Vascular Dementia

Vascular dementia is the second most common type of dementia after Alzheimer’s and affects 150,000 people in the UK. Many people have both vascular dementia and Alzheimer’s disease.

Slowness of thought, difficulty with planning, language problems, poor concentration and mood or behaviour changes may all be signs of vascular dementia. It mainly affects people over 65.

Causes

Vascular dementia occurs when the blood supply to the brain is reduced, which damages and eventually kills brain cells, affecting memory. This reduction of blood flow can have several causes.

In some cases, blood vessels inside the brain narrow - a condition known as subcorticol vascular dementia.

When a stroke occurs, a blood clot suddenly cuts the blood supply to the brain resulting in post-stroke dementia. Lots of tiny blood clots (transient ischaemic attacks) TIAs – also known as mini-strokes – can prevent oxygen reaching brain tissue. This is called multi-infarct dementia.

Symptoms

It can be hard to spot early signs, but if picked up quickly then treatment for the underlying causes can be more effective.

Early symptoms include a slow thought pattern, trouble with language, changes in behaviour and mood, problems with attention span and concentration and finding it difficult to plan things. This early stage is called vascular cognitive impairment and can often be mistaken for depression. As damage to the brain continues, symptoms worsen in sudden stages, often with periods of stability in between lasting months or years.

The signs of advanced vascular dementia will depend on the area of the brain which is damaged. Common signs include: very slow thought processes; confusion and disorientation; memory loss and poor concentration; severe personality changes; language difficulties; mood swings, depression and feeling lethargic; problems with walking and balance; incontinence and hallucinations.

Diagnosis

Getting a diagnosis is important as it ensures you get the right treatment and support. If you suffer from the symptoms listed above, it is imperative you visit your GP, who will likely refer you to a memory clinic or specialist for assessments and tests. These tests include an assessment of your symptoms and your mental ability. Blood tests are done to exclude other causes, such as vitamin B12 deficiency.

You may also be referred for a CT scan which can identify signs of a stroke or TIAs, or for an MRI scan to examine your brain in detail.

Who gets it?

Vascular dementia affects older people and is rare in those under 65. It’s slightly more common in men than women. A family history of stroke, heart disease or diabetes increases your risk of developing it; in fact, if you experience any of these, you’re twice as likely to develop vascular dementia as these conditions can damage blood vessels in your brain or cause blood clots.

Other factors that increase your risk of vascular dementia include high blood pressure, smoking, being overweight, high cholesterol, poor diet, poorly-controlled diabetes, lack of exercise, irregular heartbeat and excessive alcohol use. There's also some evidence that a history of depression may increase your chances of developing dementia.

Treatments

There's currently no cure for vascular dementia so the focus is instead on treating the underlying causes, such as a high blood pressure and raised cholesterol.

Making healthy lifestyle changes can help to prevent more damage to your brain cells. Losing weight if you’re overweight, stopping smoking, drinking less alcohol and regular exercise can all help.

Recent studies show the MIND diet (Mediterranean intervention for neurodegenerative delay) can help improve brain health. It involves eating a Mediterranean style diet, which includes plenty of antioxidant-rich fruit and vegetables, fish, whole grains, olive oil and nuts, and is low in red meat, saturated fats, sugary carbohydrates and fried foods.

You may also be prescribed the following: blood pressure tablets; statins to treat high cholesterol; aspirin or clopidogrel to reduce risk of clots or strokes; warfarin to thin the blood; or diabetes medication (metformin).

Many studies have examined the benefits of taking omega 3 fatty acids (found in oily fish), for brain health and memory function, with some evidence that taking omega 3 supplements in the early stages of dementia may improve symptoms.

Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn’t possible supplements can help. This article isn’t intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.

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