Vascular Dementia - Causes, Symptoms, Treatment
Vascular dementia is a common form of dementia in older persons that is due to cerebrovascular disease, usually with stepwise deterioration from a series of small strokes and a patchy distribution of neurologic deficits affecting some functions and not others. Risk factors include high blood pressure, an unsteady way of walking, and advanced age.
To be healthy and function properly, the brain cells need a good supply of blood. The blood is delivered through a network of blood vessels called the vascular system. If the vascular system within the brain becomes damaged and blood cannot reach the brain cells they will eventually die. This can lead to the onset of vascular dementia.
Causes of vascular dementia
Vascular dementia can be caused in several different ways. Most commonly there is a blockage of small blood vessels somewhere in the vast system of arteries that feeds the brain and enters through the base of the skull. Blockages may be caused by plaque build up on the inside of the artery wall, or by blood clots which have broken loose and clogged a tributary further downstream. Clots can form as a result of abnormal heart rhythms, or other heart abnormalities. Also, a weak patch on an artery wall can balloon outward and form an aneurysm, which can burst and deprive the brain cells of oxygen.
Symptoms
The onset of multi-infarct dementia often goes unnoticed in the early stages, particularly if the strokes are minor. If the strokes are minor, symptoms caused by each stroke may include mild weakness in the limbs, slurred speech, dizziness and a slight impairment to the short-term memory, though these do not last for long.
Treatment of vascular dementia
Because vascular dementia is closely tied to diseases of the heart and blood vessels, many experts consider it the most potentially treatable form.
Monitoring of blood pressure, weight, blood sugar and cholesterol should begin early in life. Managing these risk factors, avoiding smoking and excess alcohol, and treating underlying diseases of the heart and blood vessels could play a major role in preventing later cognitive decline for many individuals.
After a person has a stroke, medication may be prescribed to improve blood flow to the brain and reduce the risk of further stroke. A person may also benefit from different therapies to help with movement and speech, such as physiotherapy, occupational therapy or speech therapy. Aside from the treatment of the underlying causes of VaD such as hypertension, high cholesterol and diabetes, some physicians routinely recommend the use of medications called cholinesterase inhibitors.
