WHAT IS VASCULAR DEMENTIA?
After Alzheimers, vascular dementia is the most common form of dementia. In the UK alone, it affects around 150,000 people. It is sometimes referred to as Multi-Infarct Dementia (MID) or Vascular Cognitive Impairment (VCI), but we have more on the various types of vascular dementia below.
As with other forms of dementia, the condition affects brain function (including memory loss or language), but vascular dementia occurs when the brain is damaged through problems with the blood supply to it. This can occur through a variety of ways which leads to different types of vascular dementia. These include:
- Stroke-Related; Strokes can vary in their severity, the location they affect and how long the blood supply to the brain is affected. They usually occur when the blood vessels become overly narrow or blocked.
- Post-Stroke; Not everyone who has a stroke goes on to develop vascular dementia, but around 20% of those that do go on to develop this particular type of vascular dementia.
- Single-Infarct / Mutli-Infarct; These refer to one or more small strokes that may occur. Sometimes a stroke is so small that you may not necessarily recognise the symptoms, or problems may only occur temporarily as the blockage clears itself. Even so, if the supply is interrupted for a few minutes, it may lead to a small area of the brain's tissue dying. This is known as an infarct. Whilst 'small' it may still affect an important part of the brain and cause dementia. One area is a single-infarct, but a series of mini-strokes may lead to multi-infarct dementia.
- Subcortical / Small Vessel Disease; This is believed to be the most common form of vascular dementia. It occurs when the very small blood vessels that lie deep in the brain stiffen and become twisted, limiting the blood flow through them. Because of their location, the symptoms for this type is slightly different.
- Mixed; This is when someone has both Alzheimers and vascular dementia. Around 10% of people with vascular dementia have the 'mixed' type. Their symptoms may be one or the other, but can be a combination of the two.
The symptoms of vascular dementia will often occur in sudden steps, rather than a slow, gradual decline. You may notice real, sudden changes in how you feel, but then experience quite stable periods in-between but, as with anything, this will affect different people in different ways.
As with most dementias, how it affects you, when, and to what degree will vary from person to person. The symptoms may develop suddenly after a major stroke or gradually as a result of a smaller one.
Many of the symptoms of vascular dementia are similar to other forms of dementia, but others, like memory loss, are more prominent with Alzheimers. They can also vary depending on the type (see above) of vascular dementia. For example, stroke-related vascular dementia will include the physical symptoms of a stroke, i.e. paralysis of parts of the body or slurred speech (depending on the area of the brain affected).
The main symptoms of vascular dementia include:
- Decision making becomes a problem.
- Difficulty in planning or organising things.
- Slower thinking.
- Trouble concentrating and temporary confusion.
- Mood swings, apathy and anxiety (particular in the early stages).
- Loss of bladder control and clumsiness (usually only associated with subcortical vascular dementia).
WHAT CAUSES VASCULAR DEMENTIA?
The blood to the brain travels through a network called the vascular system. Vascular dementia occurs when that blood supply to the brain is reduced, usually because the vessels that deliver it have become diseased or blocked. As we mentioned above, this can occur through a number of different causes including:
- Narrowing and blockage of the smaller blood vessels (known as small vessel disease or subcortical).
- A large stroke which suddenly stops the blood supply to parts of the brain.
- A series of mini-strokes which cause small, but multiple, areas of damage.
The damage to these vessels means that the oxygen and nutrients the blood delivers to the brain is interrupted. If the supply is interrupted for any length of time, the brain doesn't get the supply of goodness it needs and the cells within it start to erode.
As these brain cells start to wither and die, they can impact on our ability to remember things, make reasoned judgements or even think clearly. As soon as it becomes bad enough that they start to impact on your daily life, it becomes vascular dementia.
It's rare (but not impossible) that vascular dementia will affect anyone younger than 65 years of age, but is definitely more common in those above that age. Once diagnosed, the average life expectancy is about 4 years.
WHAT TREATMENTS ARE AVAILABLE?
Sadly, the impact of vascular dementia is irreversible once the damage has started. When the brain cells have died, there's no way to bring them back to life. There is, however, ways to slow down the process when it does start to occur.
Medication will help, but so too will changes in your lifestyle. If you ever needed a reason to start eating healthily, lose weight, quit smoking, get fit and cut down on your alcohol intake. Now would be a perfect time.
You may also be prescribed a series of psychotherapy, occupational therapy and perhaps even speech therapy once your language starts to be affected.
If you (or someone you know) lives with vascular dementia, there may be some organisations on our Where To Turn pages that can help you. If not, and you know of one, please let us know and we'll look into it.