Which Types Of Strokes Lead To Vascular Dementia
Interruption of blood flow into the brain causes a stroke. Without blood, neurons will begin to die, and this can lead to serious complications, or even death.
There are three main types of strokes.
- Hemorrhagic strokes are the least common, but the most fatal, happening after a blood vessel bursts.
- Ischemic strokes, on the other hand, account for 87% of occurrences. They are typically caused by atherosclerosis, that is, the buildup of fatty deposits on the walls of blood vessels.
- Transient ischemic attacks result from a brief interruption of blood flow into the brain. Physicians also refer to them as ministrokes.
Ischemic strokes and TIAs are associated with vascular dementia.
What Is The Outlook For Stroke
At this time, there is no known cure for vascular dementia. While treatment can stop or slow the worsening of symptoms, or even improve them in some cases, the damage done to the brain by a stroke cannot be reversed.
As dementia progresses, behavior problems usually become more severe. Troubling behaviors like agitation, aggression, wandering, sleep disorders, and inappropriate sexual behavior may become unmanageable. The physical demands of caregiving, such as bathing, dressing, grooming, feeding, and assisting with using the toilet, may become overwhelming for family members. Under these conditions, the family may decide to place the person in a nursing home or similar facility.
Vascular dementia appears to shorten life expectancy. The most common causes of death are complications of dementia and cardiovascular disease.
How Can I Prevent Stroke
In many cases, vascular dementia is preventable. Risk factors for stroke and vascular dementia include high blood pressure, high cholesterol, heart disease, smoking, and diabetes. For many people, risk can be reduced by adopting a healthy lifestyle. People who have had a stroke may be able to reduce their risk of further strokes by drug treatment or surgery in addition to adopting a healthy lifestyle.
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Differences Between Delirium Dementia Alzheimer’s And Parkinson’s
Your brain doesnt;finish developing;until your mid-to-late 20s. Is it all downhill from there? Neuroscientists are discovering that you can continue to;rewire your brain;to encourage growth and prevent your brain cells from dying, but everyone experiences age-related cognitive decline.
Its often lumped into an umbrella category of mental slowdown that happens as you get older.
However, there are a few different brain diseases that affect aging adults. Heres how to understand the difference between delirium, dementia, Alzheimers and Parkinsons.
What Is Vascular Dementia
If you are worried about vascular dementia or know someone who is, this guide can help you understand what you need to do. It explains what vascular dementia is and how it is linked to stroke. It also explains what you can do if you or someone you know is diagnosed with vascular dementia.
Its aimed at people who’ve had a stroke or who think they may have vascular dementia, but there is information for family and friends as well. If you have a question that is not answered in this guide call our Stroke Helpline.
The information on this page can be accessed in the following formats:
- ;as a pdf or large print Word document.
- To request a braille copy, email;.
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Frequencies Of Impairment After Stroke
As the risk of death from strokes has declined, the number of stroke survivors with cerebral compromise and cognitive dysfunction has increased. Stroke survivors are at increased risk of cognitive impairment , . Meta-analysis of data from several studies yielded estimates of 1-in-10 patients being demented prior to a first stroke, 1-in-10 developing new dementia soon after a first stroke, and over 1-in-3 being demented after a recurrent stroke , . The development of cognitive impairment and incident dementia after stroke appears relatively common following stroke , . While not to be confused with periods of delirium as an immediate consequence after stroke injury , , cognitive decline following an index stroke could be insidious with the latent appearance of dementia especially in patients with small cortical and subcortical infarcts.
Symptoms Of Vascular Dementia
Symptoms of vascular dementia depend on what part of the brain is affected and to what extent. Like Alzheimer’s disease, the symptoms of vascular dementia are often mild for a long time. They may include:
- Problems with short-term memory
- Wandering or getting lost in familiar surroundings
- Laughing or crying at inappropriate times
- Trouble concentrating, planning, or following through on activities
- Trouble managing money
- Hallucinations or delusions
Symptoms that suddenly get worse often signal a stroke. Doctors look for symptoms that progress in noticeable stages to diagnose vascular dementia. Alzheimer’s, by comparison, progresses at a slow, steady pace. Another clue is impaired coordination or balance. In vascular dementia, problems walking or balancing can happen early. With Alzheimer’s, these symptoms usually occur late in the disease.
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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
Why Did We Fund This Project
Comments from members of our Research Network:
‘I would support this project due to the increase in life expectancy of those experiencing a stroke and the higher risk of developing dementia post stroke.’
‘Post stroke dementia must surely be on the increase. This work may well help to prevent this.’
‘Building on knowledge already discovered.’
Risk Factors For Cognitive Impairment After Stroke
In tandem with the age-related increased incidence of stroke itself, older age is the strongest risk factor for VCI and dementia after stroke . This is consistent with the high incidence of stroke or cerebrovascular related dementia in the elderly , . In the CogFAST studies , , we found that the mean age of cognitively impaired subjects was greater with expectedly lower CAMCOG scores than the non-demented stroke subjects.
How Can We Reduce The Risk Of Vascular Dementia
Developing habits that maintain good brain and heart health will significantly reduce the risk of strokes and vascular dementia.
- Avoid or quit smoking altogether.
- Maintain a healthy weight.
- Limit your consumption of alcohol and sugary foods.
- Stay physically active through regular exercise and movement.
- Adopt a healthy and balanced diet.
- Visit your GP / primary care physician on a predetermined schedule
- Manage and measure your cholesterol, blood pressure and blood sugar levels as suggested by your physician.
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Pathophysiology Of The Wm And The Blood Brain Barrier
Constant perfusion of the WM by deep penetrating arterioles is essential for functioning of axons and oligodendrocytes. Depending on the duration and severity of ischaemic or oligaemic injury, several features may be readily evident in the WM. These include activated microglia, clasmatodendritic astrocytosis, myelin breakdown, presence of axonal bulbs and degeneration, reactivation and loss of oligodendroglia. During subsequent periods of arteriolar changes, perivascular spacing and apoptotic oligodendroglia are seen accompanied by degeneration of myelin and expression of hypoxia markers. .
What Are The Signs And Symptoms Of Post
Each area of the brain controls different functions. Therefore, the symptoms of vascular dementia vary between individuals depending on how the brain has been affected.
Some symptoms of vascular dementia can include:
- Rapid mood swings
Its important to note that some of these symptoms alone, such as mood swings, do not necessarily signify the presence of post-stroke dementia. Many of these symptoms, when occurring alone, are common cognitive effects of a stroke. However, when many cognitive effects occur together, a doctor may diagnose it as vascular dementia.
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Small Vessel Disease And Vascular Cognitive Impairment
Vascular dementia can also be caused by small vessel disease. This is when the small blood vessels deep within your brain become narrow and clogged up. The damage stops blood from getting to parts of your brain. The damage can build up over time and may cause signs of vascular cognitive impairment. This can eventually lead to vascular dementia.
Many of the things that increase your risk of small vessel disease, such as high blood pressure and diabetes, also increase your risk of stroke.;
You can read more about how to reduce your risk of stroke and small vessel disease.
Diagnosis Of Vascular Dementia
There is no simple test for vascular dementia, but dont let this stop you visiting your GP for help. Even if someone is demonstrating all of the symptoms so the doctor will first check to see if it is something else. Often people think they have dementia only to end up with a diagnosis of an infection, vitamin or thyroid problem, the side effects of medication or a number of other conditions. All of these conditions can be quickly treated so it is worth visiting your GP no matter how scared you are.
Even if your fears are confirmed the earlier it is diagnosed the earlier treatment can start which can help slow its progression.
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Risk Factors For Post
After a stroke, the risk factors for cognitive impairment are usually associated with an overlap of dementia and frequent cerebrovascular diseases.
Some of them include:
1. Age: this is a risk factor for both cognitive decline and dementia. The prevalence of cognitive decline increases significantly after the age of 65 according to research by the American Stroke Association.
3. Recurring strokes are also documented as a risk factor for cognitive impairment.
4. Education level: this is a conflicting risk factor with some studies suggesting that higher education is related to better cognitive performance.
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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High Blood Levels Of Homocysteine
Research shows elevated blood levels of homocysteine may cause dementia. Homocysteine is an amino acid, which are needed to build up protein. Boston University researchers found high blood levels of homocysteine doubled an individual’s chance of developing Alzheimer’s disease. With this in mind, individuals can help reduce their homocysteine blood levels by taking B vitamins. A study in the Proceedings of the National Academy of Sciences found supplementing with B vitamins stopped the wasting of brain cells associated with dementia. B vitamins also slowed down cognitive decline.
Things That Affect The Severity Of A Stroke
Science has still not been able to isolate a single reason some people fare worse than others after strokes. The current focus is on reducing the number of factors that influence how much a stroke affects the brain. For example, seniors who receive prompt medical attention do better. Certain medications can break up blood clots so seniors can have better outcomes.
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.
Prognosis For People With Vascular Dementia
If the conditions that cause vascular dementia go untreated, the prognosis is not good. A person with vascular dementia may seem to improve for periods of time until another stroke takes away more brain function, memory, and independence. Eventually, untreated vascular dementia usually ends in death from stroke, heart disease, or infection.
Although vascular dementia is a serious condition, catching it early and preventing further damage are the best medicine. People with vascular dementia can work with their doctors and families to detect and manage the condition.
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How To Plan For The Future
Recovering from a stroke takes time, and your loved one should see a gradual increase in his or her abilities, but that could take many months. For now, your loved one needs to have assistance with his or her daily routine. Seniors with worsening dementia symptoms after strokes may even need constant care that includes having multiple people provide assistance. Home caregivers can help with preparing nutritious meals, providing medication reminders, and taking your loved one to therapy appointments so he or she continues to make progress in recovery.
Dementia can be challenging for seniors to manage, but they can maintain a higher quality of life with the help of professional dementia care. Columbus seniors can benefit greatly from the Cognitive Therapeutics Method , an activities-based program designed to promote cognitive health and delay the onset of dementia. CTM is included at no additional charge with any of the in-home care plans provided by Home Care Assistance. If your loved one needs assistance with the challenges of aging, reach out to one of our knowledgeable, compassionate Care Managers today at 481-8888.
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.
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Previous Stroke And Stroke Recurrence
Previous stroke as well as stroke recurrence have been found to be associated with a higher risk of PSD in some but not all studies . However, this influence of previous or recurrent stroke might depend on the etiology of PSD: the risk is increased when PSD is vascular in origin, but not when it is degenerative in origin .
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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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.