular dementia occurs due to natural wear and tear of the blood vessels. When possible, however, it’s important to identify relevant causes or risk factors, as addressing these could slow the condition’s progression.
Diagnosis and Treatment
Vascular dementia diagnosis often takes place in the aftermath of major strokes. These traumatic events can make the condition easier to diagnose. In some cases, extensive assessments may be needed to rule out other conditions.
No single test can identify vascular dementia, but a combination of lab tests, neurological exams, and brain imaging can pave the path to a prompt diagnosis.
Unfortunately, no cure exists for vascular dementia. A variety of therapies can be employed to manage symptoms, however.
Because the condition often occurs in response to strokes, those with vascular dementia may work with physiotherapists or occupational therapists to address coordination, balance or general weakness. Occupational therapy can help with daily essentials such as eating and bathing. Cognitive stimulation and other psychological pursuits may improve memory, attention and problem-solving abilities.
If vascular dementia is believed to have developed gradually in response to chronic conditions such as high blood pressure, efforts to address these issues may slow the onset of major symptoms. Diagnosed individuals are often advised to quit smoking, exercise more frequently, and make dietary changes to address cholesterol or diabetes.
A variety of medications can be used to treat the underlying causes of vascular dementia while addressing current symptoms. These include:
- Blood thinners (such as clopidogrel) and anticoagulants (such as warfarin) for reducing the risk of blood clots and strokes
- Statins and other medications designed to treat high cholesterol
- Antipsychotic medications such as haloperidol to treat the emotional manifestations of the condition — especially for those believed to be at risk of harming themselves or others
Many people are diagnosed with both vascular dementia and Alzheimer’s disease. In combination, this is referred to as mixed dementia. Patients may be prescribed medications typically associated with Alzheimer’s treatment, including galantamine, memantine or rivastigmine. These medications cannot cure or even slow the progression of dementia, but they may help to control current cognitive symptoms.
Addressing the emotional elements of the condition is just as important as taking medications or attending occupational therapy sessions. Relaxation techniques such as music therapy and massage can be especially helpful. Some people may also benefit from cognitive behavioral therapy or other clinical solutions.
Vascular Dementia Care Options
Due to the extenuating circumstances surrounding vascular dementia, many people prefer to avoid the stresses of living at home. Support is especially important for those who have experienced major strokes. Others may need increased assistance over time, especially as they begin to struggle with attention, memory and coordination.
Those with mild enough symptoms to allow for independent living may need to make changes at home. These will vary based on layout, but changes could include removing trip hazards, improving lighting or adding grab bars in key locations.
Extensive support can be found in assisted living communities, where people with vascular dementia can continue to enjoy a high quality of life. They can also receive support with general health initiatives that help to slow the onset of vascular dementia. Dietary services and exercise opportunities, for example, can be helpful for those who might otherwise struggle to prepare meals or maintain healthy habits.
Improvements in general health not only reduce the severity of the condition — they help people with vascular dementia enjoy vibrant lives while nurturing body, mind, and spirit.
The symptoms of vascular dementia can be distressing, but such concerns should not stand in the way of leading a fulfilling life. A little support can go a long way towards providing a comfortable and meaningful lifestyle.
The team members at The Atrium at Boca Raton understand the needs of those with vascular dementia, and they are skilled in offering the right level of care – for body, mind and spirit. Call us at 561-250-7555 to learn more, or start with a free copy of our Guide for Finding the Right Assisted Living Community.