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 - Northwestern Memorial Hospital - Chicago

Vascular Dementia

Vascular dementia is a common complication from stroke, occurring when brain tissue is damaged by reduction in blood flow to the brain by a stroke or series of strokes. It describes difficulties in:

  • Reasoning
  • Planning
  • Judgment
  • Memory

as well as other thought processes caused by impaired blood flow to the brain.

These may be caused by a stroke blocking an artery in your brain, or it can be caused by other conditions that deprive your brain of oxygen and nutrition.

Approximately one-fifth of people who suffer a stroke will have problems in mental ability—vascular dementia is second only to Alzheimer’s disease as a leading cause of dementia.

Occurrence increases as people age, and the number of Americans over the age of 65 years expected to have vascular dementia in the wake of stroke is expected to increase as well.

Some risk factors that increase your risk of stroke and heart disease—such as smoking, high blood pressure, and high cholesterol—will also raise your risk of getting vascular dementia.

Signs & Symptoms
 

The symptoms of vascular dementia vary depending on the part of your brain where the blood flow has been impaired.

In cases of stroke, they may occur very suddenly. They may also occur in stages through a series of mini-strokes.

The most common symptoms of vascular dementia may include:

  • Confusion
  • Decline in ability to make decisions
  • Decline in ability to analyze, plan, or communicate effectively
  • Depression
  • Difficulty concentrating
  • Impaired ability to organize thoughts or actions
  • Memory lapses
  • Restlessness paired with agitation
  • Unsteady gait
  • Urinary incontinence
  • Wandering at night

What Causes Vascular Dementia?
 

Some of the most common causes of vascular dementia may include:

  • Stroke: while strokes may cause vascular dementia by means of blockage of a brain artery, it is also possible for some strokes to occur that do not give other symptoms, but which may increase the risk of vascular dementia. Known as “silent brain infarctions,” these increase the risk
  • Narrowed or damaged brain blood vessels: anything that causes stenosis (narrowing) of brain blood vessels may lead to vascular dementia, including things like natural wear and tear that come with aging, high blood pressure, hardening of the arteries (atherosclerosis), diabetes, and other conditions

Risk Factors for Vascular Dementia
 

Risk factors are generally the same as those for heart disease and stroke. Smoking cessation, monitoring blood cholesterol and blood pressure are steps you can take to help reduce your risk of vascular dementia.

Diagnosis & Testing

There are no specific tests currently available to confirm vascular dementia, but your doctor will be able to make a diagnosis based on your medical history for stroke and use a combination of lab tests and neurological examinations to help make this determination.

Lab tests of your blood pressure, blood sugar and cholesterol levels will allow your doctor to rule out other possible causes of memory loss and confusion.

Neurological examination of your reflexes, coordination, and balance may help your doctor determine your neurological health, and testing your muscle tone and strength—particularly how it compares from one side of the body to the other—will also help determine whether there is vascular dementia.

Imaging technologies such as:

  • Computerized tomography (CT) scan
  • Magnetic resonance imaging (MRI) scan
  • Carotid ultrasound

Can help your doctor diagnose visible abnormalities caused the stroke, tumors, trauma, or other diseases of the blood vessels that may be affecting your reasoning.

Your doctor may also have specialists conduct neuropsychological tests to assess your ability to speak, write and understand language, solve problems, and work with numbers.

Treatments

While there are no FDA-approved drugs or therapies for vascular dementia, an important part of treatment of vascular dementia is slowing the rate of this disease by controlling the conditions affecting your cardiovascular health, such as:

  • Blood pressure
  • Cholesterol level
  • Blood clotting
  • Blood sugar level

Some drugs used to treat Alzheimer’s disease may offer some help with patients with vascular dementia, including:

Cholinesterase inhibitors: these drugs work to elevate the levels of a brain chemical messenger used in memory and judgment.

Support
 

Vascular dementia places great demands on patients as well as on their loved ones and caregivers. Being the caregiver for someone with dementia can be particularly demanding, both physically and emotionally.

Support groups exist to help people with dementia and caregivers receive counseling. Local Alzheimer’s Association affiliates can offer information on:

  • Available resources
  • Home care agencies
  • Residential care options
  • Information hotlines
  • Educational seminars
Last UpdateApril 30, 2012
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