Hormone Fluctuations As A Risk Factor
Male vs. Female Hormonal Risk/Benefits
Females seem to be more susceptible overall to dementia than males. The association between sex hormones and VaD is still somewhat unknown in the scientific/medical field. While there is extended gratitude to consider sex as one of the factors of VaD, there are various factors that might distinctively impact females, such as pregnancy and reproductive history.
Another study on animal models suggests that young adult male mice had worse pathological and functional outcomes following cerebral ischemia than females, which is consistent with clinical studies suggesting that high-androgen levels enhance stroke risk in younger populations . These sex differences could be due to sex hormones or sex chromosomal complement.
Hormone Therapy Risks/Benefits for VaD
How Vascular Dementia Develops
Symptoms of vascular dementia can appear suddenly if they are caused by a single stroke, or if they are caused by silent strokes they may appear gradually over time. Vascular dementia sometimes develops in steps, so that symptoms will stay the same for a while and then suddenly get worse. These steps are usually due to new strokes.
You can read more about treatments to slow down the progression of dementia.
The Cause Of Alzheimers
Alzheimers is the most common form of Dementia, with over 5 million Americans suffering from Dementia.
One of the most common questions that caregivers and doctors hear is very simple, is Dementia genetic? The answer is there are many forms of Dementia, some that are genetic and others that arent. Alzheimers, unlike Vascular Dementia, tends to lean more to a genetic disposition over a sudden event causing the disease. It can also happen from environmental and lifestyle choices.
Things like smoking, not moving, and an overall lack of exercise tend to show the most direct link to Alzheimers. That means fighting it comes down to getting up and moving. Also, it has been shown that lower and middle-income families are more likely to suffer from some form of dementia than higher-income families.
If fighting the onset of Alzheimers isnt an option anymore, you can still help your loved ones fight the more intense stages by simplifying how you interact with your loved one. Take everything step-by-step, and you can help them fight against the harsher stages to come.
Although its still widespread, there have been amazing advancements in medical care for these individuals. As it sits right now, the average age of a person experiencing the symptoms is 84.7 years of age. Make sure you are keeping an eye on your loved ones, especially as they age beyond 65. About half of the people over 85 years of age suffer from the Alzheimers or some other form of dementia.
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How Does Mixed Dementia Develop
Research indicates that mixed dementia is often not recognised and diagnosed effectively, with the person diagnosed as having one type of dementia. As well as an inaccurate diagnosis, this can lead to the diagnosed person missing out on interventions that could be helpful for the unrecognised condition. The symptoms of mixed dementia can vary depending on the part of the brain affected. If the person has two types of dementia the symptoms can be more noticeable and appear to progress more rapidly.
How Is Vascular Dementia Linked To Stroke
When you have a stroke, the blood supply to part of your brain is cut off, killing brain cells. The damage from a stroke can cause problems with memory and thinking. For many people, these problems improve over time. If the problems dont improve or get worse this may be a sign of vascular dementia.
Vascular dementia can also be caused by a series of small strokes. These result in lots of small areas of damage in your brain. Often, these strokes can be so small that you don’t know you are having them. These are known as silent strokes.
Sometimes symptoms of vascular dementia can be confused with the effects of stroke. Both stroke and vascular dementia can cause problems with memory, thinking and mood. Strokes happen suddenly while the symptoms of vascular dementia often get worse over time. The difference is that vascular dementia gets worse over time. If youre unsure, go to see your GP.
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Vascular Dementia Signs And Symptoms
Vascular dementia affects different people in different ways and the speed of the progression also 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 TIAsthe mini-strokes discussed aboveleads 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 Signs and Symptoms of Vascular Dementia|
|Mental and Emotional Signs and Symptoms|
Variables Impacting Life Expectancy Calculations
Gender. Men dont live as long with Alzheimers as women. A study of more than 500 people diagnosed with Alzheimers disease between 1987 and 1996 found that women with Alzheimers live, on average, 20% longer than men. Age. Someone diagnosed at 65 lives an average of about eight years, while someone over 90 who gets a diagnosis typically lives about three-and-a-half more years. Strength of Symptoms at Diagnosis. If someone is showing especially severe dementia-related problems at the time of diagnosis, this usually leads to an earlier death. Someone who wanders, is prone to falling, and experiences urinary incontinence , will typically not live as long. A lower mini-mental state examination score at the time of diagnosis will also not live as long. Other Health Problems. A person with a history of heart problems or asthma or diabetes, for example, will not live as long as someone without those underlying issues.
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How Does Vascular Dementia Progress
Vascular dementia usually progresses gradually in a step-wise fashion in which a person’s abilities deteriorate after a stroke, and then stabilise until the next stroke. If further strokes do not occur, the abilities of people with Vascular dementia may not continue to decline, or in some cases, may improve. However, these improvements may not last. Sometimes the steps are so small that the decline appears gradual. On average though, people with Vascular dementia decline more rapidly than people with Alzheimer’s disease. Often they die from a heart attack or major stroke.
Impact On Families And Carers
In 2019, informal carers spent on average 5 hours per day providing care for people living with dementia. This can be overwhelming . Physical, emotional and financial pressures can cause great stress to families and carers, and support is required from the health, social, financial and legal systems. Fifty percent of the global cost of dementia is attributed to informal care.
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How Do I Know If I Have Mixed Dementia
Mixed dementia is difficult to diagnose. If you suppose you or a loved one is living with Mixed Dementia, you will want to make a list of the Dementia Symptoms that you notice and talk with your doctor about your concerns.
As per experts, individuals with symptoms of cardiovascular disease and dementia, getting worse over time, can be diagnosed with Mixed Dementia because it is a strong indication that Alzheimers Disease and Vascular Disease are both present.
Common Types of Mixed Dementia
Most often, Mixed Dementia is a combination of two types of dementia. On occasion, individuals may have three types of dementia.
The two most common types of mixed dementia are
- Alzheimers Disease and Vascular Dementia
- Alzheimers Disease and Lewy Body Dementia
Stages Of Mixed Dementia
Although it follows these stages of dementia, those living with Mixed Dementia typically go through the stages much quicker because the brain is affected by two different diseases.
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How Is Vascular Dementia Diagnosed And Treated
To diagnose vascular dementia, a doctor may ask about problems with daily activities, conduct memory or thinking tests, and speak with someone who knows the person well to see if symptoms of dementia are present. Medical history, lifestyle, and brain imaging tests are often used to help determine whether vascular dementia is the cause of symptoms.
No treatments are available to reverse brain damage that has been caused by a stroke. Treatment for vascular dementia focuses on preventing future strokes. Medications to prevent strokes, such as blood thinners, may help decrease the risk of further damage to the brain. Medications that help treat the symptoms of Alzheimer’s disease might benefit people with early vascular dementia. A doctor may also recommend treating risk factors, such as high blood pressure or high cholesterol, through medications and lifestyle changes.
Environmental Factors As A Risk Factor
The physical risk factors of VaD are only one aspect of the cause. VaD can arise due to many factors but one class of factors that are often overlooked are the environmental factors which often can dictate some of the other more tangible, direct factors . Some environmental risk factors include air quality elements, toxic heavy metals, trace elements, known occupational hazards, electrical/magnetic fields, and a few others . These different environmental factors have been shown to have strong effects in propagating dementia .
Table 4. Shows the various types of environmental factors and their uses.
The factors listed in the table are the highest environmental factors that have a link to VaD, and they all are produced in different ways, some of which cannot be simply avoided. These factors can trickle down, and most likely do not directly affect the development of VaD but can exacerbate other existing risk factors. For example, the use of herbicides, pesticides, insecticides, and fertilizers are commonly used in farming practices all over the world, many of these are known endocrine disruptors that increased the risk of developing dementia .
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Caring For Someone With Vascular Dementia Vs Alzheimers
Caring for a person showing signs of dementia is a touchy subject. It can be a challenge because it requires you to completely change your approach to interactions. As a person starts to exhibit signs of Alzheimers or vascular dementia, you need to start approaching your interactions step-by-step.
There is no verified treatment for dementia. Science has proven time and again that a heart-healthy diet and exercise are a great way to combat the symptoms of dementia. Diet and exercise have also shown the ability to slow the detrimental effects of these diseases, although its not a cure.
During the early and middle stages of vascular dementia or Alzheimers, caring for a loved one is something that you can do with relative ease. If you are taking care of a loved one suffering from one of these diseases, creating designated areas and schedules is a great way to stay on track with your loved one. Add labels to areas of the house that are used for those items. A key drawer that holds the car keys can help your loved one associate where they are with what they find. That way, should they need to find an item like reading glasses, they are likely to look in the drawer where you keep all the glasses. Even if they should have an incident in the time it takes to look for what they need, the labels could remind them of what they originally intended to do.
Getting A Diagnosis For Alzheimers Vs Vascular Dementia
Getting a diagnosis for vascular dementia or Alzheimers can be done with your doctor through a series of tests. Having the conversation about seeing a doctor to get a diagnosis might be a challenge in itself. It can be a sore point for anyone who has to take the testing. Though it might be hard to have this kind of conversation, its necessary to see a doctor for a diagnosis. All the testing is necessary to pinpoint the issue.
For vascular dementia, doctors run tests on patients that test their basic function skills. They test their cognitive behavior, communication skills, judgment, and memory with several predetermined tests. They typically use these tests in conjunction with an MRI to help determine if the patient truly suffers from dementia.
For Alzheimers, the process is generally similar. With Alzheimers, however, its more of a test to eliminate all other possibilities. Things like a lack of vitamin B12 can lead to similar memory issues like those found in early-onset dementia. If there are no other direct correlations to memory loss , Alzheimers is likely the diagnosis. If you or a loved one starts to experience the signs of dementia, its time to start talking to a doctor. The pathophysiology of dementia is vast in variety but similar in nature across the board.
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The Similarities Between Vascular Dementia And Alzheimers
Vascular dementia and Alzheimers have some symptoms that overlap, and others that dont. Its important to understand the difference between the two so you can tailor your care as needed. Its also important to understand the similarities to see where the general confusion about the two lies.
It may not come as much of a surprise, but these two forms of dementia can result in similar issues in a loved one as they start to age past 65. As the years start to stack up, the chances of seeing some form of cognitive decline start to go up with them.
Although these diseases are completely different in nature, it has been found that exercise and a heart-healthy diet can really help fight both forms of dementia. Both forms of dementia can take on an early stage, middle stage, and late-stage dementia traits. Vascular dementia comes down to many different factors for its starting point. Alzheimers is more gradual.
When you boil it down dementia vs Alzheimers or vascular dementia, Alzheimers and vascular dementia are two types of the same disease: dementia.
What Can You Do
A healthy lifestyle is important to help reduce risk factors of vascular dementia. This includes eating well, limiting alcohol, not smoking, exercising, and managing stress.
If you are concerned about vascular dementia symptoms, talk with your doctor. If you or someone you know has recently been diagnosed, explore the resources on this website and linked below to find out more about the disease, care, support, and research.
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Gene Variants As A Risk Factor For Vad
Much work has been done on gene variants in AD, and the effects of these genes in VaD have been rendered. The leading players in VaD include a mutation in the Notch Receptor 3 gene, which is directly responsible for one form of VaD, and Apolipoprotein E variants . NOTCH3 is directly linked to cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy also known as CADASIL . CADASIL is considered a very rare disease and has been recorded across all ethnic groups thus far . It is most often caused by a missense mutation but can alternatively be caused by null mutations or homozygous mutations. The symptoms of CADASIL include smaller cerebral vessels which in turn cause strokes, mood disturbances, and of course VaD . The other gene attributed as a risk factor for VaD is APOE and its variants . APOE has different variants denoted by e2 , e3 , and e4 .
Figure 3. Lipid transport refers to the ability of APOE to bind to LDL receptors and assist with lipid clearance. Certain APOE alleles also interact and affect amyloid deposition, neuroplasticity, neuroimmune modulation and in re-myelination processes.
Risk Factors for Males and Females
Overlapping in Gene Variants
Tips For Visiting Your Doctor
To get the most out of your visits with your doctor, be sure to use these tips:-
- Create a list of any new symptoms you or your loved ones see. Discuss these with your doctor at your visit.
- Before your visit, write down any questions you have to remember to ask them.
- Know the reason why you are seeing the doctor.
- Bring someone with you to your appointment. They can help you remember to ask your questions and the critical points of the visit.
- Write down any new diagnosis, new medications, and available treatments.
- Understand why new medications are prescribed as well as their side effects.
- Ask if there are any available new treatments or clinical trials that you may be a candidate for, if interested.
- Understand current tests that are recommended and how they may be able to help.
- Write down all future appointments. Write the date, time, and the purpose of the visit.
- Get a care summary from your doctor to remember all the important points of the visit.
- Know the best way to contact your doctor if you have questions before your next visit.
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General Causes And Risks For Vad
Generally, the common causes of VaD are environmental and pathophysiological that affecting the brain vessels, leading to a reduction of supplies like nutrition and oxygen to the brain . Therefore, some of the risk factors for VaD coexist with the increased risk of stroke, heart disease, aging, atherosclerosis, high cholesterol, high blood pressure, diabetes, genetics, smoking, obesity, and atrial fibrillation. VaD progresses over time and targets cognitive abilities in the brain . This actively illustrates some of the neurological and behavioral changes that patients with VaD may experience such as memory impairment, loss of executive function , reasoning and organized thoughts and behaviors. Several regulatory mechanisms and cellular signaling are thought to play a role in VCI and VaD, including oxidative stress, neuroinflammation, endothelial dysfunction, hypoperfusion, blood-brain barrier disruption, cortical hyperexcitability, and neurotransmitter imbalance . In addition, serological markers that can help in the diagnosis of VaD have been discovered in several investigations. Pro-inflammatory metabolites , cytokines , and endothelial dysfunction indicators have all been reported to be elevated in VaD patients .