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Vascular dementia is the second most common type of dementia after Alzheimer's disease. Vascular dementia is a neurodegenerative disorder of the brain in which there is cognitive decline and deficiencies in mental performance that generally occur in steps. The cognitive decline of vascular dementia includes memory loss and impairment of brain function in such areas as language, intellect, judgement, behavior. Vascular dementia can eventually lead to disability and institutionalization.
Vascular dementia is due to the death (necrosis) of brain tissue because of clots that obstruct blood vessels in the brain (infarction). These clots occur due to TIA (transient ischemic attack) or stroke or a series of repeated TIAs or strokes. Vascular dementia is most common in people with these conditions and those who have risk factors for stroke. Risk factors include coronary artery disease, hypertension, atherosclerosis, peripheral vascular disease, and diabetes.
The severity and types of symptoms of vascular dementia vary depending on what area or areas of the brain are affected and how many infarcts have occurred in the brain. Other factors affecting symptoms include age, medical history, and coexisting diseases. Symptoms can include forgetfulness and other problems with memory that become progressively worse. Disorientation, poor judgement, speech difficulties, personality changes, and difficulty completing familiar tasks also occur. Physical symptoms are also common. Symptoms of vascular dementia can eventually progress to become severely disabling. For more details on symptoms and complications, refer to symptoms of vascular dementia.
There is no single specific diagnostic test that can detect vascular dementia. Making a diagnosis includes performing and evaluating a variety of tests and assessments that asses the brain and cognitive and intellectual function, and can diagnose underlying stroke. Diagnosis and treatment may require the collaboration of a variety of providers, including a primary care physician and a neurologist.
The diagnostic process begins with taking a thorough personal and family history, including symptoms, and completing a physical examination. This includes a neurological exam. A neurological exam evaluates the nerves and nervous system and such functions as reflexes, sensation, movement, balance, coordination, vision, and hearing.
Commonly used diagnostic tests include assessment tools, such as the mini-mental state examination (MMSE). The MMSE evaluates mental function by assessing the answers provided to a series of questions. Imaging tests that may be used to help diagnosis stroke or changes in the brain include CT and MRI, which provide information about the structure of the brain. A PET scan and functional MRI are imaging tests that can show how well different areas of the brain are functioning.
It is possible that a diagnosis of vascular dementia can be missed or delayed because symptoms may develop gradually and can be similar to symptoms of other diseases and conditions. In addition, it is common for people to believe that symptoms of vascular dementia are due to the normal aging process. For more information about diseases and conditions that can mimic vascular dementia, refer to misdiagnosis of vascular dementia.
Vascular dementia is not curable, and at this time there are no treatments that can slow its advancement. However, reducing the risk of stroke can help to prevent further damage to the brain. There are also interventions that can improve the quality of life for people with vascular dementia. For more information on treatment, refer to treatment of vascular dementia. ...more »
The symptoms of vascular dementia generally develop gradually and subtly in progressive steps. Sometimes there is a mild improvement of symptoms before another stroke or TIA causes further deterioration. However, symptoms and progression of vascular dementia vary depending on what area or areas of the brain are affected and how many infarcts have occurred in the brain. Other factors ...more symptoms »
Treatment of vascular dementia begins with the prevention of stroke, TIA and risk factors for developing these conditions, such as diabetes, high blood pressure, coronary artery disease, high cholesterol, and atherosclerosis. Prevention measures include not smoking, not drinking alcohol to excess, and eating a heart-healthy diet that is low in salt ...more treatments »
A diagnosis of vascular dementia may be delayed or missed because early symptoms develop gradually and are often associated with the normal aging process. In addition, symptoms of vascular dementia can mimic symptoms of a variety of diseases, disorders or conditions, such as depression, TIA, stroke, Alzheimer's disease, and delirium. These ...more misdiagnosis »
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