Occasional forgetfulness may be a normal part of aging. But more serious memory loss and confusion could be signs of dementia. Alzheimer's disease is the most common form. The second most common form is vascular dementia.
What is vascular dementia?
Vascular dementia occurs when brain cells are damaged by disrupted blood flow, usually due to a series of small strokes. These small strokes, which are called silent strokes, may go unnoticed. But over time they cause widespread damage and dementia symptoms.
Vascular dementia is also called multi-infarct dementia. A brain infarct, or stroke, occurs when an artery supplying blood to the brain becomes blocked by a clot, or bursts. A buildup of fat and other substances (plaque) along the artery wall can cause a blood clot to form. This clot can block the flow of blood to a part of the brain. A stroke can also occur when a blood clot from somewhere else in the body gets stuck in a blood vessel in the brain, cutting off the flow of blood. Another type of stroke occurs when a blood vessel bursts in the brain.
Like Alzheimer's, vascular dementia is marked by memory loss, confusion, and problems thinking and paying attention. Problems communicating, mood swings, and depression are also common. Besides having overlapping symptoms, Alzheimer's and vascular dementia can also occur together. For these reasons, it's often hard to tell the two conditions apart.
Risk factors for vascular dementia
Risk factors for vascular dementia are the same as those for stroke and heart disease. They include:
- Increasing age; usually begins between 60 and 75 years of age
- Male gender
- African American heritage
- High blood pressure
- High cholesterol
- Heart disease, especially atrial fibrillation or other heart rhythm problems, or previous heart attack, stroke, or TIA (transient ischemic attack)
- Family history of stroke or heart disease
Prevention and treatment for vascular dementia
While you can't undo brain damage, you can help prevent more strokes. To do this, it's important to control the underlying diseases that increase the risk for stroke. This may mean taking medications to control high blood pressure, diabetes, high cholesterol, heart rhythm problems, and other heart diseases. You may need medications to help prevent blood clots (anticoagulants), especially if you have atrial fibrillation.
Medications used to treat Alzheimer's-related dementia are being studied to see if they may help treat vascular dementia.
In some cases, surgery to remove a blockage in the blood vessels that carry blood to the brain may help improve blood flow. Carotid endarterectomy or angioplasty and stenting may be options for some people to help prevent stroke.
Finally, some type or types of rehabilitation may help you regain lost abilities. This may include occupational, physical, and speech therapy.
Created on 04/04/2008
Updated on 08/30/2011
- Alzheimer's Association. Vascular dementia.
- National Institute of Neurological Disorders and Stroke. Multi-infarct dementia information page.
- Helpguide.org. Vascular dementia.
- Gorelick PB. Risk factors for vascular dementia and Alzheimer disease. Stroke. 2004;35(suppl I):2620-2622.