Causes Of Vascular Dementia
Vascular dementia is caused by reduced blood flow to the brain, which 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 suddenly cut off
- lots of “mini strokes” that cause tiny but widespread damage to the brain
Not everyone who has a stroke will go on to develop vascular dementia.
Read more about vascular dementia.
Is Alcoholic Dementia Treatable What Are The Options
The best treatment for alcoholic dementia is total abstinence. If the person is still addicted to alcohol, treatment for the addiction is the first step, and many forms of help are available.
Alcohol addiction treatment begins with detoxification . A variety of sedative drugs can help manage alcohol withdrawal symptoms. Medications used to treat alcohol addiction include:
Loss Of Neuronal Connections And Cell Death
In Alzheimers disease, as neurons are injured and die throughout the brain, connections between networks of neurons may break down, and many brain regions begin to shrink. By the final stages of Alzheimers, this processcalled brain atrophyis widespread, causing significant loss of brain volume.
Learn more about Alzheimer’s disease from MedlinePlus.
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The Dementia Brain Tour
The brain is incredibly complex and this section of our site contains a lot of information about how the brain is thought to function. For more about how the brain works and the effects of dementia, see our set of videos below.
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What Increases The Risk For Dementia
- AgeThe strongest known risk factor for dementia is increasing age, with most cases affecting those of 65 years and older
- Family historyThose who have parents or siblings with dementia are more likely to develop dementia themselves.
- Race/ethnicityOlder African Americans are twice more likely to have dementia than whites. Hispanics 1.5 times more likely to have dementia than whites.
- Poor heart healthHigh blood pressure, high cholesterol, and smoking increase the risk of dementia if not treated properly.
- Traumatic brain injuryHead injuries can increase the risk of dementia, especially if they are severe or occur repeatedly.
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What Are The Most Common Types Of Dementia
- Alzheimers disease. This is the most common cause of dementia, accounting for 60 to 80 percent of cases. It is caused by specific changes in the brain. The trademark symptom is trouble remembering recent events, such as a conversation that occurred minutes or hours ago, while difficulty remembering more distant memories occurs later in the disease. Other concerns like difficulty with walking or talking or personality changes also come later. Family history is the most important risk factor. Having a first-degree relative with Alzheimers disease increases the risk of developing it by 10 to 30 percent.
- Vascular dementia. About 10 percent of dementia cases are linked to strokes or other issues with blood flow to the brain. Diabetes, high blood pressure and high cholesterol are also risk factors. Symptoms vary depending on the area and size of the brain impacted. The disease progresses in a step-wise fashion, meaning symptoms will suddenly get worse as the individual gets more strokes or mini-strokes.
- Lewy body dementia. In addition to more typical symptoms like memory loss, people with this form of dementia may have movement or balance problems like stiffness or trembling. Many people also experience changes in alertness including daytime sleepiness, confusion or staring spells. They may also have trouble sleeping at night or may experience visual hallucinations .
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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How Does Alzheimers Disease Affect The Brain
The brain typically shrinks to some degree in healthy aging but, surprisingly, does not lose neurons in large numbers. In Alzheimers disease, however, damage is widespread, as many neurons stop functioning, lose connections with other neurons, and die. Alzheimers disrupts processes vital to neurons and their networks, including communication, metabolism, and repair.
At first, Alzheimers disease typically destroys neurons and their connections in parts of the brain involved in memory, including the entorhinal cortex and hippocampus. It later affects areas in the cerebral cortex responsible for language, reasoning, and social behavior. Eventually, many other areas of the brain are damaged. Over time, a person with Alzheimers gradually loses his or her ability to live and function independently. Ultimately, the disease is fatal.
Which Part Of The Brain Is Affected With 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.
Treatments For Frontotemporal Dementia
There’s currently no cure for frontotemporal dementia or any treatment that will slow it down.
But there are treatments that can help control some of the symptoms, possibly for several years.
- medicines to control some of the behavioural problems
- therapies such as physiotherapy, occupational therapy, and speech and language therapy for problems with movement, everyday tasks and communication
- dementia activities such as memory cafes, which are drop-in sessions for people with memory problems and their carers to get support and advice
- support groups who can offer tips on managing symptoms from dementia experts and people living with frontotemporal dementia, and their families
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Tests For Vascular Dementia
There’s no single test for vascular dementia.
The tests that are needed to make a diagnosis include:
- an assessment of symptoms for example, whether these are typical symptoms of vascular dementia
- a full medical history, including asking about a history of conditions related to vascular dementia, such as strokes or high blood pressure
- 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
Find out more about the tests used to diagnose dementia.
Dementia And The Brain
Knowing more about the brain and how it can change can help to understand the symptoms of dementia. It can help a person with dementia to live well, or to support a person with dementia to live well.
These pages explain which areas of the brain are responsible for certain skills and abilities, and how these are affected by dementia. We explain how changes to the brain relate to changes a person may notice as the condition progresses.
This information is helpful for anyone who wants to find out more about how the brain is affected by dementia.
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What Neurological Problems Are Involved In Dementia
For neurons to function well, be replaced with healthy cells, and avoid premature cell death, key biological processes must occur. People with Alzheimers disease experience changes that impair critical functions:
- Communication between nerve cells. Neurons exchange information through a chemical-electric charge that crosses a microscopic gap called a synapse. A single healthy neuron may have as many as 7,000 synaptic connections to other nerve cells2.
- Regeneration and repair. Neurons have the ability to be repaired and to adjust or change their synaptic connections based on the chemical and electrical messages they receive. A healthy brain can even generate new nerve cells by the process of neurogenesis. This ability to repair or change connections and generate new cells is vital to memory and learning2.
- Nutrient delivery and metabolism. Nerve cells need a steady supply of chemicals and nutrients to perform their functions and survive. Oxygen and glucose are critical to cell survival, and good circulation delivers these key nutrients while carrying away the waste products of energy metabolism2.
How Is Dementia Diagnosed
Confirming the diagnosis of dementia can be difficult due to the many diseases and conditions that cause it as well as because its symptoms are common to many other illnesses. However, doctors are able to make the diagnosis based on the results of personal medical history, review of current symptoms, neurological and cognitive tests, laboratory tests, imaging tests and by interacting with the patient.
Current general symptoms that would indicate dementia are, by definition, a decline in such mental functions as memory, thinking, reasoning, personality, mood or behavior that are severe enough to interfere with the ability to accomplish everyday tasks. Patients undergo mental function testing to identify problems in these areas. Interviews with family members and/or close friends who may have noticed changes in these areas are helpful as well.
Laboratory tests rule out other diseases and conditions as the cause of dementia, such as thyroid problems and vitamin B12 deficiency. Similarly, brain scans can look for signs of a stroke or tumor that may be the source of the dementia. A PET scan can determine if amyloid proteins are present in the brain, a marker for Alzheimers disease.
Oftentimes, neurologists and geriatricians assist in making the diagnosis.
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Causes Of Dementia With Lewy Bodies
Lewy bodies are tiny clumps of a protein called alpha-synuclein that can develop inside brain cells.
These clumps damage the way the cells work and communicate with each other, and the brain cells eventually die.
Dementia with Lewy bodies is closely related to Parkinson’s disease and often has some of the same symptoms, including difficulty with movement and a higher risk of falls.
Read more about dementia with Lewy bodies.
Treatments For Vascular Dementia
There’s currently no cure for vascular dementia and there’s no way to reverse any loss of brain cells that happened before the condition was diagnosed.
But treatment can sometimes help slow down vascular dementia.
Treatment aims to tackle the underlying cause, which may reduce the speed at which brain cells are lost.
This will often involve:
- taking medicines, such as those used to treat high blood pressure, lower cholesterol or prevent blood clots
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Metabolic Problems And Endocrine Abnormalities
Clots And Clogs: Causes Of Ischemic Stroke
When an artery that carries blood to the brain becomes clogged or blocked, an ischemic stroke can occur. Arteries may be blocked by fatty deposits due to atherosclerosis. Arteries in the neck, particularly the internal carotid arteries, are a common site for atheromas.
Arteries may also be blocked by a blood clot . Blood clots may form on an atheroma in an artery. Clots may also form in the heart of people with a heart disorder. Part of a clot may break off and travel through the bloodstream . It may then block an artery that supplies blood to the brain, such as one of the cerebral arteries.
Strokes can destroy brain tissue by blocking the blood supply to parts of the brain. An area of brain tissue that is destroyed is called an infarct.
Dementia may result from a few large strokes or, more commonly, many small ones. Some of these strokes seem minor or may not even be noticed. However, people may continue to have small strokes, and after enough brain tissue is destroyed, dementia can develop. Thus, vascular dementia may develop before strokes cause other severe symptoms or sometimes even any noticeable symptoms.
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How Do You Get A Dementia Patient To Talk
Caring for dementia patients requires skill, understanding and compassion. The way you say something is often more important than what you say. Its important for carers to understand that patients may be very stressed and frustrated by not being able to communicate.
Experienced carers of patients whose speech is affected by dementia are sensitive to their needs and listen actively. They encourage patients with smiles and gestures, ensure there are no distractions, and talk in a warm and calm voice. In addition, they talk about one thing at time and use simple language or pictures to get their message across. They refer to people by using their name, and the key thing is to show empathy and understanding.
Speech therapists are a key part of the multidisciplinary team providing care to speech-affected dementia patients. In addition, they help ensure awareness among home care workers, clinicians and others of the importance of improving communication outcomes for patients.
In the later stages of dementia, patients with communication problems often have trouble eating and drinking. Swallowing may be difficult and this where speech therapists need to work closely with clinicians to get the best outcomes.
How Dementia Affects Speech And Language
It is well known that dementia affects speech and language. Indeed, one of the symptoms of dementia may be communication problems. The condition can develop slowly or be brought on, for instance, by a stroke. Dementia is not a normal part of ageing, or inevitable as we grow older, but it mainly affects elderly people.
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What Happens In Dementia
People with dementia may have different symptoms, depending on the type and stage of their particular dementia. A persons symptoms depend on which part of the brain is affected by the disease process, and they may change over time as the diseases progress to involve different areas of the brain. Different types of dementia tend to target particular parts of the brain. For example, the part of the brain that is important for the formation of new memories is usually affected early on in AD, which is why short-term memory loss is often one of the first symptoms of AD. Other common symptoms in dementia include difficulties with communication, planning and organization, navigation, personality changes, and psychiatric symptoms such as depression, anxiety, delusions and hallucinations.
What Happens To The Brain In Alzheimer’s Disease
The healthy human brain contains tens of billions of neuronsspecialized cells that process and transmit information via electrical and chemical signals. They send messages between different parts of the brain, and from the brain to the muscles and organs of the body. Alzheimers disease disrupts this communication among neurons, resulting in loss of function and cell death.
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Outlook For Frontotemporal Dementia
How quickly frontotemporal dementia gets worse varies from person to person and is very difficult to predict.
People with the condition can become socially isolated as the illness progresses. They may not want to spend time in the company of others, or may behave in rude or insulting ways.
The average survival time after symptoms start is around 8 to 10 years. But this is highly variable and some people live much longer than this.
If you or a loved one has been diagnosed with dementia, remember you’re not alone. The NHS and social services, as well as voluntary organisations and specialist support groups, can provide advice and support for you and your family.
Other Types Of Dementia
Other conditions that contribute to dementia include:
- Mixed dementia: This happens when several conditions contribute to your dementia. Alzheimers disease, Lewy body conditions, and vascular conditions may all be present in a case of mixed dementia.
- Huntingtons disease: This genetic condition causes damage to nerve cells in your spine and brain. You may start to notice symptoms of dementia and cognitive decline after you turn 30 if you have it.
- Parkinsons disease: The damage to your nerves caused by Parkinsons can cause dementia.
- Creutzfeldt-Jakob disease: This brain condition is thought to be caused by problems with your brain proteins or by contact with brain or nerve tissue that carries a disease. Symptoms dont often appear until after you turn 60.
These conditions are often caused by a mix of risk factors, including family history and lifestyle choices. Huntingtons disease can only be passed through families and cant be developed if you dont have the genes for it.
Some risk factors for dementia cant be controlled, including:
- your age, as your risk increases after you turn 65
- losing your memory naturally as you age
- Down syndrome, which often causes early onset dementia
- your genes, as a family history of dementia can increase your risk of developing dementia
Other risk factors may respond to lifestyle changes or treatment. These include:
- drinking a lot of alcohol
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