What Are The Different Types Of Vascular Dementia
There are several types of vascular dementia. Two of the most common are:
- Multi-infarct dementia: This is a common form of vascular dementia caused by several strokes which damage the brains cortex, the area responsible for learning, memory and language.
- Binswanger’s disease or subcortical vascular dementia: This form develops when high blood pressure, thickening of the arteries and inadequate blood flow damage the white matter in the brain.
What Is The Difference Between Dementia And Alzheimers
Dementia is a general term used to describe the deterioration of a person’s mental ability.
It is an umbrella term, as there are many different types of the condition.
One of those is Alzheimer’s – which is the most common form of dementia.
It accounts for 60-80 per cent of dementia cases, which is why the names may sometimes be used interchangeably.
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.
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Treatment Of Vascular Dementia
Drugs, such as cholinesterase inhibitors Drugs to treat Alzheimer disease Alzheimer disease causes progressive cognitive deterioration and is characterized by beta-amyloid deposits and neurofibrillary tangles in the cerebral cortex and subcortical gray matter. Diagnosis… read more and memantine, may be helpful if Alzheimer disease could also be present. Cholinesterase inhibitors may improve cognitive function. Memantine, an NMDA antagonist, may help slow the loss of cognitive function in patients with moderate to severe dementia and may be synergistic when used with a cholinesterase inhibitor.
However, efficacy of cholinesterase inhibitors and memantine is uncertain in vascular dementia. Nonetheless, a trial of these drugs is reasonable because older patients with vascular dementia may also have Alzheimer disease.
Causes Of Alzheimer’s Disease
Alzheimer’s disease is the most common type of dementia.
Alzheimer’s disease is thought to be caused by the abnormal build-up of 2 proteins called amyloid and tau.
Deposits of amyloid, called plaques, build up around brain cells. Deposits of tau form “tangles” within brain cells.
Researchers do not fully understand how amyloid and tau are involved in the loss of brain cells, but research into this is continuing.
As brain cells become affected in Alzheimer’s, there’s also a decrease in chemical messengers involved in sending messages, or signals, between brain cells.
Levels of 1 neurotransmitter, acetylcholine, are particularly low in the brains of people with Alzheimer’s disease.
Medicines like donepezil increase levels of acetylcholine, and improve brain function and symptoms.
These treatments are not a cure for Alzheimer’s disease, but they do help improve symptoms.
Read more about treatments for dementia.
The symptoms that people develop depend on the areas of the brain that have been damaged by the disease.
The hippocampus is often affected early on in Alzheimer’s disease. This area of the brain is responsible for laying down new memories. That’s why memory problems are one of the earliest symptoms in Alzheimer’s.
Unusual forms of Alzheimer’s disease can start with problems with vision or with language.
Read more about Alzheimer’s disease.
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What Is The Prognosis If You Are Living With Vascular Dementia
Regardless of the type of Dementia that you are living with, it is a progressive disease that worsens over time. Dementia affects individuals differently. While some living with Vascular Dementia may see a prolonged decline, others may decline at a much more rapid pace.
Currently, there is no cure for Vascular Dementia. You can do things that may reduce your risk factors or help slow its progression.
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.
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Why Is It Challenging To Diagnose Vascular Dementia
It is often challenging to diagnose Vascular Dementia, because it depends on the size of the blockage or the area that is affected in the brain. Suppose a small portion is involved in the area that controls your memory. In that case, you may just become a little bit more forgetful, but you can still function as expected in your life. In part, it goes unnoticed. But, if larger areas are affected, this may affect bigger things like solving problems or extensive memory impairments. This will be more noticeable but may be classified as a different type of Dementia.
Who Is At Risk For Vascular Dementia
Some risk factors for vascular dementia can be managed others, like age and gender, cannot. Among all factors, high blood pressure carries the greatest risk vascular dementia almost never occurs without it.
Likewise, a high risk of stroke goes hand in hand with risk for vascular dementia. One-quarter to one-third of strokes are thought to result in some degree of dementia. People who smoke, consume excessive amounts of alcohol, have diabetes, or heart disease also have a higher rate of the condition.
Vascular dementia most commonly occurs in people between the ages of 60 and 75. Men seem to be more vulnerable than women, and the condition affects African-Americans more often than other races. People whose age, sex, or race puts them at increased risk of vascular dementia have that much more reason to manage risk factors within their control.
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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.
The Causes And Treatments Of Dementia
Dementia is a term for a range of symptoms, including memory loss, language confusion, difficulty with reasoning, as well as various behavioral or personality changes. Learn more about the causes and treatments of dementia.
Currently, toxic protein clumps around brain cells are considered to be a key factor in developing dementia. For Alzheimerâs disease, these proteins are known as amyloid and tau. When these symptoms begin to interfere with daily life, a dementia diagnosis will be made. Alzheimerâs disease causes around 60-70% of all cases, but there are other causes of dementia, such as vascular dementia. Alzheimerâs treatment for almost 20 years, suggesting that the possibility of a cure may increase in the future.
It is not uncommon to know someone with dementia, whether a family member, friend or neighbor. Estimates say around 55 million live with the condition, though that number will increase as the global population rises.
As dementia appears in so many people, there is a strong interest in causes and treatments. There has been a long history of clinical research, slowly reshaping the understanding of the matter. However, there are still many widespread misconceptions about dementia.
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Lifestyle Changes To Improve Vascular Dementia Symptoms
A diagnosis of dementia is scary. But its important to remember that many people with dementia can lead healthy, fulfilling lives for years after the diagnosis. Dont give up on life! As much as possible, continue to look after your physical and emotional health, do the things you love to do, and spend time with family and friends.
The same strategies used to keep your brain healthy as you age and prevent the onset of dementia can also be used to improve symptoms.
Find new ways to get moving. Research suggests that even a leisurely 30-minute walk every day may reduce the risk of vascular dementia and help slow its progression. Regular exercise can also help control your weight, relieve stress, and boost your overall health and happiness.
Create a network of support. Seeking help and encouragement from friends, family, health care experts, and support groups can improve your outlook and your health. And its never to late to make new friends and expand your network.
Eat for heart health. Heart disease and stroke share many of the same risk factors, such as high LDL cholesterol , low HDL cholesterol , and high blood pressure. Adopting a heart-healthy diet may help to improve or slow down your dementia symptoms.
Make it a point to have more fun.Laughing, playing, and enjoying yourself are great ways to reduce stress and worry. Joy can energize you and inspire lifestyle changes that may prevent further strokes and compensate for memory and cognitive losses.
What Are The Types Of Dementia
According to the Alzheimers Association®, Dementia is an overall term for diseases and conditions characterized by a decline in memory, language, problem-solving and other thinking skills that affect a persons ability to perform everyday activities. Although there are several types of dementia, each type may present itself with similar symptoms, making it difficult to fully assess which type of dementia a person has in the early stages. In certain instances, a person may even experience multiple forms of dementia concurrently, which is referred to as mixed dementia.
To help break down the main types of dementia, their individual symptoms, and the most common causes, weve created this list. Here are the four main types of dementia and their symptoms:
1. Alzheimers Disease
The most common type of dementia, Alzheimers usually begins gradually and worsens over time. This disease can cause problems with memory, behavior, and thinking, and symptoms may eventually become severe enough to interfere with an individuals ability to manage daily tasks.
The Alzheimers Association states that this disease accounts for 60 to 80 percent of all dementia cases. Common symptoms of Alzheimers include:
- Difficulty speaking, swallowing and walking
What Causes Alzheimers?
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Dementia Terms You May Hear
- Alzheimers disease: the most common type of dementia, caused by clumps of proteins building up in the brain.
- Mild cognitive impairment: this can happen after a stroke. This is when someone has memory and thinking problems but they are not severe enough to interfere with their day-to-day activities.
- Other types of dementia: you may hear about dementia with Lewy bodies, frontotemporal dementia and young-onset dementia, as well as other rarer types.
- Small vessel disease: damage to the blood vessels deep inside the brain, often caused by high blood pressure.
- Vascular cognitive impairment: this describes all memory and thinking problems associated with stroke. It includes vascular dementia and mild cognitive impairment.
- Vascular dementia: problems with memory and thinking due to reduced blood flow in your brain.
Managing The Effects Of Vascular Dementia
The drugs that are routinely prescribed for Alzheimers disease do not have benefits for vascular dementia and are not recommended for it. If vascular dementia is caused by or related to heart disease, diabetes, or strokes, changing lifestyle and taking medication to control these conditions may prevent dementia from getting worse. Regular health checks are advisable so physical health can be monitored and appropriate interventions given which may include medication for an underlying condition e.g. diabetes, high cholesterol level, heart disease and vascular problems. Advice should also be given on diet, activity, smoking cessation and alcohol consumption.
If someone is depressed, anxious, or finding it difficult to come to terms with the diagnosis, counselling, cognitive behavioural therapy or medication may also be recommended.
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Dementia Risks And Prevention
âDespite the fact that around 5% of Alzheimerâs cases are familial or hereditary, itâs widely accepted that most dementia is not genetic. However, carrying specific genes does increase the chances of having the condition.
The presiding argument is that there are multiple dementia risk factors, including genetics, age, and existing conditions, as well as lifestyle choices that influence blood pressure and/or cholesterol, such as diet, exercise, and smoking/alcohol use.
Here are the ways in which you can lower risk to prevent dementia:
â1. Exercise Regularly: Physical activity strengthens the heart, enabling it to pump more blood with less effort. Having a healthy heart reduces the chance of cardiovascular diseases, such as strokes or heart attacks, which lowers the risk of developing vascular dementia or Alzheimerâs disease.
â2. Avoid Smoking/Alcohol: Smoking tobacco poisons blood vessels in all parts of the body, raising the risk of developing dementia, amongst an array of other diseases. Excessive alcohol consumption can raise cholesterol and blood pressure, both key risk factors of dementia diseases.
â3. Watch the Cholesterol: A balanced, low-fat diet is usually enough to manage cholesterol, but consider cholesterol-lowering medications if you need them. Lowering the risk of strokes and heart attacks also reduces the likelihood of vascular dementia.
Preparing For An Appointment
If you’ve had a stroke, your first conversations about your symptoms and recovery will likely take place in the hospital. If you’re noticing milder symptoms, you may decide you want to talk to your doctor about changes in your thought processes, or you may seek care at the urging of a family member who arranges your appointment and goes with you.
You may start by seeing your primary care doctor, but he or she is likely to refer you to a doctor who specializes in disorders of the brain and nervous system .
Because appointments can be brief, and there’s often a lot of ground to cover, it’s a good idea to be well-prepared for your appointment. Here’s some information to help you get ready and know what to expect from your doctor.
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What Abilities Are Affected
Forgetfulness and problems with reasoning or problem solving are often the most noticeable change in someone with vascular dementia but other abilities can be impaired, too, including thinking speed, communication skills, spatial skills , or attention and concentration. The size and location of damaged brain areas determine which abilities are affected. If additional strokes occur or problems with reduced blood flow continue, more and more brain tissue is damaged and more abilities are affected.
It Is Important To Remember
âDementia is not a disease but a syndrome . It is impossible to fully understand dementia until the range of degenerative diseases that cause it have been studied further. Until then, treatment remains focused on quality of life and patient comfortability rather than a cure.
Dementia is not a natural part of aging, though the irreversible nature of the condition often leads people to assume so. If you or someone you know is exhibiting early signs of dementia, seek medical advice. Depending on the underlying cause, treatments will vary. Getting an early diagnosis gives patients the best chance to extend their quality of life.
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Etiology Of Vascular Dementia
. Although each infarct may be only minimally symptomatic in itself, the combination of multiple small infarcts can cause enough neuronal or axonal loss to impair brain function.
Vascular dementias include the following:
Multiple lacunar infarction: Small blood vessels are affected. Multiple lacunar infarcts occur deep within hemispheric white and gray matter.
Multi-infarct dementia: Medium-sized blood vessels are affected.
Strategic single-infarct dementia: A single infarct occurs in a crucial area of the brain .
Binswanger dementia : This uncommon variant of small-vessel dementia is associated with severe, poorly controlled hypertension and systemic vascular disease. It causes diffuse and irregular loss of axons and myelin with widespread gliosis, tissue death due to an infarction, or loss of blood supply to the white matter of the brain.
Hereditary vascular dementia: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy is a cerebral small vessel disease caused by mutations in the NOTCH3 gene, which codes for a transmembrane receptor located on vascular smooth muscle cells. Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy is also a small vessel disease it is caused by mutations in the HTRA1 gene.
Memory Loss And Other Symptoms Of Dementia
âOne of the earliest signs of dementia is a significant change to short-term memory , such as struggling to recall recent events despite being able to remember experiences that happened long agoâmisplacing items or losing track of your ideas while speaking can also be early indicators of dementia.
Frequent cognitive symptoms include:
Â· Difficulty forming language
Â· Poor problem-solving or reasoning
Â· Weakened visual-spatial performance
Â· Diminished movement and motor skills
Â· Inability to handle complicated tasks
Â· General confusion
Itâs important to note that dementia does not simply affect functional skills but also causes psychological concerns:
Â· Personality changes
Inappropriate behaviors and sudden personality changes can be incredibly upsetting for the friends and family of those who have dementia.
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How Is Dementia Treated
There is no specific treatment for dementia and no way to reverse the damage to the brain that has already occurred.
However, treatment may help slow down the progression of the condition and the main aim is to treat the underlying cause to help prevent further problems, such as strokes.
Medicines and lifestyle changes will be encouraged including eating healthily, losing weight if necessary, stop smoking, get fit and cutting down on alcohol.
Support such as physiotherapy, occupational therapy and speech and language therapy is also beneficial, but despite treatment dementia can significantly shorten life expectancy.
The average survival time from diagnosis is around four years and most people will die either from complications of dementia, such as pneumonia, or from a subsequent stroke.