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Vascular dementia

Cognitive decline related to stroke is usually called vascular dementia or vascular cognitive impairment to distinguish it from other types of dementia.

People who have had a stroke are at nine times greater risk of dementia than people who have not had a stroke. About one in four people who have a stroke develop signs of dementia within one year.

Vascular dementia is most common in older people, who are more likely than younger people to have vascular diseases. It is also more common in men than in women.

Vascular dementia is the second most common cause of dementia in older people. Because it has a lower profile than Alzheimer’s, many people don't suspect vascular dementia when forgetfulness becomes problematic.

Determining the root cause can help determine the best action plan. If it's vascular dementia, certain lifestyle changes can help prevent further damage. We take a look at vascular dementia, its causes, symptoms and prognosis.

What is vascular dementia?

Vascular dementia is considered the second leading type of dementia. Vascular dementia affects more than 111,000 people in the UK.

Compared to Alzheimer's disease, which happens when the brain’s nerve cells break down, vascular dementia happens when part of the brain doesn't get enough oxygen and nutrients.

Though they happen in different ways, it is possible to have both vascular dementia and Alzheimer's disease. Discouraging as this sounds, there is ample reason to bring vascular dementia under control. Allowing the condition to run its course without interference can make Alzheimer's disease worse.

What causes vascular dementia?

Vascular dementia occurs when vessels that supply blood to the brain become blocked or narrowed, depriving brain tissue of oxygen and nutrients. Strokes take place when the supply of blood carrying oxygen to the brain is suddenly cut off. However, not all people with stroke will develop vascular dementia.

Vascular dementia can occur over time as ‘silent’ strokes reoccur. Quite often, vascular dementia draws attention to itself only when the impact of so many strokes adds up to significant disability. Avoiding and controlling risk factors such as diabetes, high blood pressure, smoking and high cholesterol can help curb the risk of vascular dementia.

Catching the condition early may also help stop vascular dementia in its tracks. Early detection requires a delicate balance of watching for symptoms without letting fear take control. Anyone who suspects vascular dementia should seek medical advice.

Symptoms of vascular dementia

Symptoms of vascular dementia depend on what part of the brain is affected and to what extent. Like Alzheimer's disease, the symptoms of vascular dementia are often mild for a long time. They may include:

  • Problems with short-term memory
  • Wandering or getting lost in familiar surroundings
  • Laughing or crying at inappropriate times
  • Trouble concentrating, planning or following through on activities
  • Trouble managing money
  • Inability to follow instructions
  • Lost bladder or bowel control
  • Hallucinations or delusions

Symptoms that suddenly get worse often signal a stroke. Doctors look for symptoms that progress in noticeable stages to diagnose vascular dementia. Alzheimer's, by comparison, progresses at a slow, steady pace. Another clue is impaired coordination or balance and when it becomes apparent. In vascular dementia, problems walking or balancing can happen early. With Alzheimer's, these symptoms usually occur late in the disease.

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