When Do I Need To Call My Healthcare Provider After Ive Been Diagnosed With Vascular Dementia
You, or your caregiver, should call your healthcare provider if they notice any worsening of your symptoms or when new symptoms appear. Your healthcare provider or healthcare team will want to assess any changes and adjust drug dosages or change medications as needed or conduct more tests to determine whats causing the change in your symptoms.
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 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:
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Slowing Down The Progression Of Vascular Dementia
Although there is no proven treatment for vascular dementia, it may be possible to prevent mild problems developing into dementia. Treatments may also slow down how quickly dementia progresses.
Doctors will work with you to try to reduce your risk of having further strokes, and lower the rate of damage due to small vessel disease. Some activities you may try include:
- Treating high blood pressure.
- Taking medications for high cholesterol.
- Taking blood-thinning medication to stop clots forming in your blood.
- Stopping smoking.
Treatments For Vascular Dementia
While there are no FDA-approved medications or therapies for vascular dementia, it may be possible to slow the progression of the disease by controlling the conditions affecting your cardiovascular health, such as:
- Blood pressure
- Blood clotting
- Blood sugar level
Some medications used to treat Alzheimers disease may also offer some help for vascular dementia. These include cholinesterase inhibitors, which work to elevate the levels of a brain chemical messenger used in memory and judgment.
If someone you love has vascular dementia, Northwestern Medicine is home to skilled neurologists, rehabilitation specialists and other caring professionals who can provide the diagnosis, treatment and support you need.
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What Causes Vascular Dementia
Vascular dementia is caused by different conditions that interrupt the flow of blood and oxygen supply to the brain and damage blood vessels in the brain.
People with vascular dementia almost always have abnormalities in the brain that can be seen on MRI scans. These abnormalities can include evidence of prior strokes, which are often small and sometimes without noticeable symptoms. Major strokes can also increase the risk for dementia, but not everyone who has had a stroke will develop dementia.
Other abnormalities commonly found in the brains of people with vascular dementia are diseased small blood vessels and changes in “white matter” the connecting “wires” of the brain that are critical for relaying messages between brain regions.
Who Is At Risk For Vascular Dementia
Many of the medical conditions that would put you at risk for heart disease and stroke are the same risk factors that can make you more vulnerable to vascular dementia. You may have a higher risk if you:
- Are of older age .
- Are physically inactive.
- Are overweight.
- Have a family history of rare inherited diseases of the blood vessels that block the flow of blood in the brain.
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Are There Treatments For Vascular Dementia
There are treatments to help with many of the symptoms of dementia. At the moment we do not have a treatment that cures vascular dementia.
How quickly it progresses is different for everyone. Your symptoms may stay the same for months, or even years, but then they will suddenly get worse. Although your dementia will not get any better, it may be possible to slow down how quickly it progresses.
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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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.
Helping Someone With Vascular Dementia
Caring for a person with vascular dementia can be very stressful for both you and your loved one. You can make the situation easier by providing a stable and supportive environment.
- Modify the caregiving environment to reduce potential stressors that can create agitation and disorientation in a dementia patient.
- Avoid loud or unidentifiable noises, shadowy lighting, mirrors or other reflecting surfaces, garish or highly contrasting colors, and patterned wallpaper.
- Use calming music or play the persons favorite type of music as a way to relax the patient when agitated.
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Living With Vascular Dementia
Vascular dementia is a progressive disease that has no cure, but the rate at which the disease progresses can vary. Some people with vascular dementia may eventually need a high level of care due to the loss of mental and physical abilities. Family members may be able to care for a person with vascular dementia early on. But if the disease progresses, the person may need more specialized care.
Respite programs, adult daycare programs, and other resources can help the caregiver get some time away from the demands of caring for a loved one with vascular dementia.
Long-term care facilities that specialize in the care of people with dementias, Alzheimer’s, and other related conditions are often available if a person affected by vascular dementia can no longer be cared for at home. Your healthcare provider can recommend caregiver resources.
What Are The Vauses Of Vascular Dementia
Any condition that damages blood vessels anywhere in the body can cause brain changes linked to vascular dementia. Advancing age is a major risk factor.
Additional risk factors are the same ones that raise risk for heart problems, stroke, and other diseases that affect blood vessels. Follow these steps to reduce the risk of developing vascular dementia:
- Dont smoke
- Keep a healthy blood pressure, cholesterol level, and blood sugar
- Eat a healthy diet
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What Are The Symptoms Of Vascular Dementia
People with vascular dementia may experience:
- Difficulty performing tasks that used to be easy, such as paying bills
- Trouble following instructions or learning new information and routines
- Forgetting current or past events
- Misplacing items
- Loss of interest in things or people
- Changes in personality, behavior, and mood, such as depression, agitation, and anger
- Hallucinations or delusions
- Poor judgment and loss of ability to perceive danger
Tests For Vascular Dementia
There is no single test for vascular dementia.
The tests that are needed to make a diagnosis include:
- an assessment of symptoms
- a full medical history
- an assessment of mental abilities this will usually involve several tasks and questions
- a brain scan, such as an MRI scan or CT scan, to look for any changes that have happened in your brain
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Medicines To Treat People With Vascular Dementia And Other Vascular Cognitive Impairments
Review question
What is the evidence for cholinesterase inhibitors , when used with people who have vascular dementia?Background
Vascular dementia is a term used when a person has problems with memory and thinking that are caused by a disruption of blood supply. There are few drug treatments for vascular dementia.
In this review, we evaluated three drugs from the cholinesterase inhibitor family, donepezil, rivastigmine, and galantamine. These medications are widely used in Alzheimer’s dementia but may also be useful in people with vascular dementia. Previous reviews of these cholinesterase inhibitor drugs could not draw definitive conclusions for people with vascular dementia.Purpose of this review
We wanted to learn whether cholinesterase inhibitors benefit people with vascular dementia. We were interested in their effects on memory, thinking, and daily functioning. We wanted to learn of any harms associated with these drugs.
As some time has passed since the previous reviews, we wanted to update them by searching for new studies. We combined the three previous reviews on donepezil, rivastigmine and galantamine into one review.What we did
We searched for studies that described the effects of donepezil, rivastigmine, and galantamine for people with vascular dementia. We searched databases of scientific studies and contacted drug manufacturers and experts in vascular dementia. Our search is current to 19 August 2020.
Treating The Signs Of Vascular Dementia
Vascular dementia can cause problems like depression, anxiety and falls. The stroke or dementia team can work with you to find ways around many of these problems. You might have medication for anxiety, or physiotherapy to reduce falls.
MedicationSometimes medication may be used to improve your mood if you are feeling very down or depressed. Medication can also help with some of the problems seen in advanced vascular dementia. However, there are risks in taking these drugs, so its important that you talk through all the advantages and disadvantages with your family and doctor before you decide to try them.
Rehabilitation therapyMemory and stroke services often have a team of experts that can help with various dementia problems. If your dementia is causing physical problems, such as falls, then you may be able to work with a physiotherapist to try to improve them.
A speech and language therapist may be able to help you with any communication problems that youre having. An occupational therapist will also be able to work with you to make sure that you can be as independent as possible, particularly in your home environment.
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What Happens In Vascular Dementia
Vascular dementia can cause different symptoms depending on where the blood vessels are damaged in the brain. For example, a person who had a stroke may have sudden problems with memory, balance, or speech. However, a person can have several strokes that may be unnoticeably small, but the damage can add up over time.
Many people with vascular dementia have trouble with memory. Others may have difficulty with organization and solving complex problems, slowed thinking, or being easily distracted. People with vascular dementia may also have changes in mood or behavior, such as irritability, loss of interest, or depression.
Sometimes, people with vascular dementia have trouble with balance and movement. This might include weakness on one side of the body, and the symptoms may get worse over time.
Causes Of Vascular Dementia
Vascular dementia is caused by reduced blood flow to the brain. This damages and eventually kills brain cells.
This can happen as a result of:
- narrowing and blockage of the small blood vessels inside the brain
- a single stroke, where the blood supply to part of the brain is cut off
- lots of ‘mini strokes’ – these cause tiny but widespread damage to the brain
Often, these problems are linked to underlying conditions. These could be things like high blood pressure and diabetes, or lifestyle factors, such as smoking and being overweight.
Tackling these may reduce your risk of vascular dementia in later life. But it’s not yet clear exactly how much your risk of dementia can be reduced.
Content supplied by the NHS and adapted for Ireland by the HSE
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Are There Medicines To Treat Vascular Dementia
Though there is no cure for vascular dementia yet, there are medications that can help manage the symptoms. Sometimes medications used to treat memory problems in Alzheimers disease may be helpful for vascular dementia. Sometimes, people with vascular dementia can have mood changes, such as depression or irritability. These can be managed by medications like the ones used for depression or anxiety.
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.
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Keep Asking Questions Until You Get The Answer You Need
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3. Ginseng
It has been used in China to help us prevent aging and disease for centuries. Some researchers reported a ginseng study that involves 40 patients with mid to moderate vascular dementia. Twenty-five of 40 patients received ginseng extract, and 12 weeks later, they showed a significant memory improvement over the patients who did not receive ginseng extract. Additionally, a recent study showed that black ginseng may protect against cognitive and neuronal impairment and may be used to help people with vascular dementia.
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4. Treatments For Vascular Dementia With Coconut Oil
Coconut oil contains plenty of health benefits, and it is found to be useful to treating dementia because it is a powerful antioxidant and assists to keep the tissues and arteries healthy in our body. Add 1-2 tbsp. of virgin coconut oil everyday to prevent the symptoms of vascular dementia. Just ensure the coconut oil you use is organic, virgin coconut oil. Whereas, processed coconut oil has trans fatty acids and thus, it should not be eaten.
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5. Fish Oil
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6. Treatments For Vascular Dementia Bananas
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Treatment Options For Vascular Dementia
Vascular dementia cannot be cured. The primary goal for vascular dementia is to treat the underlying conditions that affect the blood flow to the brain. Treating these underlying conditions can help to reduce the risk factors for further damage to brain tissue.
Such treatments may include:
- Medications to manage blood pressure, cholesterol, triglycerides, diabetes, and problems with blood clotting.
- Lifestyle modifications, 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/or stenting the carotid arteries are located in the neck and provide blood flow from the heart to the brain.
- Medications, such as cholinesterase inhibitors to treat the progression of dementia.
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Clinical Definitions And Epidemiology
Vascular dementia represents a clinical syndrome that includes a wide spectrum of cognitive dysfunctions resulting from brain tissue death due to ischemia caused by vascular disease. A number of excellent reviews have been written on the topics of its diagnosis, pathogenesis, and epidemiology . It is believed that vascular dementia is a distinct clinical and pathological entity from Alzheimers dementia, Lewy body dementia, or fronto-temporal dementia, although elements of vascular disease may be present in all of these conditions. Treatment of vascular dementia has also received extensive coverage . The prevailing conclusion of these reports is that most vascular dementia trials have produced disappointing results. It is important to note that so far no drug has been approved by regulatory agencies to treat vascular dementia . Epidemiologically, vascular dementia is considered the second most prevalent type of dementia after Alzheimers disease although this point of view maybe brought to doubt by our increasing understanding of Lewy body disease . From a clinicians point of view, vascular dementia represents a major source of frustration because of its relatively high prevalence and lack of effective treatment options.