Causes and Symptoms of Vascular Dementia

An Overview

Vascular dementia is a type of cognitive disorder caused by compromised cerebral blood flow, leading to the progressive death of brain cells. Like all forms of dementia, it is characterized by a progressive and irreversible deterioration of cognitive functions due to the death of brain cells. This condition can distort memory, language, judgment, thinking, behavioral abilities, and more.

Often, vascular dementia is preceded by vascular cognitive impairment, a milder disorder that can be seen as an early stage or a warning sign of the disease. The prevalence of vascular dementia has been increasing over the years, particularly among the elderly population. It is the second most common form of dementia, following Alzheimer's disease.

Causes of Vascular Dementia

Vascular dementia is primarily caused by reduced blood circulation within the brain. The conditions that can impact cerebral blood circulation include small blood vessel disease, stroke, mixed dementia, multi-infarct dementia, and atherosclerosis.

The most common predisposing factor of vascular dementia is small blood vessel disease, which leads to the narrowing or blockage of the deeper cerebral blood vessels. This obstruction hampers the oxygen supply and subsequently causes brain damage.

Other less frequent causes include stroke, mixed dementia, multi-infarct dementia, and atherosclerosis. Genetic factors and unhealthy lifestyles, such as poor diet, obesity, smoking, and uncontrolled blood pressure, are also considered significant risk factors for vascular dementia.

Symptoms and Manifestations

The symptoms of vascular dementia are similar to other forms of dementia. However, the progression of cognitive decline may vary based on the extent of ischemic damage. Symptoms depend on the specific area of the brain affected by the vascular compromise and can include cognitive/behavioral manifestations and motor disorders of varying nature and severity.

At the onset, individuals may experience difficulty concentrating, mental confusion, and loss of short-term memory. The ability to learn and acquire new information becomes challenging. Speech problems, mood instability, and personality changes may develop. Functional autonomy may be limited by agnosia (reduced ability to identify objects) and apraxia (less ability to perform previously learned motor tasks), despite the integrity of sensory and motor functions.

As the condition progresses, motor disorders and other focal neurologic deficits often develop. These can include gait abnormalities, limb weakness, hemiplegia, increased urge to urinate, or problems controlling urges. Patients may lose their sense of time and space, and the risk of falls or accidents resulting from a state of confusion increases.

In the late stages, individuals with vascular dementia are at risk of malnutrition, pneumonia, and pressure ulcers, as they cannot walk, eat, or carry out any other activities of daily living. In the terminal phase, coma and death occur, generally as complications of serious infections.

Diagnosis and Treatment

The diagnosis of vascular dementia is similar to that of other dementias and involves a series of clinical and instrumental tests, such as blood and cerebrospinal fluid tests, and neuroradiological tests with magnetic resonance imaging or computed tomography.

While it is not possible to recover from vascular dementia, its progression can be slowed down, and its symptoms can be managed. Treatment strategies include lifestyle modifications, medications for hypertension or Alzheimer's, and specific therapies for dementia.

Pharmacological treatments may include drugs against hypertension, acetylcholinesterase inhibitors, memantine, and drugs against conditions favoring vascular dementia. Cognitive rehabilitation for dementia may involve cognitive stimulation, reality orientation therapy, validation method, and behavioral therapy. Rehabilitation therapy may include physiotherapy and speech therapy.

Prognosis and Life Expectancy

In the case of vascular dementia, the prognosis is generally unfavorable. However, the various therapeutic treatments can improve symptoms and slow cognitive deterioration, allowing patients to lead a better life. On average, patients with vascular dementia live for about five years from the time of diagnosis.

In conclusion, vascular dementia is a significant health concern that requires increased attention. Understanding this condition, its causes, symptoms, diagnosis, treatment, and prognosis can aid in promoting awareness and improving the quality of life of affected individuals.

Vascular dementia is a serious condition that affects many individuals, particularly the elderly. Understanding this form of dementia, its symptoms, risk factors, and potential treatments is crucial for providing the best care for those affected. While there is no cure for vascular dementia, managing vascular risk factors and maintaining a healthy lifestyle can help slow down the progression of the disease.