23rd Nov 2022
Vascular neurocognitive disorder, more commonly called vascular dementia, is a form of dementia that occurs when there is a lack of blood and oxygen flowing to the brain. The condition causes cognitive decline, and it is often treated by slowing the progression of the disease, through medications and/or modifying risk factors like smoking .
Dementia is an umbrella term that refers to conditions that cause cognitive decline and an impairment in daily functioning. Vascular dementia is the second most common form of dementia, falling behind Alzheimer’s disease as the most prevalent form of this condition .
Cases of vascular dementia are caused by a lack of blood and oxygen flow to the brain. This lack of blood flow can be a result of blood clots or fatty deposits that block the blood vessels. Vascular dementia is more likely to affect older adults. Additional risk factors include cigarette use, diabetes, high blood pressure, and high cholesterol .
Vascular dementia, sometimes also referred to as multi-infarct dementia, causes cognitive decline, which can lead to difficulties with attention, memory, language use, and overall executive functioning, which is the ability to plan tasks and use logical reasoning .
When a person has vascular dementia, symptoms may occur suddenly, or they may appear gradually. Common symptoms of the condition are as follows :
While the list above provides general symptoms of vascular dementia, it’s also helpful to know that dementia can occur in stages. Sometimes, symptoms appear suddenly, but in other cases, a person has a gradual onset of symptoms, and they decline over time.
One symptom of mild dementia includes episodes of forgetfulness, which a person may try to cover up because they are aware that they are becoming forgetful. A person with mild dementia can generally communicate well and perform daily tasks, but others may notice changes to their behavior. The person may experience signs of depression, because they recognize that their cognitive capacities are beginning to decline .
As vascular dementia progresses to the moderate stage, a person experiences more evident signs of cognitive decline. They may stop caring for themselves, and it can be difficult for them to perform daily activities without assistance. A person with moderate dementia symptoms will begin to struggle with communication, and they may become frustrated when they cannot think of the correct word to say in conversation .
Finally, in the advanced stage of dementia, a person becomes dependent on other people for their daily care, and they may not communicate verbally at all. A person with advanced vascular dementia will need someone to assist them with all daily activities; they may experience difficulty with mobility and feeding themselves. .
Vascular dementia is ultimately the result of a lack of blood and oxygen flow to the brain. This can occur for a number of reasons. Some medical conditions that increase the risk of vascular dementia include :
Beyond these specific health conditions, certain lifestyle factors can increase the risk of developing vascular dementia. For example, smoking and obesity have both been identified as risk factors for vascular dementia .
Healthy lifestyle habits, such as eating a nutritious diet, limiting alcohol intake, avoiding smoking, getting plenty of exercise, and managing stress, can all reduce the risk of vascular dementia .
When making a diagnosis of vascular dementia, a physician begins by taking the patient’s history. The physician will ask about the nature of cognitive deficits and problems with daily functioning and gather information about when the symptoms began, as well as how they have progressed. When gathering historical information from a patient, a physician may also speak to family members who have knowledge of the patient’s functioning .
If it appears that a patient may be experiencing vascular dementia, it is also common for medical providers to conduct cognitive testing to determine the degree of a patient’s impairment. A physician must also rule out alternative diagnoses, such as depression, infections, thyroid problems, or alcohol misuse, that may be contributing to cognitive decline. To rule out these conditions, a physician may order blood work to test levels of thyroid hormone and other blood markers related to metabolic functioning .
A physician may also order an magnetic resonance imaging (MRI) scan to evaluate neurological deficits in specific areas of the brain .
Once gathering all materials for a diagnosis, a physician will diagnose vascular dementia utilizing the criteria in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM 5). This manual refers to vascular dementia with the term, “major or mild vascular neurocognitive disorder.” The diagnostic criteria for this condition are as follows :
While mild neurocognitive disorder does represent a state of cognitive decline, a person is still able to be independent in daily life. In major neurocognitive disorder, cognitive decline does interfere with independence, and a person requires assistance with daily tasks like paying bills, because cognitive impairment is substantial.
Vascular dementia can be prevented by modifying risk factors for the disease. For example, keeping blood pressure within a healthy range can reduce the risk of vascular dementia. If you have high blood pressure, it’s important to take steps to control the condition, as uncontrolled high blood pressure can cause damage to the brain .
Other strategies that can reduce the risk of vascular dementia are as follows :
While there is no cure for vascular dementia, the goal of treatment is to slow the progression of brain damage from the disease. This is achieved by treating not only vascular dementia, but also any co-occurring conditions, such as diabetes, that can lead to worsening of the disease .
Vascular dementia treatment often involves the use of one or more of the following medications :
In addition to prescribing medication, a doctor treating a patient for vascular dementia will likely recommend lifestyle changes, which can reduce the risk of further brain damage. For example, a doctor will often recommend that patients with vascular dementia give up smoking and reduce their alcohol intake .
If you have vascular dementia, it’s important for you to take steps to care for yourself; lead a healthier lifestyle, cut down on unhealthy food, and train your body and mind, and you can help slow the progression of the condition. With healthy lifestyle habits, you can preserve your cognitive functioning and slow the rate of decline from vascular dementia. Some common self-care tips recommended for people who live with vascular dementia include:
If a loved one lives with vascular dementia, there are things you can do to help. Consider the following strategies for caring for your loved one:
Recent estimates show that in people aged 50 and above, there are 116 cases of vascular dementia per 10,000 individuals. The condition is more common among females compared to males, and it is also more prevalent in North America and Europe when compared to Asia, Africa, and South America. The risk of vascular dementia increases with age .
While vascular dementia can be managed to slow the progression of the disease, individuals with this condition do have a shortened life expectancy. In patients who have had a cerebrovascular accident, such as a stroke, the 5-year survival rate is 39%. Given the link between high cholesterol and vascular dementia, heart disease is a common cause of death among patients with vascular dementia .