What you need to know about vascular dementia
Vascular dementia is the second most common cause of dementia after Alzheimer’s disease.
People with vascular dementia have problems with reasoning, judgment, and memory.
These symptoms can appear suddenly or they could be mild at first and gradually worsen.
It can be challenging to diagnose because it can occur together with Alzheimer’s and the symptoms can vary from case to case.
We explain what vascular dementia is, common symptoms, how it compares to Alzheimer’s, risk factors, and treatment options.
What is vascular dementia?
Vascular dementia is a condition that causes a decline in cognitive function.
It’s caused by a blockage or lack of blood flow to the brain – often from stroke or transient ischemic attack (TIA).
Lack of oxygen and blood can damage the brain, even in a short period of time.
Vascular dementia symptoms
Vascular dementia symptoms can vary. It depends on which part of the brain is affected and how serious the damage is.
Generally, symptoms include:
- Problems with short-term memory
- Trouble concentrating, planning, or following through on activities
- Trouble managing money
- Not being able to follow instructions
- Wandering or getting lost in familiar areas
- Laughing or crying at inappropriate times
- Incontinence
- Hallucinations or delusions
Sudden symptoms after a stroke
Vascular dementia symptoms are usually the most obvious after a major stroke. Symptoms that suddenly get worse often signal another stroke.
Post-stroke changes include:
- Confusion and disorientation
- Trouble speaking or understanding speech
- Vision loss
These cognitive changes often happen along with physical stroke symptoms, like sudden headache, difficulty walking, or numbness or paralysis on one side of the face or body.
Gradual symptoms from mini-strokes or TIA
Multiple small strokes or other conditions that affect blood vessels often cause gradual changes in cognitive function.
Early signs include:
- Impaired planning and judgment
- Trouble finding the right words
- Difficulty in social situations
- Uncontrolled laughing and crying
- Reduced ability to pay attention
Vascular dementia vs Alzheimer’s
Vascular dementia and Alzheimer’s are not the same disease, but it’s possible to have both at the same time.
In fact, the most common form of mixed dementia (more than one dementia at the same time) is vascular dementia and Alzheimer’s.
When that happens, the person could have symptoms of both types of dementia.
Here’s how they’re different.
Vascular dementia:
- Is caused by stroke or TIA
- Symptoms usually progress in noticeable stages
- Impaired coordination or balance usually happens early on
- Related to vascular problems like high cholesterol and high blood pressure
Alzheimer’s:
- No known cause
- Symptoms typically worsen at a slow, steady pace
- Impaired coordination or balance usually happens late in the disease
- Risk increases with age
Vascular dementia risk factors
A high risk for stroke is closely associated with risk for vascular dementia. 25 – 33% of strokes are thought to cause some amount of dementia.
Vascular dementia is more common in people aged 60 to 75 and is more likely to occur in men than women.
Common vascular dementia risk factors include:
- Age – it’s rare before age 65, risk rises significantly in the 80s and 90s
- Stroke or transient ischemic attack (TIA)
- Heart attack
- High blood pressure
- High cholesterol
- Diabetes
- Heart or blood vessel disease
- Hardening of the arteries
- Smoking
- Drinking excessive amounts of alcohol
- Abnormal heart rhythm
Vascular dementia treatment and life expectancy
There is no cure for vascular dementia, but the earlier it’s diagnosed, the better chance there is of reducing the impact and severity of symptoms.
Lifestyle changes
The goal of vascular dementia treatment is to improve the conditions that may be causing it.
Lifestyle changes can help prevent further damage and slow the progression of symptoms.
Your older adult’s doctor will help create a plan to lower high blood pressure and high cholesterol.
They’ll also encourage a healthier diet and regular exercise to prevent clogged arteries, heart attack, and stroke.
Stopping smoking, reducing the use of alcohol, and keeping diabetes well-controlled also reduces damage from vascular problems.
Drugs to treat vascular dementia
There aren’t any FDA-approved drugs that treat symptoms of vascular dementia.
But certain drugs approved to treat Alzheimer’s may help to boost memory and cognitive abilities.
Life expectancy
Like other types of dementia, vascular dementia shortens life span. But catching it early and preventing further damage is the best treatment.
If the conditions that cause vascular dementia aren’t treated, the outcome isn’t good.
Vascular dementia disease progression isn’t always visible. Someone may seem fine without treatment…until another stroke takes away more brain function.
Without treatment, vascular dementia usually causes death from stroke, heart disease, or infection.
Recommended for you:
- What is Lewy Body Dementia? 5 Main Symptoms
- 8 Treatable Diseases That Mimic Dementia
- 15 Insightful Dementia Communication Tips
By DailyCaring Editorial Team
Brenda
My mother is 89, has vascular dementia and has been in a nursing home for the last 3 years. Up until about 8 mo ago, she needed no assistance walking, eating, hygiene etc. Since then things have been declining. She had a TIA almost 2 weeks ago and the doctor, who won’t even go into the home during Covid, (based on the observations and diagnosis from the nurses at the home) deemed her palliative, removed all nourishment and started initiating dilaudid and anti psycotic and anti schizophrenic drugs for end of life. It was hard for us as she is an hour and a half away from us but we kept a 24 hour vigil of alternate family members around her and had them stop these drugs and within 48 hrs she was regaining strength and mobility of her left side. The most concerning thing was that her swallowing ability worsened, but that started improving too and she was drinking thickened fluids and eating pureed food. I think she would be dead now if we had gone along with the doctors orders and now I’ve lost my trust in the nursing home’s judgement. If this is a sign of things to come, and based on the rush to judgement to give up so easily on my mom, how do we determine when it’s actually time to let go?
DailyCaring
So sorry to hear about what’s been happening with your mother. It does sound like the doctor didn’t make the best diagnosis for your mother. It might be a good idea to find another doctor who can give a better recommendation based on her actual health conditions. If possible, try to find a doctor who specializes in treating older adults or someone who specializes in treating someone with dementia.
More info here – What Does a Geriatric Doctor Do? How Seniors Can Benefit From a Specialist https://dailycaring.com/what-does-a-geriatric-doctor-do-find-out-from-experts/
Tracy Morgan
hi my mum got vascul dementia she is 78 and in and out of hospital at the mim from falling all the time they say my mam as got muiltable when I asked which dementia she got I don’t under stand it can you tell me a little about it please she seams to be getting worse every week
DailyCaring
Hopefully the article above answered some of your questions about vascular dementia. Another article that might be helpful is one that discusses the different types of dementia – 8 Forms of Dementia You Might Not Know About https://dailycaring.com/8-forms-of-dementia-you-might-not-know-about-infographic/
Joyce Persgard
My Dad is 82. He had a stroke in 2008. Lately he has been doing eractic things and brings up stuff from childhood. Could my Dad be showing symptoms of vascular dementia?
DailyCaring
It’s difficult to say what might be causing unusual behavior. The best thing to do is let his doctor know what’s been happening and ask him to do a thorough exam to find out what’s causing this.
It’s possible that he has a treatable health condition that’s causing dementia-like symptoms. Or, he could have Alzheimer’s or dementia. It may also help to evaluate his medications, vitamins, and supplements to make sure that there aren’t any negative interactions that are causing problems.
These articles may be helpful:
— 8 Treatable Diseases That Mimic Dementia https://dailycaring.com/8-treatable-diseases-that-mimic-dementia/
— 7 Treatable Health Conditions with Symptoms Similar to Dementia https://dailycaring.com/7-treatable-health-conditions-with-symptoms-similar-to-dementia/
— Medications That Worsen Dementia and Increase Dementia Risk: Anticholinergics https://dailycaring.com/medications-worsen-dementia-and-increase-dementia-risk-anticholinergics/
Carol
All types of dementia are so hard. Right now my husband is refusing to bath or shave. Any suggestions would be helpful.
DailyCaring
Dementia is such a tough disease, both for the person and for the people who care for them. Getting someone to bathe is a challenge for many families.
These articles may have helpful suggestions:
— 7 Tips to Get Someone with Alzheimer’s to Take a Bath https://dailycaring.com/7-tips-to-get-someone-with-alzheimers-to-take-a-bath/
— How Often Should Seniors Bathe? 3 Essential Health Tips https://dailycaring.com/senior-bathing-whats-really-necessary/
— 4 Ways to Get Someone with Dementia to Change Clothes https://dailycaring.com/4-ways-to-get-someone-with-dementia-to-change-clothes/
Paul Collins
Maureen has mixed dementia predominantly vascular. The fascinating thing about her condition is her reality changing within minutes. I can be her dad one minute, the manager of a Care Home the next and even her husband a few minutes later. This can be rather challenging because a slap on the face might be her reaction to a hug if I get it wrong!
DailyCaring.com
Wow, it takes a lot of creativity and fast thinking to keep up with her! Big hugs to you for all that you do 💜
Brenda Edde Moore
My mother is headed to 102 next June. She has had many TIAs and has advanced vascular dementia. We do not take her to the hospital nor call the doctor anymore due to the COVID-19 epidemic. I feel like that we might not be doing all we can, but sending her to the hospital would be a death sentence for sure and she would die alone and scared. She currently lives in her own home and is taken care of by her three daughters and a granddaughter. Mom is like a box of chocolates—you never know what you’re going to get day to day but we love her anyway.
DailyCaring
It sounds like you’re taking wonderful care of your mother.
If there are any medical concerns, you could call her doctor for advice, while letting them know that you don’t want to take her to any hospitals due to the risk of Covid-19. There may be other options that the doctor can recommend.