Vascular Dementia

Overview

Definition

Vascular dementia (VD) is a type of dementia. It is caused by disease of the small blood vessels in the brain. This makes it harder for your brain to get the oxygen it needs to work.

Healthy and Injured Brain Blood Vessels
Blood Flow and Lack of Blood Flow to the Brain
Copyright © Nucleus Medical Media, Inc.

Causes

VD occurs when brain cells die because they do not get enough oxygen and nutrients. This is due to hardening and narrowing of the blood vessels in the brain.

Risk Factors

VD is more common in older adults.

Having one or more of these risk factors may raise your chance of VD:

  • History of smoking
  • Lack of activity
  • Obesity
  • High blood pressure
  • Diabetes
  • Stroke
  • Heart disease
  • Atrial fibrillation
  • Peripheral artery disease
  • Chronic kidney disease

SymptomsandDiagnosis

Symptoms

In some people, signs of VD appear quickly with changes like those caused by a stroke. Sometimes, the small strokes that lead to VD can happen without other signs. This makes VD hard to detect.

In some cases, things may stay the same or even get better. But VD worsens in most people.

The main symptoms of VD are:

  • Loss of intellectual abilities, speed of thinking or acting, and cognitive and motor abilities
  • Memory loss
  • Problems walking
  • Incontinence

Other symptoms are:

  • Personality changes
  • Laughing, crying, or smiling at the wrong times
  • Problems speaking
  • Swallowing problems
  • Paralysis or lack of strength in one or both sides of the body
  • Inactivity
  • Depression, which may cause a loss of interest in activities
  • Tremors, clumsiness, loss of trunk mobility
  • Seizures
  • Nighttime confusion
  • Paranoia

Diagnosis

VD can look like other causes of dementia, such as Alzheimer.

Your doctor will ask about your symptoms and health history. A physical exam will be done.

Your bodily fluids may be tested. This can be done with blood tests.

Pictures may be taken of your brain and body structures. This can be done with:

  • MRI scan
  • CT scan

Cognitive testing may also be done.

Treatments

Treatment

There is no known cure for VD. The goal is to slow VD and make your quality of life better.

You may be given medicine control mental health problems, such as depression and confusion.

You may also be given medicine to treat other conditions you may have, such as:

  • High blood pressure
  • Heart arrhythmias
  • High cholesterol
  • Conditions that cause the blood to clot
  • Diabetes

Prevention

Taking these steps may reduce your risk of VD:

  • If you smoke, talk to your doctor about how you can successfully quit.
  • Eat a diet that is low in fat and salt. Diets that include fish, such as the Mediterranean Diet, may help.
  • Limit alcohol. This means no more than two drinks per day for men and one drink per day for women.
  • Have your blood pressure and blood cholesterol levels checked at least once a year.
  • If you have diabetes, keep your blood glucose in your goal range.
  • Exercise regularly.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (Binswanger’s Disease; Senile Dementia; Binswanger’s Type; Vascular Cognitive Impairment; Arteriosclerotic Dementia; Atherosclerotic Disease)

RESOURCES

Alzheimer’s Association http://www.alz.org 

National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov 

CANADIAN RESOURCES

Alzheimer Society of Canada http://www.alzheimer.ca 

Heart & Stroke Foundation http://www.heartandstroke.com 

References

Caplan LR. Binswanger’s disease—revisited. Neurology. 1995;45(4):626-633.

Kirschner H. Vascular dementia: a review of recent evidence for prevention and treatment. Curr Neurol Neurosci Rep. 2009;9(6):437-442.

Purkayastha S, Fadar O, Mehregan A, et al. Impaired cerebrovascular hemodynamics are associated with cerebral white matter damage. J Cereb Blood Flow Metab. 2014;34(2):228-234.

Roman GC. Brain hypoperfusion: a critical factor in vascular dementia. Neurol Res. 2004;26(5):454-458.

Roman GC, Erkinjuntti T, Wallin A, Pantoni L, Chui HC. Subcortical ischaemic vascular dementia. Lancet Neurol. 2002;1(7):426-436.

Sabayan B, Sorond FA. Reducing risk of dementia in older age. JAMA. 2017;317(19):2028.

Smith EE. Leukoariosis and stroke. Stroke. 2010;41(10 Suppl):S139-S143.

Tomassoni D, Lanari A, Silvestrelli G, Traini E, Amenta F. Nimodipine and its use in cerebrovascular disease: evidence from recent preclinical and controlled clinical studies. Clin Exp Hypertens. 2008;30(8):744-766.

Vascular cognitive impairment. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T115874/Vascular-cognitive-impairment . Updated November 8, 2017. Accessed June 14, 2018.

Vascular dementia. Alzheimer's Association website. Available at: http://www.alz.org/dementia/vascular-dementia-symptoms.asp. Accessed June 14, 2018.

Vascular dementia: A resource list. National Institute on Aging website. Available at: https://www.nia.nih.gov/health/vascular-dementia-and-vascular-cognitive-impairment-resource-list. Accessed June 14, 2018.

9/3/2014 DynaMed's Systematic Literature Surveillance. Available at:  http://www.dynamed.com/topics/dmp~AN~T115874/Vascular-cognitive-impairment : Wippold FJ, Brown DC, Broderick DF, et al. American College of Radiology (ACR) Appropriateness Criteria for dementia and movement disorders. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/DementiaAndMovementDisorders.pdf. Updated 2014. Accessed September 3, 2014.