Vascular Dementia

What is Vascular Dementia?

Vascular dementia is a type of dementia caused by reduced blood flow to parts of the brain. This reduced blood supply deprives brain cells of oxygen and nutrients, leading to damage over time.

Vascular dementia often develops after a stroke, transient ischemic attacks (TIAs) or and/or repeated small strokes. It can also result from damage to the small blood vessels in the brain caused by atherosclerosis, also known as hardening of the arteries.

This is the second most common form of dementia (after Alzheimer’s Disease). Symptoms may appear suddenly after a stroke or develop gradually as blood vessel damage accumulates over time.

Who is Affected?

• Older adults (65+)
• People with a history of stroke or cardiovascular disease

What are the Causes and Risk Factors of Vascular Dementia?

Vascular dementia develops when blood flow to the brain is interrupted or reduced. This can happen suddenly or slowly over time.

Common causes of this blood-flow disruption include:

• Ischemic stroke(s) 
• Hemorrhagic stroke(s)
• Transient Ischemic Attacks (TIAs)
• Atherosclerosis affecting blood vessels
• Damage to small blood vessels deep in the brain

Uncontrollable Risk Factors

• Increasing age
• History of stroke or TIAs
• History of cardiovascular disease
• Family history of cardiovascular disease
• Genetic factors

Controllable Risk Factors

• High blood pressure
• Unmanaged diabetes
• High cholesterol
• Smoking
• Heart disease
• Obesity
• Physical inactivity

What Steps Can You Take to Reduce Your Risk?

Managing vascular health is key to reducing the risk of vascular dementia. Steps that can help do that include:

• Controlling blood pressure
• Managing diabetes
• Manage cholesterol 
• Stop smoking
• Stay physically active
• Follow a heart-healthy diet

What are the Signs and Symptoms of Vascular Dementia?

Symptoms of vascular dementia vary depending on which part of the brain has been impacted by the blood-flow disruption and how much damage occurred. Symptoms may appear suddenly or gradually over time.

Common Symptoms Include:

• Difficulty with thinking, reasoning or problem solving
• Slowed thinking or difficulty concentration
• Memory problems
• Trouble with planning or organizational tasks
• Poor judgement
• Mood or personality changes
• Problems with walking or balance

How is Vascular Dementia Diagnosed?

The diagnostic process includes symptom evaluation and medical history, especially any history of stroke, TIAs and / or cardiovascular disease.

Tests May Include:

• Neurological examination
• Cognitive and memory assessments
• Brain imaging (such as MRI or CT) to identify strokes or blood vessel damage
• Blood tests to evaluate risk factors or rule out other diagnoses

How is Vascular Dementia Treated?

There is no cure for vascular dementia. Treatment focuses on managing symptoms and preventing additional damage to blood vessels.

As this is often seen after strokes, many of the treatments noted are the same as anyone who has experienced a stroke.

Lifestyle

• Heart-healthy behaviors including diet and physical activity
• Manage blood pressure, cholesterol and diabetes
• Staying mentally and socially active
• Establish safety measures to reduce fall risk

Devices

• Mobility aids if balance or walking is affected
• Memory aids to support daily functioning

Medical

• Medications to control blood pressure, cholesterol and diabetes
• Medications to reduce risk of stroke
• Medications to manage mood or behavioral symptoms

Surgical

• There are no surgical treatments for vascular dementia.
• There may be surgical procedures needed to address high stroke risk such surgical procedures to address carotid artery disease

Other

• Physical therapy
• Occupational therapy
• Speech therapy to address communication and swallowing
• Caregiver education and support

When to See Your Doctor

Talk to your doctor if you or your loved one experiences memory problems, slowed thinking or difficulty with daily tasks, especially with history or stroke or cardiovascular disease.

When to Seek Emergency Medical Care

Seek emergency medical treatment and call 911 if there are symptoms of stroke, including balance problems, sudden eye or vision changes, facial weakness on one side, arm or leg weakness or trouble with speech or communication.

Many conditions can affect memory, and not all memory loss is caused by dementia. If you or a loved one have noticed changes in memory, thinking or problem-solving, especially if there is a history of stroke, start by talking with your primary care provider. They can help identify possible causes and refer you to a neurologist if additional testing or specialized care is needed.

Visit Understanding Memory to learn more about the many things than can impact memory.

To learn more and connect with support, visit Riverside Health’s Martha W. Goodson Center.