Vascular Dementia

1 What is Vascular Dementia?

Vascular dementia is a type of dementia that occurs as a result of damage to the blood vessels supplyin the brain with oxygen and nutrients.

Like other types of dementia it is accompanied by

  • problems with reasoning,
  • planning,
  • judgement,
  • memory
  • other though processes.

Severe cases of stroke and other diseases that can lead to damage of vessels going to the brian cancause vascular dementia.

People with high blood pressure, blood sugar and cholesterol can increase the chances of developing this disease.

Cntrolling thses factors can be very beneficial as it prevents vascular dementia from worsening.

2 Symptoms

The symptoms of vascular dementia include:

  • Confusion
  • Difficulty paying attention or concentrating
  • Reduced ability to organize thoughts or actions
  • Decline in the ability to analyze a problem, develop an effective plan and communicate it to others
  • Problems with memory
  • Restlessness and agitation
  • Unsteady gait
  • Depression
  • Increased grequency or inability to control urination

3 Causes

Conditions that damage blood vessels can cause vascular dementia.

This is due to a reduction in the ability of blood vessels to supply the brain with oxygen and nutrients that it requires in oreder to perform thought processes effectively.

Stroke (infarction) and narrowed or chronically damaged blood vessels can lead to dementia.

4 Making a Diagnosis

Doctors usually diagnose vascular dementia based on a medical history for stoke or diseases that affect the heart or blood vessels. There is no specific test that can be used to confirm vascular dementia. 

Tests used include:

  • Lab tests in which the blood pressure and blood levels of sugar and cholesterol are measured. Blood tests can also be carried out to rule out thyroid disorders or vitamin deficiencies as the cause of confusion and memory loss.
  • Neurological exam to check the overall neurological health. It can be done by checking
    • reflexes,
    • muscle tone and strength,
    • sense of touch and sight,
    • balance and coordination.
  • Neuropsychological tests can be used to check a patient's ability to
    • speak,
    • write or understand language,
    • work with numbers,
    • learn and remember information,
    • respond effectively to hypothetical situations.
  • Brain imaging tests to pinoint the abnormalities caused by
    • strokes,
    • blood vessel diseases,
    • tumors or trauma.

         Imaging tests include computerized tomography (CT) scan and magnetic resonace imaging (MRI).

  • Carotid ultrasound-is a procedure in which high-frequency sound waves are used to check for signs of narrowing of the carotid areteries (they run on either side of the neck).
  • A doppler ultrasound may also be used.

5 Treatment

The treatment of vascular dementia is aimed at treating the underlying cause, which in this case is damage of vessels.

The type of treatments is different for different patients. They involve prescribing medications which:

  • Lower blood pressure
  • Reduce cholesterol levels
  • Prevent blood clots from forming
  • Help control the blood sugar in patients with diabetes

Some drugs which can reduce some symptoms of Alzheimer's disease may also be effective in people with vascular dementia.

The drugs include:

  • Cholinesterase inhibitors like donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon). These drugs act by increasing the levels of a neurotransmitter that is involved in memory and judgement. Nausea, vomiting, muscle cramps and diarrhea are among the adverse effects of these drugs.
  • Memantine (Namenda), regulates a nurotransmitter that is responsible for processing, storing and retrieving information. Side effects can include headache, constipation, confusion and dizziness.

6 Prevention

The following measures can prevent vascular dementia:

  • Maintaining a healthy blood pressure
  • Keeping the levels of cholesterol in check
  • Preventing or controlling diabetes
  • Avoiding smoking
  • Exercising regularly                                                                                 

7 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope vascular dementia.

People with dementia may experience a mixture of emotions like:

  • fraustration,
  • anger,
  • fear,
  • depression,
  • grief
  • uncertainty.

People with dementia are encouraged to join support groups. Family members can also benefit from such groups.

Providing a calm and detectable environment can be helpful.

8 Risks and Complications

The risk factors for developing vascular dementia include:

  • Being an older adult
  • A history of heart attack ,strokes or mini strokes
  • Atherosclerosis
  • High cholesterol
  • High blood pressure
  • Diabetes
  • Smoking
  • Obesity
  • Atrial fibrillation                                                                                                
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