Understanding and Preventing Vascular Dementia

Vascular dementia is the second most common type of dementia after Alzheimer’s disease and, like Alzheimer’s, can cause decline in cognitive function, memory loss and difficulty performing complex tasks. While we currently have no known way to prevent Alzheimer’s, vascular dementia is largely preventable – if you commit to live your healthiest life.

What is vascular dementia?
Vascular dementia is a type of dementia caused when the brain's blood vessels are damaged, which in turn can lead to brain tissue damage. Several conditions can harm these blood vessels, including high blood pressure, heart disease, diabetes and high cholesterol. A stroke or series of mini-strokes can also damage the brain’s blood vessels.

Signs and symptoms 
Like Alzheimer’s, symptoms of vascular dementia can present in diminished physical and mental capacity as well as emotional – and vary greatly depending on the severity of the damage to the brain and the specific areas of the brain that are affected.

Some common symptoms and indications of vascular dementia include:

• Changes in behavior and mood
• Difficulties with hearing and vision 
• Balance and coordination problems
• Fatigue, difficulty sleeping or insomnia
• Pervasive and ongoing aches and pains
• Difficulty with reasoning and thinking 
• Problems with language and communication
• Memory loss

How vascular dementia progresses
Vascular dementia’s onset and progression can vary greatly from person to person. Some people experience a gradual decline in their cognitive abilities, while for others it’s a more sudden decline. The severity of the symptoms can also vary from person to person, which, as with Alzheimer’s, makes vascular dementia hard to definitively pinpoint in its early stages.

It’s an important reason to develop and commit to an ongoing relationship with your primary care physician and have frequent and honest discussions about any concerns you have with changes you are experiencing or that your loved ones are noticing in your ability to perform and cope with daily living tasks and situations. 

How vascular dementia is diagnosed
There is no single test that can diagnose vascular dementia. Your primary care physician may see indications or have concerns if noticeable signs are developing, usually captured by updating your medical history and status at each appointment and through physical exams. 

If signs are concerning to your doctor, he or she may also order blood tests, tests that assess your cognitive function and a brain MRI or CT scan. Your doctor may also ask someone you know about changes in your ability to carry out everyday tasks.

Can vascular dementia be cured?
While research continues and there is yet no cure for vascular dementia, there are some treatments that can help slow the progression of the disease and improve quality of life for people suffering from vascular dementia. 

These include:

•    Medications to help control risk factors, including for high blood pressure and diabetes
•    Rehabilitation therapy to help with regaining lost function and skills 
•    Supportive care for patients, their families and caregivers to help cope with vascular dementia’s challenges

What happens when someone is diagnosed with vascular dementia?
The impact of vascular dementia on a person's life can be significant. It can interfere with their ability to work, drive and care for themselves. It can also lead to changes in mood, behavior and personality – which is particularly difficult for loved ones, friends, family and caregivers.

Daily living activities like cooking, getting dressed and bathing become challenging – and, critically, those who suffer likely will require help managing medications and finances and with transportation. 

While caring for loved ones with vascular dementia can be very difficult, emotionally draining and take up a lot of time, it plays an extremely important role in providing practical as well as loving support. 

How to prevent or delay vascular dementia
There are some things you can do to reduce your risk of developing vascular dementia. 

• Manage your blood pressure and be sure to comply with taking your blood pressure medication as subscribed
• Keep your cholesterol in check. If it’s been a while, have your cholesterol levels checked and discuss any dietary changes you can make and any medications you may need to lower it.
• Control your blood sugar – especially if you’ve been diagnosed with diabetes.
• Eat a healthy low-fat, low-sugar and low-sodium diet.
• Stay mentally active. Learn a new skill, pursue hobbies and crafts, read and do puzzles.
• Quit smoking. Chemicals in cigarette smoke can thicken the blood and form blood clots in veins and arteries, as well as increase the formation of plaque in blood vessels resulting in restricted blood flow to the brain, heart and other major organs.
• Exercise regularly.
• Reduce stress.
• Get enough sleep.
• Stay connected. An increasing body of research is showing that social isolation and loneliness increase your risk of dementia.

While it doesn’t get the attention that Alzheimer’s disease receives, vascular dementia is a serious condition that can significantly impact life. If you have any concerns about your or a loved one’s risk, discuss your concerns with your primary care physician.