Potential New Drug For Incurable Vascular Dementia
A drug already used to treat high blood pressure could be re-purposed as the first treatment to tackle a type of vascular dementia caused by damaged and leaky small blood vessels in the brain, according to research part-funded by the British Heart Foundation and published today in the Journal of Clinical Investigation.
High blood pressure is known to be the main risk factor in developing vascular dementia. However, the way that high blood pressure damages the small blood vessels, causing them to narrow and restrict blood flow to specific areas of the brain, has been unknown. The effectiveness of different types of blood pressure medication on these arteries has also never been directly tested.
Now, researchers at the University of Manchester working with colleagues in the USA have discovered that the blood pressure drug amlodipine could help treat vascular dementia or stop it in the early stages.
They looked at blood flow in the brains of mice with high blood pressure and vascular damage in the brain. Mice treated with amlodipine had better blood flow to more active areas of the brain. Their arteries were able to widen, allowing more oxygen and nutrients to reach the parts of the brain that needed it most.
The team also discovered for the first time that high blood pressure decreases the activity of a protein called Kir2.1 that is present in cells lining the blood vessels and increases blood flow to active areas of the brain.
Causes Of Potentially Reversible Dementia Symptoms
Worried that a loved one has Alzheimer’s disease? While you may be right, you should be sure to have a physician conduct a thorough evaluation to be certain. Some illnesses and conditions that look and act like Alzheimer’s are reversible with appropriate treatment.
Here are 10 potentially reversible causes of dementia symptoms.
Metabolic And Toxic Causes
Several endocrinal disorders and vitamin deficiencies can masquerade as dementia and need to be investigated, especially in young and rapidly progressive dementias. Several toxins can cause RPD. Exposure to heavy metals, such as arsenic, mercury, aluminum, lithium, or lead, can lead to cognitive decline, particularly after acute exposure. Most cases of acute exposures result in florid encephalopathies that progress over hours to days and thus would not be confused with rapidly progressive dementias, which progress over weeks to months. Manganese toxicity, found usually in miners, can present with significant Parkinsonism. Bismuth is a metal used to treat gastrointestinal disorders, principally peptic ulcer disease and diarrhea. Bismuth intoxication, typically caused by overdosing on bismuth-containing products, such as Pepto-Bismol, can cause a disorder mimicking Creutzfeldt-Jakob disease . Patients initially manifest with apathy, mild ataxia, and headaches, which progress to myoclonus, dysarthria, severe confusion, hallucinations , seizures, and, in severe cases, even death. Blood levels of bismuth, greater than 50 mg/L, are considered in the toxic range. The condition usually is reversible however, extremely prolonged use can result in permanent tremors.
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What Are The Symptoms Of Vascular Dementia
The symptoms of vascular dementia depend on the location and amount of brain tissue involved. Vascular dementia symptoms may appear suddenly after a stroke, or gradually over time. Symptoms may get worse after another stroke, a heart attack, or major surgery. These are signs and symptoms of vascular dementia
- Increased trouble carrying out normal daily activities because of problems with concentration, communication, or inability to carry out instructions
- Memory problems, although short-term memory may not be affected
- Confusion, which may increase at night
- Stroke symptoms, such as sudden weakness and trouble with speech
- Personality changes
- Mood changes, such as depression or irritability
- Stride changes when walking too fast, shuffling steps
- Problems with movement and/or balance
- Urinary problems, such as urgency or incontinence
Is Vascular Dementia Reversible
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Learn More About Dementia
A person with dementia may also exhibit the following types of behaviors:
Changes in mood behavior, such as irritability Placing everyday objects in odd places, such as putting a hat in the microwave Forgetting the day, month, time or location Loss of desire to initiate activities or be as active as usual
Key Points About Vascular Dementia
- Vascular dementia is a disorder characterized by damaged brain tissue due to a lack of blood flow. Causes can include blood clots, ruptured blood vessels, or narrowing or hardening of blood vessels that supply the brain.
- Symptoms can include problems with memory and concentration, confusion, changes in personality and behavior, loss of speech and language skills, and sometimes physical symptoms such as weakness or tremors.
- Vascular dementia tends to progress over time. Treatments can’t cure the disease, but lifestyle changes and medicines to treat underlying causes might help slow its progress.
- Surgical procedures to improve blood flow to the brain can also be helpful. Other medicines might slow the progression of dementia or help with some of the symptoms it can cause.
- A person with vascular dementia may eventually need full-time nursing care or to stay in a long-term care facility.
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Certain Types Of Fish
Eating fish can enhance memory and boost brain health, according to the Academy of Nutrition and Dietetics. Omega 3 fatty acid, in particular present in fish, helps to maintain a fully functional brain.
Salmon, herring, sardines, and anchovies are heavy in omega 3s.
They also contain selenium, potassium, B vitamins, and magnesium, which also help in the war against dementia.
Fish like salmon and tuna are also known to a healthy heart, which is also essential for preventing dementia and cognitive decline. It is okay to eat fish at least once or twice a week.
Preventing And Possibly Reversing Dementia & Alzheimer
Inadequate blood flow can damage and eventually kill cells anywhere in the body, but the brain is especially vulnerable.
In vascular dementia, changes in thinking skills sometimes occur suddenly after a stroke, which blocks major blood vessels in the brain. Thinking difficulties may also begin as mild changes that gradually worsen as a result of multiple minor strokes or another condition that affects smaller blood vessels, leading to widespread damage. A growing number of experts prefer the term vascular cognitive impairment to vascular dementia because they feel it better expresses the concept that vascular thinking changes can range from mild to severe.
Vascular brain changes often coexist with changes linked to other types of dementia, including Alzheimer’s disease and Lewy body dementia. Several studies have found that vascular changes and other brain abnormalities may interact in ways that increase the likelihood of dementia diagnosis. Sign up for our e-news to receive updates about Alzheimers and dementia care and research. Vascular changes that start in brain areas that play a key role in storing and retrieving information may cause memory loss that looks very much like Alzheimer’s disease.
Under the diagnostic approach recommended in the 2011 statement, the following criteria suggest the greatest likelihood of mild cognitive impairment or dementia is caused by vascular changes:
Vascular dementia signs and symptoms include:
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Which Part Of The Brain Is Affected By Vascular Dementia
A different kind of vascular dementia, called subcortical vascular dementia, follows disease of the small blood vessels deep in the brain. This disease often causes widespread damage to white matter beneath the cortex. These nerve fibres carry signals between different parts of the cortex, including the frontal lobes.
Medications Side Effects Or Interactions
It’s not uncommon to see people who are on many different medications. While they might all be appropriate and beneficial, there are also times when some medications should be discontinued or decreased. Multiple medications increase the chance for medication interactions and negative side effects, and both of these are well-documented causes of confusion and memory loss.
Ask your physician to review your medication list and make sure she knows all of the medicines that have been prescribed for you by other doctors such as specialists. Cognition can significantly improve if this issue is identified and addressed.
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How Is Vascular Dementia Diagnosed
In addition to a complete medical history and physical exam, your healthcare provider may order some of the following:
- Computed tomography . This imaging test uses X-rays and a computer to make horizontal, or axial images of the brain. CT scans are more detailed than general X-rays.
- FDG-PET scan. This is a PET scan of the brain that uses a special tracer to light up regions of the brain.
- Electroencephalogram . This test measures electrical activity in the brain
- Magnetic resonance imaging . This test uses large magnets, radiofrequencies, and a computer to make detailed images of the brain.
- Neuropsychological assessments. These tests can help sort out vascular dementia from other types of dementia and Alzheimer’s.
- Neuropsychiatric evaluation. This may be done to rule out a psychiatric condition that may resemble dementia.
What Causes Vascular Dementia
Vascular dementia is caused by a lack of blood flow to a part of the brain. Blood flow may be decreased or interrupted by:
- Blood clots
- Bleeding because of a ruptured blood vessel
- Damage to a blood vessel from atherosclerosis, infection, high blood pressure, or other causes, such as an autoimmune disorder
CADASIL is a genetic disorder that generally leads to dementia of the vascular type. One parent with the gene for CADASIL passes it on to a child, which makes it an autosomal-dominant inheritance disorder. It affects the blood vessels in the white matter of the brain. Symptoms, such as migraine headaches, seizures, and severe depression, generally start when a person is in his or her mid-30s but, symptoms may not appear until later in life.
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Vascular Dementia Treatment And Support
A person can live well with vascular dementia with drug and non-drug treatment, support and activities.
The person should have a chance to talk to a health or social care professional about their dementia diagnosis. This could be a psychiatrist or mental health nurse, a clinical psychologist, occupational therapist or GP. Information on what support is available and where to go for further advice is vital in helping someone to stay physically and mentally well.
Do Dementia Medications Work For Vascular Dementia
Cholinesterase inhibitors, also known as AChE inhibitors, are drugs that are used to help with the symptoms of Alzheimers disease.These medications have been tried in vascular dementia, but they do not work as well as they do in Alzheimers disease. They also have side effects. Sometimes doctors will try using these medications in vascular dementia, especially if they think a patient has a mix of vascular and Alzheimers disease.
Memantine is a dementia drug that is only recommended for people with Alzheimers.
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Dementia & Alzheimer’s Disease
For years, research has been ongoing to identify the foods to reverse dementia. Even though dementia currently does not have a cure, experts state that lifestyle and diet can play a significant role in preventing and even reversing pre-dementia and early dementia.
Dr. Mark Hyman, a champion of the body-mind effect, explains that the things you do to your body end up affecting the brain. Thus, the importance of healthy diet and nutrition.
Going by the fact that dementia usually begins with too much sugar in the brain, controlling blood sugar levels can help in reversing cognitive decline and dementia.
Controlling blood sugar has a lot to do with what you eat.
Lets look at nine foods that can help to reverse dementia.
Treating And Managing Dementia Symptoms
Dementia symptoms generally begin to appear later in life, after or around age 60, with the most common form being Alzheimer’s disease. Most forms of dementia are treatable, but not curable. For treatable, but degenerative forms of dementia, medication can help manage symptoms, although for most people, there are only modest benefits to treatment.
However, sometimes dementia symptoms may be caused by treatable conditions, and if the underlying conditions are treated, the patient’s mental functions can at least partially, if not completely, improve. It is estimated that about 20 percent of patients with dementia symptoms actually have a curable condition, thus it is important to rule these out in order to make a firm diagnosis of a degenerative type of dementia.
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The Tajiri & Kurihara Projects
Regarding the prevalence of MCI, unlike a rather clear difference between healthy controls and frank dementia, the more subtle difference between healthy controls and MCI can be affected by the method of sampling or by the neuropsychological tests used. It is important to examine community representative large samples and to perform neuropsychological tests sensitive enough to identify MCI. In the following section, we present the incidence and prevalence of vascular MCI based on the Tajiri & Kurihara Projects. Therefore, we followed our Prevalence Study conducted in 1998 with an Incidence Study in 2003 in Tajiri, Japan . The data of the Kurihara Project was also analyzed .
Briefly, our Prevalence Study in Tajiri conducted in 1998 included 497 randomly selected participants, including 346 CDR 0, 119 CDR 0.5, and 32 CDR 1. The first two groups were targeted for the follow-up Incidence Study in 2003. Based on the database, we reanalyzed the prevalence of subcortical VaD in the subjects with CDR 0.5 and VaD, prognosis with CVD, and two types of VaD onset . The criteria for subcortical VaD were met by 67% of those with vascular dementia and by 7% of those with vascular MCI. In the cognitively normal group, CVD had no effect on prognosis however, in the CDR 0.5 group, CVD had an effect on death by cardiovascular disease .
How Is Vascular Dementia Treated
Vascular dementia can’t be cured. The main goal is to treat the underlying conditions that affect the blood flow to the brain. This can help cut the risk of further damage to brain tissue.
Such treatments may include:
- Medicines to manage blood pressure, cholesterol, triglycerides, diabetes, and problems with blood clotting
- Lifestyle changes, such as following a healthy diet, getting physical activity, quitting smoking, and quitting or decreasing alcohol consumption
- Procedures to improve blood flow to the brain, such as carotid endarterectomy, angioplasty, and stenting the carotid arteries are located in the neck and provide blood flow from the heart to the brain
- Medicines, such as cholinesterase inhibitors to treat the symptoms of dementia or antidepressants to help with depression or other symptoms
What Is Vascular Dementia
Vascular dementia is the second most common form of dementia after Alzheimer’s disease. It’s caused when decreased blood flow damages brain tissue. Blood flow to brain tissue may be reduced by a partial blockage or completely blocked by a blood clot.
Symptoms of vascular dementia may develop gradually, or may become apparent after a stroke or major surgery, such as heart bypass surgery or abdominal surgery.
Dementia and other related diseases and conditions are hard to tell apart because they share similar signs and symptoms. Although vascular dementia is caused by problems with blood flow to the brain, this blood flow problem can develop in different ways. Examples of vascular dementia include:
- Mixed dementia. This type occurs when symptoms of both vascular dementia and Alzheimer’s exist.
- Multi-infarct dementia. This occurs after repeated small, often “silent,” blockages affect blood flow to a certain part of the brain. The changes that occur after each blockage may not be apparent, but over time, the combined effect starts to cause symptoms of impairment. Multi-infarct dementia is also called vascular cognitive impairment.
Researchers think that vascular dementia will become more common in the next few decades because:
Neurobehavioral And Neuropsychological Characteristics Of Vascular Mci
Vascular MCI is characterized by executive dysfunction, slowed information processing, memory deficit and mood and personality disorders . The main neuropathological substrate for vascular MCI is a disruption of the fronto-subcortical networks due to white matter lesions. Other vascular lesions could also contribute to the cognitive impairment, damaging white matter and/or subcortical structures .
There are various systematic reviews of the neuropsychological tests for vascular MCI . There were significant differences in all cognitive domains between VCI not demented and healthy controls, especially in processing speed, working memory, and visuospatial construction . When compared with non-vascular MCI, subjects with VCI-ND had significantly greater deficits in processing speed and executive function, while those with non-vascular MCI had a greater relative deficit in delayed memory .
Other screening instruments have recently been developed specifically for vascular MCI. The Brief Memory and Executive Test includes tasks for executive functioning, processing speed, orientation and memory . The Oxford Cognitive Screen incorporates tests for five cognitive domains: executive function, language, memory, number processing, and praxis .
Operational definitions of cognitive impairment are preferred over qualitative descriptions of cognitive symptoms .
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Type : Inflammatory Or Hot
These are patients with mainly inflammatory symptoms. They have a brain that is figuratively on fire and balance cannot be restored until the inflammation has been brought under control. There have been many similarities observed between adults with this type of Alzheimers and children on the autism spectrumwith some overlap of successful treatment modalities for both.
Symptoms Of Azheimer’s Disease
Alzheimer’s is a form of vascular dementia – the most common form of the disease in the UK.
If the vascular system within the brain becomes damaged – so that the blood vessels leak or become blocked – then blood cannot reach the brain cells and they will eventually die.
This death of brain cells can cause problems with memory, thinking or reasoning, and when these cognitive problems are bad enough to impact on daily life, it is known as vascular dementia.
Many cases of dementia start with early warning signs.
This early stage is known as cognitive impairment and can be barely noticeable or mistaken for something else, such as depression.
These include slight:
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