Symptoms Risk Factors Characteristic Features And Subtypes Of Vad
The symptoms of VaD differ depending on which part of the brain the vessels and blood flow are obstructed . However, the common indications might appear as disorientation, difficulty thinking, understanding, inability to create new memories, agitation, or behavioral symptoms . Moreover, VaD symptoms may be most obvious when they happen soon after a major stroke, and they can gradually develop . Figure 1 shows some of the risk factors, characteristic features, and subtypes associated with VaD.
Figure 1. Subtypes of VaD that are associated with some of the vascular risk factors and their characterized features.
Dementia is a consequence and a risk factor for stroke and VaD. Stroke is one of the primary causes of disability, and having a stroke doubles your risk of developing VaD . Lower education, older age, diabetes mellitus, myocardial infarction, atrial fibrillation, epileptic seizures, sepsis, cardiac arrhythmias, congestive heart failure, global cerebral atrophy, and medial temporal lobe atrophy, and white matter changes have all been linked to an increased risk of dementia after a stroke . Post-stroke depression is another risk factor for VaD, which is more common in women than in men . Female sex, medial temporal lobe atrophy, and a family history of dementia are all better predictors of pre-stroke dementia than post-stroke dementia . Pre-stroke dementia could be a symptom or cause of a fundamental degenerative condition that makes vascular events more likely .
What Is The Difference Between Dementia And Alzheimers Center
Dementia is a group of symptoms characterized by a decline in memory, thinking and reasoning. Although dementia is a cluster of symptoms, Alzheimers is a slowly progressive disorder of the brain that destroys memory and thinking skills. Read more: What Is the Difference Between Dementia and Alzheimers? Article
The Use Of The Word Senile
The common use of the word senile loosely references the loss of cognitive abilities or the inability to think clearly. Although still occasionally used, this term has lost its popularity, partly because it has a negative, disrespectful tone, as in, The old man is senile.
Senile was used more commonly in the past, especially when memory loss and confusion were thought of, by some, as a normal consequence of getting older. The view used to be that the body and the mind both could be expected to decline together as someone aged, and that poor mental functioning was just a normal part of aging.
An individual was often described as having senile dementia or senile Alzheimers, meaning that the disease and its associated mental decline developed in older age.
Science now understands that significant memory loss, disorientation, and confusion are not normal parts of aging but rather are symptoms of a neurocognitive disorder such as Alzheimers, vascular dementia, frontotemporal dementia, or Lewy body dementia.
Senile is sometimes used to describe the plaques that build up in the brain as Alzheimers disease progresses. These senile plaques are often described as one of the hallmarks of Alzheimers disease, along with neurofibrillary tangles.
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How Is Vascular Dementia Treated
Because many different disease processes can result in different forms of vascular dementia, there may not be one treatment for all. However, vascular dementia is often managed with medications to prevent strokes and reduce the risk of additional brain damage. Some studies suggest that medications that are used to treat Alzheimer’s might benefit some people with an early form of vascular dementia. Treating modifiable risk factors like high blood pressure, diabetes, high cholesterol, and problems with the rhythm of the heartbeat can help prevent additional stroke. Living a healthy lifestyle is important to help reduce the risk factorsof vascular dementia.
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Frontotemporal Dementia With Parkinsonism
One form of familial FTD, also known as frontotemporal dementia with Parkinsonism-17 , is caused by genetic changes in the gene for tau protein, located on chromosome 17. No other risk factors for this condition are known.
FTDP-17 is rare and accounts for only three per cent of all cases of dementia. Symptoms progressively get worse over time and usually appear between the ages of 40 and 60. The condition affects both thinking and behavioural skills and movements such as rigidity, lack of facial expression and problems with balance .
It can be distressing to be told that you have a genetic disorder or are at risk of having one. Genetic counselling provides the person and their family with information about a genetic disorder and its likely impact on their lives. This can assist a person with FTDP-17 to make informed medical and personal decisions about how to manage their condition and the challenges it presents to their health and wellbeing. Prenatal genetic counselling is also available for parents to help them decide about a pregnancy that may be at risk of FTDP-17.
The Effects Of Alzheimers On The Brain
Damage to the brain begins years before symptoms appear. Abnormal protein deposits form plaques and tangles in the brain of someone with Alzheimers disease. Connections between cells are lost, and they begin to die. In advanced cases, the brain shows significant shrinkage.
Its impossible to diagnose Alzheimers with complete accuracy while a person is alive. The diagnosis can only be confirmed when the brain is examined under a microscope during an autopsy. However, specialists are able to make the correct diagnosis up to 90 percent of the time.
The symptoms of Alzheimers and dementia can overlap, but there can be some differences.
Both conditions can cause:
- behavioral changes
- difficulty speaking, swallowing, or walking in advanced stages of the disease
Some types of dementia will share some of these symptoms, but they include or exclude other symptoms that can help make a differential diagnosis. Lewy body dementia , for example, has many of the same later symptoms as Alzheimers. However, people with LBD but are more likely to experience initial symptoms such as visual hallucinations, difficulties with balance, and sleep disturbances.
People with dementia due to Parkinsons or Huntingtons disease are more likely to experience involuntary movement in the early stages of the disease.
Treatment for dementia will depend on the exact cause and type of dementia, but many treatments for dementia and Alzheimers will overlap.
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Data Source And Selection
A Medline -based literature review was performed by using the following search terms, in different combinations: Vascular dementia,Vascular cognitive impairment,Vascular cognitive impairment and dementia,Arteriosclerotic dementia,multi-infarct dementia,vascular contributions to cognitive impairment and dementia,sex, and gender. The studies had to include individuals with a clinical diagnosis of any type of Vascular dementia in relation to sex or gender and severity according to the internationally accepted guidelines or diagnostic criteria. Duplicated entries, studies on physiological brain aging or diseases different from VaD, VCI, or VCID, works on animals or cell cultures, studies not reporting the statistical analysis, non-English written papers, publications that are not research studies , conference, meeting proceedings, or any other paper not published in international peer-reviewed journals, study protocols, personal communications, or unpublished data, as well as any other study that did not fit with the scope of this review were excluded. Articles listed in the references were also reviewed in search of more data.
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
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Difference Between Alzheimers And Vascular Dementia
As both the conditions are some or the other type of dementia, it is common to mix up the two. But the two conditions surely have some differences in them, which when understood well can help in dealing with the condition better.
Let us look at the difference between Alzheimers and vascular dementia
How Long Can You Live After Being Diagnosed With Vascular Dementia
The experience with vascular dementia differs from one person to another. Generally, vascular dementia is experienced after a major stroke or an event of that kind. After such event, if a person acquires the symptoms of vascular dementia, life expectancy ranges for around five years. This may also vary depending on the severity of other existing or inciting conditions such as heart attack or stroke.
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Middle Stages Of Dementia
In those stages, patients may still be able to live independently, although they will require more assistance with their activities of daily living. Managing finances, and assistance with dressing and bathing are commonly needed, as people with mid-stage dementia often experience more confusion, additional memory loss, sleep pattern disturbances such as sleeping during the day and restlessness at night.
Risk Factors For Dementia
Two of the most common risk factors for Alzheimers and dementia are age and genetics. Most individuals with Alzheimers are 65 or older, and those who have a parent or sibling with Alzheimers are more likely to develop the disease. However, there is evidence to suggest that there are other factors that people can influence.
According to research from the University of Cambridge, one-third of Alzheimers disease cases were attributed to preventable risk factors. The seven main risk factors for Alzheimers disease are diabetes, hypertension, obesity, physical inactivity, depression, smoking and low educational attainment.
Minimizing the risk of these factors can potentially minimize the onset of dementia, but to an unknown degree, Ory said. We know that physical activity, a healthy diet and healthy lifestyle can help reduce the symptomology of many major diseases, and similarly these can affect the onset and progression of dementia symptomatology.
If youre looking for a start to reducing the risk for dementia or Alzheimers, a healthy diet and getting enough exercise is a good start. Exercise has been shown to increase blood flow and help connections between neurons, which is important with cognitive functioning.
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Vascular Dementia And Underlying Sex Differences
- 1Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
- 2Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- 3Neuroscience Graduate Program, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States
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
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Symptoms And Signs Of Vascular Dementia
The Hachinski Ischemic Score is sometimes used to help differentiate vascular dementia from Alzheimer disease .
The diagnosis of CADASIL and CARASIL can be confirmed by genetic tests, which identify characteristic mutations of the NOTCH3 gene for CADASIL and HTRA1 gene for CARASIL. Sometimes a skin biopsy can be done instead to confirm the diagnosis of CADASIL.
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What Is Vascular Fementia
Vascular dementia is a decline in thinking skills caused by conditions that block or reduce blood flow to various regions of the brain, depriving them of oxygen and nutrients. Vascular dementia is considered the second most common cause of dementia after Alzheimers disease, accounting for up to 30% of cases.
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Causes And Risk Factors
The cause depends on the type, but the exact causes of many forms of dementia are currently unclear.
Dementia is not an inevitable part of aging, but age is one of the main risk factors. In fact, up to 50% of people aged 85 years and older may have a type of dementia.
Also, in the United States, around 11.3% of people aged over 65 years currently have Alzheimers disease, according to the Alzheimers Association. This number rises to 34.6% in those aged 85 years and older. Symptoms tend to worsen with age.
It is possible to develop dementia at a younger age, but the condition is more common among older adults.
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What Is The Best Treatment For Vascular Dementia
There are no definite drugs approved by experts for vascular dementia yet. The signs of vascular dementia may call for different forms of treatment. The most efficient way to prevent the condition from worsening is to control the risk factors. This may delay the development of the condition, even though it does not fully take it away.
Some ways to help prevent the risk factors from developing is through any of the following:
- Maintain a healthy blood pressure and cholesterol level.
- Avoid vices such as alcohol and smoking to avoid further damaging the immunity of the body.
- Do physical exercise as often as possible.
- Avoid food and practices that may progress the cause of dementia .
What Is The Difference Between Alzheimers And Vascular Dementia Treatments
There is no cure for Alzheimers disease or vascular dementia, but there are treatments available that can slow down the relentless progress of both types of dementia and help the patient to maintain a good quality of life for as long as possible. However, some treatments that are useful for patients with Alzheimers disease can cause side effects in those with vascular dementia, which suggests that the underlying brain chemistry of both forms of dementia is different.
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Talking With A Doctor
After considering the persons symptoms and ordering screening tests, the doctor may offer a preliminary diagnosis or refer the person to a Cognitive Dementia and Memory Service clinic, neurologist, geriatrician or psychiatrist.Some people may be resistant to the idea of visiting a doctor. In some cases, people do not realise, or else they deny, that there is anything wrong with them. This can be due to the brain changes of dementia that interfere with the ability to recognise or appreciate the changes occurring. Others have an insight of the changes, but may be afraid of having their fears confirmed.One of the most effective ways to overcome this problem is to find another reason for a visit to the doctor. Perhaps suggest a check-up for a symptom that the person is willing to acknowledge, such as blood pressure, or suggest a review of a long-term condition or medication.Another way is to suggest that it is time for both of you to have a physical check-up. Any expressed anxiety by the person is an excellent opportunity to suggest a visit to the doctor. Be sure to provide a lot of reassurance. A calm, caring attitude at this time can help overcome the persons very real worries and fears.Sometimes, your friend or family member may refuse to visit the doctor to ask about their symptoms. You can take a number of actions to get support including:
- talking with other carers who may have had to deal with similar situations
- contacting your local Aged Care Assessment Team