Vascular dementia

• Vascular dementia is caused by damage from restricted blood flow in your brain.

• Vascular dementia can happen to anyone and is difficult to diagnose because it often occurs alongside other dementias, like Alzheimer’s disease.

• There is no known cure for vascular dementia, but medication and treatment can help slow the decline. Support is available.

About vascular dementia

Vascular dementia is caused by damage from restricted blood flow in your brain. ‘Vascular’ refers to your blood vessels.

Vascular dementia affects your reasoning, planning, judgement and attention, and how you function. These changes are significant enough to interfere with your daily life.

Often, vascular dementia occurs alongside Alzheimer’s disease or other brain disease, and it can be difficult to diagnose.

There is no known cure for vascular dementia, but medication and treatment can help slow the decline. Support is available.

Causes of vascular dementia

Anyone can develop vascular dementia, but your risk of developing it increases as you get older.

You’re more likely to develop vascular dementia if you have a history of:

• high blood pressure
• high cholesterol
• diabetes
• obesity
• smoking
• physical inactivity and poor diet
• heart rhythm abnormalities
• heart disease
• blood vessel disease
• a large stroke, or multiple strokes.

Staying healthy can reduce your risk of developing vascular dementia.

Types of vascular dementia

There are three types of vascular dementia.

Strategic infarct dementia

A single large stroke can sometimes cause vascular dementia, depending on its size and location in the brain. This is known as strategic infarct dementia.

Strategic infarct dementia will cause sudden changes in your thinking skills or behaviour after the stroke. Your exact symptoms will depend on the location of the stroke in your brain.

If you have no further strokes, your symptoms may remain stable or even improve over time. However, if you have more strokes or develop other vascular diseases affecting your brain, your symptoms might get worse.

Multi-infarct dementia

Multi-infarct dementia is caused by multiple strokes. As more strokes happen, more damage is done to the brain.

You might not notice symptoms of multi-infarct dementia when the strokes first occur. But over time, your thinking and functioning will be affected. Depending on the location of the brain damage, you may also experience depression and mood swings.

After each new stroke, your symptoms will worsen and then stabilise for a while.

Subcortical vascular dementia

Subcortical vascular dementia happens when disease in your blood vessels causes damage deep in your brain. Symptoms get worse over time as more damage occurs.

Signs and symptoms of subcortical vascular dementia can include:

• behavioural changes
• trouble controlling your bladder
• reduced ability to plan, problem solve, organise and think logically
• forgetting things, or repeatedly saying the same things
• trouble walking or moving.

Diagnosing vascular dementia

Currently there is no single test to tell if a person has vascular dementia.

A medical specialist will only make a diagnosis of vascular dementia after careful assessment. This might include:

• testing your thinking and behaviour, and how they’re affecting the way you function
• blood tests
• brain imaging to find damage from strokes or blood vessel disease
• an ultrasound to check for damage in your carotid arteries
• testing your reflexes, senses, coordination and strength
• memory tests
• your detailed medical history.

Vascular dementia can be hard to tell apart from other forms of dementia because the symptoms are often similar. Some people have ‘mixed dementia’ — a combination of vascular dementia and other conditions, such as Alzheimer’s disease or Lewy body dementia.

Treatment and management of vascular dementia

There’s no single treatment or cure for vascular dementia yet.

If the dementia is stroke-related, treatment to prevent more strokes is important, as is treating any conditions affecting the health of your heart and blood vessels. This can sometimes slow the progression of vascular dementia and may prevent further decline.

Your doctors may prescribe medications to treat your high blood pressure, high cholesterol, heart disease and diabetes.

They may also prescribe medication to prevent clots from forming in your blood vessels.

Medications for treating Alzheimer’s disease may help to improve your memory, thinking and behaviour.

Exercise, a healthy diet and avoiding smoking will help reduce your risk of further strokes or vascular brain damage.

Occupational therapy can help you adapt to changes in abilities and stay independent and social.

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