Vascular dementia (VaD), more formally known as vascular cognitive impairment or vascular neurocognitive disorder, is another condition describing impairment with reasoning, judgment, memory, planning and other problems with the process of thinking. It is caused by an interruption in blood flow to the brain. This may happen after a stroke that has blocked or narrowed blood supply carrying oxygen and nutrients to the brain. When this happens, the cells are injured in the area of attack. It is important to note that not all strokes cause dementia.
The old term for a stroke was “multi-infarct dementia” and an older term was “hardening of the arteries”. There is evidence that shows that a person can have VaD without blowouts caused by major strokes. In the beginning, tiny blood vessels that are damaged can sometimes be undetected by brain imaging, until there are multiple tiny strokes that are damaged in one area.
Multiple strokes or mini strokes, known as transient ischemic attack (TIA), increases risk to developing VaD. TIAs are temporary blockage of blood supply to a brain part causing sudden symptoms like a stroke that can typically resolve in 20 minutes to three days. Symptoms may include drooling, slurred speech, difficulty in talking, one side of the body weaker, sleeping and seizure-like behaviour. It is also believed that mini strokes may lead to a major stroke.
After repeated damage to small blood vessels in the brain, symptoms of VaD can be that the person doesn’t pay attention to functioning the left side of their body. You can tell the person to stand up straight, they will respond “I am,” while leaning to the left. They also tend to drag their left foot and stumble. Or, you can give them a plate of food and they will eat only food on the right side and ask for more food. If you turn the plate around, they will then be able to see the food.
Unlike Alzheimer’s with an average lifespan from 8 to 12 years, VaD has a life span of 3 to 30 years. Depending on how many stokes or TIAs, a person’s decline is based on where the blood flow interruption is. A person can have a few in a row, level out for a while and then have a blowout type of stroke and a bigger decline will occur. Each person with VaD is unique. While Alzheimer’s affects more women than men, VaD affects more men. There is no cure. However, it is highly encouraged to reduce risk factors such as getting your blood pressure under control or managing your diabetes. If you smoke, then quit; keep stress at a minimum and exercise.
VaD is the second largest dementia type globally. In some countries, such as Cuba and Japan, the rate is higher than Alzheimer’s.
Questions about dementia
Q: Can a person have both Vascular and Alzheimer dementia? If so what is the difference?
A: Yes, a person can have both and it is known as mixed dementia.
Alzheimer’s: First symptoms always involve memory struggles. It’s a neurodegenerative disease with a slow progressive decline, gradually affecting word search, vision, motor skills, thinking and processing of information received,
leading to the inability to communicate. It eventually affects breathing and heart regulation.
Vascular dementia: First symptoms are usually a language struggle, emotional irregularity and depression. It is acondition caused by interruption of blood flow in the brain. The rate of decline depends on the damage to tiny blood vessels.
Mixed Dementia: First symptoms can vary depending on what came first. The progression of Alzheimer’s can be accelerated by vascular pathology or be slowed down by its prevention according to UCLA Health. What you may see is a gradual decline with steps in-between.
-By Regina Posvar
Regina Posvar is president of the Saint Lucia Alzheimer’s and Dementia Association and has been a licensed nurse for 25 years. SLADA is supported by volunteers and donations and aims to bring awareness and support by providing awareness public workshops, family support, memory screenings, the Memory Café, counselling and family training for coping skills and communication with persons living with dementia.