What is vascular dementia?

Vascular dementia refers to a subtle, progressive decline in memory and cognitive functioning. It occurs when the blood supply carrying oxygen and nutrients to the brain is interrupted by a blocked or diseased vascular system. If blood supply is blocked for longer than a few seconds, brain cells can die, causing damage to the cortex of the brain—the area associated with learning, memory, and language.

Depending on the person, and the severity of the stroke or strokes, vascular dementia may come on gradually or suddenly. Currently, there is no known cure, but the good news is that making certain lifestyle changes and using practical strategies may help prevent strokes, compensate for cognitive loses, and slow its development.

Multi-infarct dementia: The most common type of vascular dementia
The most common type of vascular dementia is multi-infarct dementia (MID), which is caused by a series of small strokes, or “mini-strokes,” that often go unnoticed and cause. These mini-strokes, also referred to as transient ischemic attacks (TIAs), result in only temporary, partial blockages of blood supply and brief impairments in consciousness or sight. Over time, however, as more areas of the brain become damaged, the symptoms of vascular dementia begin to appear.

Signs and symptoms of vascular dementia
Vascular dementia affects different people in different ways and the speed of the progression varies from person to person. Some symptoms may be similar to those of other types of dementia and usually reflect increasing difficulty to perform everyday activities like eating, dressing, or shopping.

Behavioral and physical symptoms can come on dramatically or very gradually, although it appears that a prolonged period of TIAs—the mini-strokes discussed above—leads to a gradual decline in memory, whereas a bigger stroke can produce profound symptoms immediately. Regardless of the rate of appearance, vascular dementia typically progresses in a stepwise fashion, where lapses in memory and reasoning abilities are followed by periods of stability, only to give way to further decline.
Common mental and emotional signs and symptoms of vascular dementia

  • Slowed thinking
  • Memory problems; general forgetfulness
  • Unusual mood changes (e.g. depression, irritability)
  • Hallucinations and delusions
  • Confusion, which may get worse at night.
  • Personality changes and loss of social skills

Common physical signs and symptoms of vascular dementia

  • Dizziness
  • Leg or arm weakness
  • Tremors
  • Moving with rapid, shuffling steps
  • Balance problems
  • Loss of bladder or bowel control

Common behavioral signs and symptoms of vascular dementia

  • Slurred speech
  • Language problems, such as difficulty finding the right words for things
  • Getting lost in familiar surroundings
  • Laughing or crying inappropriately
  • Difficulty planning, organizing, or following instructions
  • Difficulty doing things that used to come easily (e.g. paying bills or playing a favorite card game)
  • Reduced ability to function in daily life

Causes of vascular dementia
Causes of vascular dementiaStroke, small vessel disease, or a mixture of the two can cause vascular dementia. Most commonly there is a blockage of small blood vessels somewhere in the vast system of arteries that feeds the brain and enters through the base of the skull. Blockages may be caused by plaque build up on the inside of the artery wall, or by blood clots which have broken loose and clogged a tributary further downstream. Clots can form as a result of abnormal heart rhythms, or other heart abnormalities. Also, a weak patch on an artery wall can balloon outward and form an aneurysm, which can burst and deprive the brain cells of oxygen.

It is estimated that about 50 percent of the cases of vascular dementia result from hypertension, or high blood pressure. Less common causes of vascular dementia are associated with autoimmune inflammatory diseases of the arteries such as lupus and temporal arteritis, which are treatable with drugs that suppress the immune system.
Helping someone with vascular dementia
Caring for a person with vascular dementia can be very stressful for both you and your loved one. You can make the situation easier by providing a stable and supportive environment.

A stable environment starts with a stable, healthy you. It’s easy to lose sight of your own needs when your loved one is dealing with dementia. But taking care of yourself isn’t optional. Stress and burnout are common in caregivers—and that isn’t a good thing for you or the person you’re caring for. Nurturing and protecting your own emotional and physical health isn’t selfish. It’s the best thing you can do for the person you love.

Tips for caring for a loved one with vascular dementia

  • Avoid changing things up. Your loved one will feel more comfortable and less frightened or agitated when he or she is on a regular routine and in familiar surroundings.
  • Use calendars and clocks. Place large calendars and clocks around your loved one’s living area. They can help people with dementia reorient if they’ve forgotten the date or time.
  • Keep your loved one busy. Encourage your loved one to continue physical and social activities as long as possible. Whether it’s going for a walk or spending time at the local senior center, it’s important that he or she has regular activities to participate in.
  • Provide plenty of stimulation. Make sure your loved one’s room is colorful and inviting. Do they have a nice view outside? If not, you can bring the outdoors in with some flowers or a plant. Also make sure they have a TV, radio, or other things to look at and do.
  • Tell your loved one what you’re doing, and why. If it’s time for dinner, say so. Don’t just lead them into the kitchen without explaining what’s going on. Be sure to communicate, even if you’re not sure your loved one understands. Even if he or she doesn’t understand your words, your tone of voice and body language can provide reassurance.
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