VASCULAR DEMENTIA

Dementia is referred as the cognitive impairment (loss of mental ability) associated with gradual loss of brain cells. And usually occurs in the elderly (greater than 65 years old).

What causes vascular dementia?

Vascular dementia is caused by reduced blood flow to the brain, causing damage and eventual loss of brain cells.

This can develop as a result of:

  • narrowing and occlusion of the small blood vessels deep inside the brain (known as small vessel disease)
  • a single large stroke (where the blood supply to part of the brain is suddenly cut off)
  • lots of mini-strokes that cause tiny, but widespread, damage to the brain

High blood pressure and diabetes are the usual underlying conditions associated with vascular dementia. Other risk factors include lifestyle factors such as smoking and obesity.

Shifting to healthy lifestyle by controlling the mentioned conditions may reduce risk of developing vascular dementia and strokes later in life.

Many cases of vascular dementia start with early warning signs, including slight:

  • slowness of thought
  • difficulty with planning
  • trouble with language
  • problems with attention and concentration
  • mood or behavioural changes

If symptoms become unusual, medical advise should be sought. Lifestyle changes and treatment may stop or slow down the course of vascular dementia if spotted at an early stage.

Left untreated, symptoms may continue to get worse.

Diagnosing vascular dementia 

Confirming a diagnosis of vascular dementia can be difficult, particularly when the condition is in its early stages. This is because many of the symptoms of dementia can also be caused by other conditions.

However, the importance of an early diagnosis will benefit by stopping or slowing down the progression of the condition.

A series of examinations and procedures are done to aid in the diagnosis of vascular dementia including:

  • an assessment of symptoms and mental abilities, including how quickly symptoms have developed
  • a full medical history, including ahave a history of conditions related to vascular dementia, such as strokes or high blood pressure
  • a physical examination
  • a review of the medication
  • a range of tests, including blood tests, to rule out other possible causes of your symptoms, such as a vitamin B12 deficiency
  • brain scans, such as a computerised tomography (CT) scan, which can check for signs of a stroke or brain tumour, or a magnetic resonance imaging (MRI) scan, which can detect any shrinking of the brain
  • a heart rhythm test called an electrocardiogram (ECG)

 

Medication

Treatment will depend on the underlying cause. The following medications may be offered: 

  • antihypertensives, such as angiotensin-converting enzyme (ACE) inhibitors and beta-blockers, to treat high blood pressure
  • statins to treat high cholesterol
  • antiplatelets, such as aspirin or clopidogrel, to reduce your risk of blood clots and further strokes
  • blood thinners or anticoagulants, such as warfarin, which can also reduce your risk of blood clots and further strokes
  • diabetes medication, such as metformin
  • antidepressants to treat depression

Acetylcholinesterase inhibitorssuch as donepezil (Aricept), galantamine (Reminyl) or rivastigmine (Exelon), which are commonly used to treatAlzheimer’s disease, aren’t designed to treat vascular dementia specifically, but may sometimes be used.

They can be particularly helpful if you have a combination of vascular dementia and Alzheimer’s disease.

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