Vascular Dementia (VD)

 

VASCULAR DEMENTIA BASICS

WHAT IS VASCULAR DEMENTIA?

Vascular dementia is the subtle progressive worsening of memory and other cognitive functions that can be attributed to vascular disease within the brain. In people with this condition, symptoms of dementia, such as memory loss and difficulty with thinking, language, and problem solving, occur due to brain damage caused by blood supply problems in the brain. The problems could be a block or lack of blood flow to the brain. Reduced blood flow in turn, deprives the brain of oxygen. Together, it can cause brain damage, even in a short period of time.
 
Also known as vascular cognitive impairment, the condition accounts for an estimated 10% of dementia cases, although, many experts believe that it is underdiagnosed. As with dementia in general, people above the age of 65 are at a higher risk of being diagnosed.

Vascular dementia is caused by reduced blood flow to the brain, which damages and eventually kills brain cells. This can happen due to a number of reasons such as the narrowing of small blood vessels deep inside the brain, aneurism, a stroke, or several mini-strokes. Sometimes, the damage could also be due to Alzheimer’s. In such cases, it is known as mixed dementia. 

Vascular Dementia - Ischemic Stroke Vascular Dementia - Hemorrhagic Stroke
Within the realm of vascular dementia itself, there are several different types identified. Two of the most common are Multi-infarct dementia and Binswanger’s disease. Below is a brief overview on both:
 

Multi-infarct Dementia

Thought to be the most common form of vascular dementia, this is caused by a number of strokes. The symptoms tend to develop progressively over a period of time. When the strokes cause damage to the area of the brain associated with learning, memory, and language, it leads to the corresponding symptoms of dementia. Other symptoms can include depression, mood swings, and epilepsy. Unlike Alzheimer’s, patients with this condition are more likely to retain their insight and personality intact for a longer period before worsening.
 

Binswanger’s Disease

Binswanger’s Disease, also known as subcortical vascular dementia, was thought to be a rare type. However, recently experts are reassessing and suspect that it may in fact be one of the more common types around. This condition is also related to stroke related changes, but in this case, it is the white matter deep within the brain that is affected. Causes include high blood pressure, thickening of the arteries, and a lack of blood flow. Symptoms for this condition includes lethargy and slowness, difficulty with movements, mood swings, and lack of bladder control, all of which appear early in the course of the disease.

VASCULAR DEMENTIA VS. ALZHEIMER'S

To the average person, Vascular Dementia and Alzheimer's often seem like the same thing. Sometimes, the two terms are even used interchangeably. However, although the two are somewhat related, each condition has its own distinct differences.

Both Vascular Dementia and Alzheimer's are types of dementia. Alzheimer's is much more common then VD and symptoms of the diseases vary significantly. While Alzheimer's typically affects in the late stages of life (65+), Vascular Dementia can start to show symptoms at an earlier age and are typically prompted abruptly by a stroke in the brian. 

Typically, the first symptoms of Alzheimer's are memory loss, whereas early Vascular Dementia symptoms are primarily loss of motor function, slurred speech, and impairment in executive function. 

To compare types of dementia's - visit our Compare Diagnosis Page or visit these diagnosis specific pages:

 
VASCULAR DEMENTIA VS. OTHER TYPES OF DEMENTIA

Obtaining a clear diagnosis for dementia is extremely difficult for physicians.

Misdiagnosis and undiagnosed is common in dementia because while brain imaging, blood testing, and comprehensive tests can help in the diagnosis, it is still not a perfect science. Physicians rely on the tests as well as the progressing deterioration and occurrence of different symptoms to make as best of a diagnosis and treatment plan as possible. 

While there are many types of dementia, the four largest subset of dementias are Alzheimer's (estimated at 60%-80% of the cases), Fronto-temporal Lobe Dementia (estimated at 5-10% of cases), Lewy Body Dementia (estimated at 5-10% of cases), and Vascular Dementia (estimated at 10-20% of cases). Mixed dementia - or having multiple types of dementia (example: Alzheimers and Fronto-temporal Lobe) is also common in dementia patients, making it even more complex to diagnose and treat. 

Vascular Dementia specifically compared to other symptoms shows itself primarily with slowness in thought, changes to the persons gait, and trouble with language.  Memory loss is most prevalent in the early stages of Alzheimer's and in Lewy Body Dementia, drastic fluctuations in mood or behaviors, vivid hallucinations and motor difficulties similar to parkinsonism.  By comparison, behavioral issues such as depression, compulsiveness and apathy are more prominent in the earlier stages of Fronto-temporal Dementia (FTD).

Towards the middle and later stages, patients with Vascular Dementia show pronounced loss of physical capabilities such as urinary disturbances, speech difficulties and slowness in thought.  In contrast, Alzheimer's and FTD patients tend to suffer from wandering, progressed memory loss, and issues with word finding and word association. Patients with LBD show progressed behavioral and emotional disturbances such as sleep disorders, vivid hallucinations and severe paranoia. 

Being informed about the other types of dementias and symptoms experienced by those who have it, assists in the diagnosing and treating of the disease. It is extremely important to take note of the progressive changes of symptoms as this will enable the physician to make customized treatment and medication plans to counter the symptoms of the disease. 

This chart compares the symptoms of the different types of diseases to show what types of symptoms are more or less in the various diseases. 

Comparing Different Types of Dementia

Comparing Different Types of Dementia

For more information on comparing the different types of dementia's - visit our Compare Diagnosis Page or visit these diagnosis specific pages:

 
SYMPTOMS & STAGES OF VASCULAR DEMENTIA

Symptoms of Vascular Dementia can often overlap with symptoms of Alzheimer’s, but is largely dependent on the location of impaired blood flow within the brain. It is easiest to identify the symptoms when it occurs after a stroke. In cases where the patient suffers multiple strokes or mini strokes, the progression of the symptoms tend to be more stepwise, abrupt and noticeable rather than the steady decline you find in other cases of dementia. As is the case with all types of dementia, the progress of vascular dementia on each individual is different. However, it only worsens over time. The many signs of vascular dementia can be divided into three categories: mental & emotional, physical, and behavioral.

Stage 1: Behavioral Deterioration

Unlike Alzheimer’s, the early symptoms of vascular dementia do not start with memory problems. Instead it involves a set of behavioral deterioration. This involves difficulties with planning or organizing, following instructions/steps, decision making, concentration. It can also include some mental and emotional deterioration such as slowness of thought and short periods of confusion.
 

Stage 2: Early Stages

During the early stages of progression, the person’s mental and emotional aspects tend to get further affected. They are very likely to suffer from apathy, mood swings, and even be unusually emotional. Anxiety and depression is also not uncommon. This is mainly due to the fact that they tend to be aware of the problems caused by their dementia. There are also several physical symptoms during this stage. They include weak limbs, problems with speech and vision, tremors, and other unsteady physical movements.

 

Stage 3: Middle Stages

As the progression of vascular dementia tends to be more step-wise rather than a steady decline, a person can reach this stage quite abruptly. Usually, the aggravation happens due to additional strokes and affects more areas of the brain. At this stage, the symptoms will grow to include severe confusion or disorientation, more problems with communication and reasoning. Memory loss will become quite bad. Behavior wise, the patient tends to become more irritable, agitated, and even aggressive due to the confusion. Disturbed sleep is also quite common at this stage. In some people, early signs of hallucinations and delusions can also develop. Due to all this, the person is likely to need support with daily activities like cooking or cleaning.

Stage 4: Late Stages

In the final stage of vascular dementia, a person suffering from it is aware of very little of what is happening around them. They will have difficulties eating and walking without help and become extremely frail. Severe memory problems and loss of speech control will also develop. At this stage, the symptoms will be almost identical to that of Alzheimer’s and patients will require full time assistance as they will not be able to care for their selves anymore.

This infographic summarizes symptoms experienced at general progressions of Vascular Dementia. Symptoms in bold are more common in VD than in other types of dementia:

Vascular Dementia Stages
CAUSES, DIAGNOSIS, TREATMENTS

Vascular Dementia Guide


For more detailed information about Vascular Dementia including it's causes, how to detect and diagnose the disease, treatments, care options, and important resources for families caring for a loved one, check out our Vascular Dementia Guide at this link

 

 

CAREGIVER TOOLS

VASCULAR DEMENTIA CARE TIPS

Care Tips on dealing with every aspect of Vascular Dementia (VD) care including how to keep your loved one safe, how to choose the right care home or tips on how to keep them at home and independent as long as possible.

Alzheimer's Disease Care Tips
  • Causes of VD
  • Detection & Diagnosis of VD
  • Prevention of VD
  • Research of VD
  • Symptoms of VD
  • Treatments for VD
  • ASSISTIVE CLOTHING FOR VASCULAR DEMENTIA

    If your loved one suffers from Vascular Dementia and has trouble dressing, transitioning to using diapers, or undresses themselves, our Bear Hug Onesie is a game changer for them.

    It zips in the back to relieve the caregiver burden while also respecting the persons dignity. For more information - click below to see details on the onesie:

    CARE ARRANGEMENTS

    Care Arrangements for Vascular Dementia

    In terms of care arrangements for VaD patients, there are generally two types of options that the patient’s friends and family can opt for: in-home care or out-home care

    During the initial stages, while the patient is still able to function independently, most people may prefer to remain at home, where they are most familiar with their surroundings.

    After initial diagnosis, the primary caregiver may still be able to handle the tasks of looking after the patient. But as the symptoms progress to the early and middle stages, they can opt for in-home care arrangements. There are several types available in this category:

    • Companion services – to help with supervision and recreational activities.
    • Personal carers – to help with various personal care tasks such as bathing, dressing, eating, and exercising.
    • Homemaker services – to help with housekeeping, cooking, or shopping.
    • Medical carers – to help with medical needs, physical, and/or mental therapies

    Another option for patients who are still able to function relatively independently, is Adult Day Care Centers. These facilities provide a safe environment for dementia patients to pursue activities, interests, and socially interact with people. This type of care arrangement can give the patients a sense of freedom while dealing with their diagnosis. They are also likely to have counselling, health services, meal services, personal care, behavior management, therapy, and other related services available.

    During the last stages of dementia, when the patient is unable to fend for themselves, the best choice often will be residential care in the form of Personal Care HomesAssisted LivingNursing Homes with special care or memory units. There, they can receive specialized care and treatment to ease their situation. Each of these facilities will offer different levels of care. Selecting one will depend on the patient’s needs and progression of Vascular Dementia. Read our detailed guides on each one to assess which may be the best fit for you or your loved one.

    Hospice Care and Geriatric Psychiatric Facilities are two lesser talked about short-term arrangements for patients with dementia. These systems assist with end of life comfort measures (hospice) and medication rebalancing (Geriatric Psychiatric Unit), both of which are crucial to maintaining the patient’s dignity and safety for them and their caregivers.

    Hospice Care services are available with any care arrangement and are attached to the patient wherever they go as long as the organization providing the services is able to provide services.

    Geriatric Psychiatric Facilities are meant to be a resource for when a patient is experiencing severe behavioral changes that need to be adjusted for with medication in order to ensure the patients, and his/her caregivers safety.

     For more information on the differences, how to find a care facility and on commonly experienced issues with each care arrangement, visit the following pages:

    • Care at Home
    • Adult Day Care
    • Assisted Living
    • Nursing Home
    SUPPORT & RESOURCES
    For family members and friends who would like to educate themselves further on the details of vascular dementia, its symptoms, treatments, and challenges, you should seek the assistance of local or national Dementia or Alzheimer’s Association.

    Alzheimer’s Association
    1-800-272-3900 (toll-free) 
    1-866-403-3073 (TTY/toll-free) 
    info@alz.org
    www.alz.org
     
    Alzheimer’s Foundation of America
    1-866-232-8484 (toll-free) 
    info@alzfdn.org
    www.alzfdn.org


    Other websites to obtain more information on vascular dementia:

     

    VASCULAR DEMENTIA RESEARCH

    VASCULAR DEMENTIA IN THE NEWS

    Click the following links for News Articles on Vascular Dementia (VD)

    In the News: Lewy Body Dementia
    FINDING A PHYSICIAN

    For a list of providers close to your area, follow this link.

    CLINICAL TRIALS

    As is the case in almost any facet of the medical field, there is constant research and development being done with regards to vascular dementia. The following is a list of types of clinical trials that are being done:

    • Treatment trials—to find more effective blood thinners, anticoagulants, and any drug that can reduce the risk of blood clots and strokes.
    • Diagnostic studies—to find new tests and methods to diagnose vascular dementia earlier and more accurately.
    • Prevention trials—to explore various means of preventing the formation of blood clots and resulting strokes.
    • Quality of life studies—to explore ways to improve the quality of life for patients and caregivers at different stages of the illness’s progression.
    .