What Is Vascular Dementia?
Vascular dementia is a common type of neurodegenerative condition that falls within the broader category of dementia, a group that also includes Alzheimer’s disease, Lewy Body Dementia, and Frontotemporal Dementia.
Vascular dementia integrates both the nervous and cardiovascular systems resulting in brain damage [1, 2].
The cause of Vascular dementia includes a variety of changes in the brain resulting in the loss of brain cells. Vascular dementia can be a result of a transient ischaemic attack or stroke.
The risk factors for vascular dementia include increasing age, low education, female sex and vascular risk factors (this includes smoking, hypertension, diabetes, obesity, and family history of vascular or heart diseases) [3, 4].
In addition, reduced cerebral blood flow and vascular dysfunction are linked to vascular dementia [5, 6]. Interestingly, higher blood pressure in mid-life has been linked to a higher chance of having vascular dementia later in life [7].
Vascular Dementia Symptoms
Vascular dementia can vary in the observed symptoms and the symptoms are dependent on the involved region of the brain. However, some common symptoms are [2, 7, 8]:
- Aphasia - The patient has problems with using the language and is often quieter than usual. Additionally, the patient can't use the right words in a sentence.
- Apraxia - The patient may experience motor control problems, especially with performing skilled movements. This is a common symptom observed also in Corticobasal Degeneration.
- Memory Loss - The patient experiences severe memory problems.
- Cognitive Impairment - The patient experiences attention and concentration problems.
What are The 7 Stages of Vascular Dementia?
Vascular dementia is a progressive neurodegenerative disease. The early stages such as mild forgetfulness of the disease vary drastically from the final stages which result in an individual being dependent on a carer. Let’s understand the stages of vascular dementia:
Stages of Vascular Dementia
Stage 1: Normal Behaviour
In the first stage of vascular dementia, we do not observe any symptoms which might signal the disease. However, the pathology causing the disease onset is slowly building up in the brain.
Stage 2: Very Mild Cognitive Impairment
The first symptom “forgetfulness” is appearing. The patient is forgetting for instance where they placed objects. However, mild cognitive decline can be seen in ageing individuals as well without having vascular dementia.
Stage 3: Mild Cognitive Decline
As the pathology is building up, the cognitive decline might become more visible. The patient’s memory is declining and the symptoms are similar to general mild dementia symptoms. In addition to memory loss and forgetting where they placed objects, they might start having problems with forgetting recent events and appointments as well.
Stage 4: Moderate Cognitive Decline
In this stage, we observe symptoms of moderately severe dementia. The patient is starting to have problems with money. In particular, we observe problems with paying bills.
Stage 5: Severe Cognitive Decline
In this stage, the patients are starting to lose the ability to live independently. Their daily living activities become hard to manage on their own. The patients have problems with dressing up and remembering names, dates and addresses.
Stage 6: Incontinence and Swallowing Problems
In this stage, the patient starts having problems with incontinence and swallowing. It is important to adjust the diet to it and choose meals which have a liquid texture so that swallowing becomes easier for the patient. Additionally, in later stages, the patient requires 24-hour care.
Stage 7: Late Stage: The End-stage of Vascular Dementia
This is the final stage of the disease. The patient loses the ability to communicate their needs and is in late-stage dementia. The crucial part of this stage is to preserve the quality and comfort of life for the patient until the final days.
Treatment for Vascular Dementia
Currently, there is no treatment for vascular dementia. The recommended strategy to treat vascular dementia is to reduce the risk factors. This includes reducing blood pressure, increasing physical activity and reducing fat and alcohol intake. Additionally, some drugs are being used to help with the symptoms [10].
Pharmacological Treatment
From the available drugs recommended for dementia treatment, Memantine has been shown to be effective in improving the function of the patients and reducing their dependency on carers. Further cholinesterase inhibitors, Galantamine, Rivastigmine and Donepezil also showed benefits in elevating some of the symptoms of vascular dementia [9,10].
Importantly, researchers are trying to find more drugs for these patients to improve their lives. Currently, some of the possible drugs are in phases II and III for vascular dementia [9,10].