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What is Vascular Dementia: Everything You Need to Know

Vascular dementia (VaD) — otherwise known as vascular cognitive impairment — is a condition that impairs one’s planning, reasoning, memory, judgment, and thought processes. It is the result of brain damage that occurs due to restricted blood flow to the organ. It is the second-most common type of dementia, next to Alzheimer’s disease, and affects nearly one-third of people over 70.

Vascular cognitive impairment (VCI) differs from other types of dementia in that it is typically the result of a specific, acute event that interrupts the blood flow to the brain. The most common cause of VCI is stroke, which blocks arteries in the brain. The severity of dementia following a stroke depends mainly on the severity and location of the stroke.

Vascular dementia can develop gradually over time due to slow blood flow or a minimal blockage. Conditions that may contribute to the prolonged development of vascular dementia include high blood pressure and high cholesterol. Smoking can also increase a person’s risk.

The Stages of Vascular Dementia

Vascular dementia, unlike other forms of dementia, does not have clear-cut stages of typical timelines. The severity of symptoms and when they set in depends largely on what causes the disease in the first place. If vascular cognitive impairment results from a minuscule blockage in the brain or several minor strokes, symptoms may appear gradually at first. They may be mild in the beginning and grow progressively worse as the underlying health condition remains untreated. On the other hand, vascular dementia results from a significant and sudden event, the onset of severe symptoms may be sudden.

Often, vascular dementia occurs concurrently with Alzheimer’s disease and Lewy body dementia. Just 5% to 10% of people with vascular cognitive impairment have vascular cognitive impairment alone. The remaining 90% to 95% live with mixed dementia. Individuals afflicted by more than one type of dementia may follow patterns more consistent with the second type of dementia.

Symptoms of Vascular Dementia

How VaD affects individuals varies significantly from person to person and depends largely on the underlying cause. Some symptoms, such as memory loss, may be similar to those associated with other forms of dementia, but this is not always the case. In fact, unlike with Alzheimer’s disease, memory loss is not always among the first early symptoms of VCI. The most common signs that a person is in the early stages of vascular cognitive impairment include the following:

  • Difficulty making decisions, planning, organizing, or solving problems

  • Trouble concentrating and/or experiencing bouts of confusion

  • Difficulty following through with a series of steps, such as following a recipe

  • Slowed thought process

The afflicted individual may also struggle to recall past events, have problems recognizing familiar objects or be unable to clearly articulate their thoughts. In addition to cognitive impairments, persons with VaD may also demonstrate mood changes, such as anxiety, apathy, or depression. Depression is particularly common in people with this type of dementia because, unlike people who live with Alzheimer’s, they are often aware of their impairments. Afflicted persons may also be prone to rapid mood swings and almost manic-like tendencies (extreme happiness one minute, extreme tearfulness the next).

Vascular cognitive impairment is also characterized by physical symptoms. For instance, it is not uncommon for VCI patients to experience weakness of the limbs or paralysis. Some may develop vision problems and slurred speech. Others may lose all bladder control or become clumsy and prone to falling.

As VaD progresses into the later stages, a person may begin to exhibit out-of-character behaviors. Though these can vary, the most common late-stage behavioral changes include aggression, agitation, irritability, and insomnia. He or she may also experience extreme disorientation and develop delusions or hallucinations.

Outlook and Potential Treatment for People With VaD

Though this type of dementia affects everyone differently, the life expectancy of afflicted individuals is around five years from the onset of symptoms. Unfortunately, there is no way, at this time, to improve life expectancy for VaD patients. There are, however, ways to improve patients’ quality of life during their final years.

In stroke patients, rehabilitation efforts may help to improve or stabilize physical symptoms, especially during the first six months following the episode. In all VaD patients, treatment primarily focuses on helping patients and their families manage the underlying health conditions that may have contributed to dementia in an attempt to prevent the worsening or progression of symptoms. Depending on a patient’s unique circumstances, a doctor may prescribe cholesterol medication, blood pressure medication, and medication to control blood sugar levels and/or prevent blood clotting. Additionally, though the FDA has not approved any medications to treat VaD specifically, research does suggest that drugs used to improve Alzheimer’s symptoms may also have some benefits in people with modest cases of VaD.

Once a person develops vascular cognitive impairment, they will live with it for life. However, with the proper care and treatment, they can lead a relatively fulfilling life for years following a diagnosis.

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