Vascular dementia

Description

Vascular dementia is a general term that describes problems with reasoning, planning, judgment, memory and other thought processes, caused by brain damage from impaired blood flow to your brain.

You can develop vascular dementia after a stroke blocks an artery in the brain, but strokes don't always cause vascular dementia. If a stroke affects your thinking and reasoning depends on your stroke's severity and location. Vascular dementia can also result from other conditions that damage blood vessels and reduce circulation, depriving your brain of vital oxygen and nutrients.

Factors that increase your risk of heart disease and stroke — including diabetes, high blood pressure, high cholesterol, and smoking also increase the risk of developing vascular dementia. The control of these factors can help to reduce your chances of developing vascular dementia.

Symptoms

Vascular dementia symptoms vary, depending on the part of his brain, where the blood flow is affected. The symptoms often overlap with those of other types of dementia, especially Alzheimer's disease, dementia. But unlike Alzheimer's disease, the most significant part of the symptoms of vascular dementia tend to involve the speed of thought and problem-solving, instead of memory loss.

Vascular dementia signs and symptoms include:

  • The confusion
  • Difficulty paying attention and concentrating
  • Reduced ability to organize thoughts or actions
  • Decrease in the ability to analyze a situation, develop an effective plan and communicate the plan to others
  • Slow thinking
  • Difficulty with organization
  • Difficulty to decide what to do next
  • Problems with memory
  • Restlessness and agitation
  • Unsteady gait
  • Sudden or frequent urge to urinate or inability to control the passage of urine
  • Depression or apathy

The symptoms of Vascular dementia can be more clear when they occur suddenly of an attack of apoplexy. When the changes in your thinking and reasoning seems clearly linked to a stroke, this condition is sometimes called post-stroke dementia.

Sometimes a characteristic pattern of symptoms of vascular dementia following a series of strokes or mini attacks the brain. The changes in the thought processes occur notable steps down from its previous level of functioning, unlike the steady and gradual decrease which typically occurs in Alzheimer's disease, dementia.

But vascular dementia can also develop very slowly, such as Alzheimer's disease, dementia. What is more, vascular disease and Alzheimer's disease often occur together.

Studies show that many people with dementia and the evidence that the brain vascular disease also have Alzheimer's disease.

Causes

Vascular dementia results from conditions that damage the blood vessels of the brain, which reduces your ability to supply your brain with the amount of nutrition and oxygen it needs to perform the thought processes effectively.

Common conditions that can lead to vascular dementia are:

  • Stroke (infarction), the blockage of an artery in the brain.Strokes that block an artery in the brain often cause a variety of symptoms that may include vascular dementia. But some strokes do not cause any noticeable symptoms. These silent strokes increase the risk of developing dementia. With so much silence and apparent stroke, the risk of vascular dementia increases with the number of strokes that occur over time. A type of vascular dementia involving many strokes is called multi-infarct dementia.
  • Bleeding in the brain. Often caused by high blood pressure and weakening of a blood vessel leading to bleeding in the brain, causing damage or the accumulation of the protein in the small blood vessels that occur with the aging of weakening over time (cerebral amyloid angiopathy)
  • The narrowing or chronic damages the blood vessels of the brain. The conditions that are close or cause long term damage to the brain from the blood vessels can also lead to vascular dementia. These conditions include the wear and tear associated with aging, high blood pressure, aging, abnormal blood vessels (atherosclerosis), diabetes,

Stroke (infarction), the blockage of an artery in the brain. Strokes that block an artery in the brain often cause a variety of symptoms that may include vascular dementia. But some strokes do not cause any noticeable symptoms. These silent strokes increase the risk of developing dementia.

With so much silence and apparent stroke, the risk of vascular dementia increases with the number of strokes that occur over time. A type of vascular dementia involving many strokes is called multi-infarct dementia.

Risk factors

In general, the risk factors for vascular dementia are the same as those for heart disease and stroke. The risk factors for vascular dementia are:

  • The increase of the age. The risk of vascular dementia increases as it grows. The disorder is rare before the age of 65, and the risk increases substantially by 90.
  • History of heart attacks, strokes or mini attacks the brain. If you have had a heart attack, you may be at greater risk of having problems in the blood vessels of the brain. The brain damage that occurs with a stroke or mini-stroke (transient ischemic attack) may increase your risk of developing dementia.
  • Abnormal aging of the blood vessels (atherosclerosis). This condition occurs when deposits of cholesterol and other substances (plaque) builds up in the arteries and narrows the blood vessels. Atherosclerosis may increase the risk of vascular dementia by reducing the flow of blood that nourishes the brain.
  • High cholesterol. The elevated levels of low-density lipoprotein (LDL) cholesterol, the "bad" cholesterol, is associated with an increased risk of vascular dementia.
  • The high blood pressure. When your blood pressure is too high, it puts extra stress on the blood vessels in all parts of your body, including the brain. This increases the risk of vascular problems in the brain.
  • Diabetes. High glucose levels damage blood vessels throughout the body. The damage to the blood vessels of the brain can increase your risk of stroke and vascular dementia.
  • The habit of smoking. Smoking directly damages the blood vessels, increasing the risk of atherosclerosis and other diseases of the circulatory system, including the vascular dementia.
  • Obesity. Being overweight is a known risk factor for vascular disease in general, and therefore, probably increases the risk of vascular dementia.
  • Atrial fibrillation. In this abnormal rhythm of the heart, the upper chambers of your heart begins to beat rapidly and irregularly, in coordination with the lower chambers of the heart. Atrial fibrillation increases the risk of stroke because it causes blood clots in the heart that can break off and go to the blood vessels of the brain.

Prevention

The health of the blood vessels of the brain is closely linked to your overall heart health. Taking these steps to keep your heart healthy may also help reduce the risk of vascular dementia:

  • To maintain a healthy blood pressure. Keep the blood pressure in the normal range can help to prevent both vascular dementia and Alzheimer's disease.
  • Prevent or control diabetes. Prevent the onset of type 2 diabetes, with diet and exercise, is another possible way to reduce the risk of dementia. If you already have diabetes, check your blood glucose levels may help protect blood vessels of the brain damage.
  • Stop smoking. Smoking tobacco damages the blood vessels in all parts of your body.
  • Do physical exercises. Regular physical activity should be a key part of any wellness plan. In addition to all its other benefits, exercise can help to prevent vascular dementia.
  • Keeping your cholesterol under control. A healthy, low-fat diet and cholesterol lowering drugs if you need them, you can reduce the risk of strokes and heart attacks that could lead to vascular dementia, probably due to the reduction of the amount of plaque deposits build up inside your brain arteries.

Vascular dementia

Diagnosis

Doctors can nearly always determine that you have dementia, but there is no specific test that confirms you have vascular dementia. Your doctor will make a judgment about whether vascular dementia is the most likely cause of the symptoms based on the information that you provide, your medical history for stroke or disorders of the heart and blood vessels, and the results of the tests that can help clarify the diagnosis.

Laboratory tests

If your medical history does not include the last values of the key indicators of the health of your heart and blood vessels, your doctor will perform a scan:

  • Blood pressure
  • Cholesterol
  • Of sugar in the blood

He or she may also order tests to rule out other possible causes of memory loss and confusion, such as:

  • Thyroid disorders
  • Deficiencies of vitamins

Neurological examination

Your doctor is likely to check your overall neurological health, by the proof of your:

  • Reflections
  • Muscle tone and strength, and how the force on one side of its body compared to the other side
  • Ability to get up from a chair and walk around the room
  • The sense of touch and sight
  • Coordination
  • Balance

Images of the brain

The images of your brain can identify visible abnormalities caused by stroke, blood vessel diseases, tumors, or trauma that can cause changes in thinking and reasoning. A brain-imaging study may help your doctor to zero in on the most likely causes of your symptoms and rule out other causes.

Brain-imaging procedures your doctor may recommend to help diagnose vascular dementia are:

  • Magnetic resonance imaging (MRI).A Magnetic resonance imaging (MRI) uses radio waves and a powerful magnetic field to produce detailed images of your brain. You will lie on a narrow table that slides into a tube shapedMRImachine, which makes loud knocking noise while producing images. Mris are painless, but some people feel claustrophobic inside the machine and are disturbed by the noise.Mris are generally preferred imaging test becauseMRIs can provide even more detail than the computed tomography (CT) on the stroke, mini attacks the brain and blood vessel abnormalities and that is the test of choice for the evaluation of vascular dementia.
  • Computed tomography (CT scan).For aCTscan, you lie on a narrow table that slides into a small chamber. The X-rays pass through your body from different angles, and a computer uses this information to create detailed cross-sectional images (slices) of your brain. ACTscan can provide information about the brain structure; to know if the regions that show the contraction; and to detect evidence of a stroke, mini-stroke (transient ischemic attacks), a change in the blood vessels or of a tumor.

Magnetic resonance imaging (MRI). A Magnetic resonance imaging (MRI) uses radio waves and a powerful magnetic field to produce detailed images of your brain. You will lie on a narrow table that slides into a tube-shaped mri machine, which makes loud knocking noise while producing images.

Mri's are painless, but some people feel claustrophobic inside the machine and are disturbed by the noise. The mri s are generally preferred imaging test because of mri's can provide even more detail than the computed tomography (CT) on the stroke, mini attacks the brain and blood vessel abnormalities and that is the test of choice for the evaluation of vascular dementia.

Computed tomography (CT scan). In a ct scan, you lie on a narrow table that slides into a small chamber. The X-rays pass through your body from different angles, and a computer uses this information to create detailed cross-sectional images (slices) of your brain.

A ct scan can provide information about the brain structure; to know if the regions that show the contraction; and to detect evidence of a stroke, mini-stroke (transient ischemic attacks), a change in the blood vessels or of a tumor.

Neuropsychological tests

This type of test that assesses your ability to:

  • Speak, write and understand the language
  • Working with numbers
  • Learn and remember information
  • Develop a plan of attack and solve a problem
  • Effectively respond to hypothetical situations

Neuropsychological tests, at times, show a feature of outcomes for people with different types of dementia. People with vascular dementia can have an exceptionally difficult to analyze a problem, and the development of an effective solution.

May be less likely to have problems in the learning of new information and remember that they are people with dementia due to Alzheimer's disease, at least your problems in the blood vessels affect specific regions of the brain important for memory. However, there is often a lot of overlap in the results of the examinations for the people with vascular dementia and people who also have changes in the brain of Alzheimer's disease.

The overlap between vascular and Alzheimer's dementia

Meanwhile, emphasis is placed on distinguishing Alzheimer's dementia, vascular dementia, it turns out that there is usually substantial overlap. The majority of people diagnosed with Alzheimer's dementia have a vascular component, and in the same way the majority of people with vascular dementia have some degree of coexistence of Alzheimer's disease changes in the brain.

Treatment

Often the treatment focuses on the management of health conditions and risk factors that contribute to vascular dementia.

The control of the conditions that affect the underlying health of your heart and blood vessels can sometimes reduce the speed at which the vascular dementia gets worse, and sometimes may also prevent the decline. Depending on your particular situation, your doctor may prescribe medicines to:

  • Lower blood pressure
  • To reduce the level of cholesterol
  • To prevent the coagulation of the blood and to keep the arteries clean
  • Help control your blood sugar if you have diabetes

Self-care

Despite the fact that these have not been demonstrated to alter the course of vascular dementia, your doctor will probably recommend that you:

  • Participate in a regular physical activity
  • Healthy eating
  • Try to maintain a normal weight
  • Participate in social activities
  • Challenge your brain with games, puzzles, and new activities, such as an art class or listen to new music
  • Limit the amount of alcohol you drink

Coping and support

People with any type of dementia-and their carers — if it is vascular dementia or Alzheimer's disease — experience a mix of emotions, including confusion, the frustration, the anger, the fear, the uncertainty, the pain and the depression.

Caring for a person with dementia

  • Seek support. Many people with dementia and their families benefit from counseling or local support services. Contact your local Alzheimer's Association affiliated to connect with support groups, resources, and referrals, home care agencies, residential care facilities, a telephone help line, and educational seminars.
  • Plan for the future. While your loved one is in the early stages of the disease, talk with a lawyer about the types of documents that you will need in the future, such as the power of attorney, health care proxy and an advanced directive.
  • Give encouragement. Care partners can help a person to cope with vascular dementia for being there to listen, reassure the person that life can still be enjoyed, provide support, and doing your best to help the person to preserve the dignity and self-respect.
  • Provide a calm environment. A calm and predictable environment can help reduce the worry and agitation. Establish a daily routine that includes enjoyable activities well within the comfort zone of the person with vascular dementia.
  • Do activities together. Instead of concentrating on what is coming, try to find activities that you both like to do, such as a painting class or a long walk.
  • The respect for the independence as often as is safe. It may be a long time before your loved one has to live alone or driving. The early stages of dementia may last for years, and your loved one may still be able to do many things on your own. If you and your loved one can't agree on when it is time to stop certain activities, such as driving, ask your loved one doctor for their advice.

Caring for the caregiver or the care of the couple

The provision of health care and the support of a person with dementia is physically and emotionally demanding. The feelings of anger and guilt, frustration, and discouragement, worry, and sadness, and social isolation are common. But pay attention to their own needs and well-being is one of the most important things you can do for yourself and for the person in your care.

If you are a caregiver or care partner:

  • Learn about the disease as you can. Ask your primary care physician or a neurologist about good sources of information. Your local librarian can also help you find good resources.
  • Questions of the doctors, social workers and other professionals involved in the care of your loved one.
  • Call friends and family members for help when you need it.
  • Take a break each day.
  • Take care of your health by seeing their own doctors in programming, eat healthy foods and exercise.
  • Make time for friends, and consider joining a support group.

Preparing for your appointment

If you have had a stroke, the first conversations about their symptoms and the recovery is likely to take place in the hospital. If you are noticing symptoms more mild, you may decide that you want to talk with your doctor about any changes in their thought processes, or you may seek care in the requirement of a family member who is in charge of booking your appointment and will be going with you.

You can start by seeing your primary care physician, but he or she is likely to refer you to a doctor who specializes in disorders of the brain and nervous system (neurologist).

Because appointments can be brief, and there is often a lot of ground to cover, it is a good idea to be well-prepared for your appointment. Here's some information to help you to be prepared and know what to expect from your doctor.

What you can do

  • Be aware of any pre-appointment restrictions. When you make your appointment, ask if you need to fast for blood tests or if you need to do anything to prepare for the diagnostic tests.
  • Write down all of your symptoms. Your doctor will want to know the details of what is the cause of your concerns about your memory or mental function. Make notes about some of the most important examples of lack of memory, lack of judgment or other lapses you want to mention. Try to remember when he began to suspect that something might be wrong. If you think that your difficulties are getting worse, be ready to describe them.
  • Take along a family member or a friend, if possible. The corroboration of a relative or a trusted friend can play a key role in the confirmation that their difficulties are obvious to others. To have someone along can also help you to remember all information provided during your appointment.
  • Make a list of your other medical conditions. Your doctor will want to know if you are being treated for diabetes, high blood pressure, heart disease, past strokes or any other condition.
  • Make a list of all your medications, including over the counter medications and vitamins or supplements.

Write a list of questions ahead of time can help you remember your most important concerns and make the most of your appointment. If you are seeing your doctor with regard to the concerns about vascular dementia, some questions are:

  • Do you think I have memory problems?
  • Do you think that my symptoms are due to circulation problems in my brain?
  • What tests do I need?
  • If I have vascular dementia, will you or another doctor to deal with my ongoing care? Can you help Me to get a plan of work with all of my doctors?
  • What treatments are available?
  • Is there anything I can do that might help slow the progression of dementia?
  • There are clinical trials of experimental treatments that I have to take into account?
  • What should I expect to happen in the long term? What steps should I take to prepare?
  • My symptoms affect how I manage my other health conditions?
  • Do you have any brochures or other printed material that I can take my house? What web sites and support resources do you recommend?

In addition to the questions that you have prepared ahead of time, do not hesitate to ask your doctor to clarify any part you do not understand.

What to expect from your doctor

Your doctor is also likely to have questions for you. Be prepared to answer them you can free up time to focus on the points that I want to talk in-depth. Your doctor may ask:

  • What types of problems with thinking and mental lapses is it about? When did you first notice them?
  • They are constantly getting worse, or are they sometimes better and sometimes worse? They have suddenly gotten worse?
  • Has someone close to you expressed concern about their thinking and reasoning?
  • Have just started having problems with no long-standing activities or hobbies?
  • Do you feel sadder or more anxious than usual?
  • You've lost lately in a driving route, or in a situation that is often familiar to you?
  • Have you noticed changes in the way you react to people or events?
  • Do you have any change in your energy level?
  • He is currently being treated for high blood pressure, high cholesterol, diabetes, heart disease or a stroke? Has been treated by some of these in the past?
  • What medications, vitamins or supplements that you are taking?
  • Do you drink alcohol or smoke? How much?
  • Have you noticed any shaking or difficulty walking?
  • Do you have any difficulty remembering appointments or when to take your medications?
  • You have had your vision and hearing tested recently?
  • Does anyone else in your family have problems with thinking or remembering things as I was growing up? Was once someone is diagnosed with Alzheimer's disease or dementia?
Symptoms and treatment of Vascular dementia