Vascular dementia (vascular dementia) is a form of dementia that is directly related to pathologies affecting the blood supply to the central nervous system. Symptoms of vascular dementia are not specific. So how do you know if a patient is suffering from vascular dementia, and - perhaps most importantly - is there any way to prevent it?

Vascular dementia( vascular dementia ) can be caused by a stroke, but also by multiple ischemia of only minor brain areas. Symptoms of vascular dementia may resemble those of Alzheimer's, but these entities differ in some features.

Alzheimer's disease is considered to be the most common form of dementia. However, it is not only this unit that can cause memory disorders and other problems related to dementia, which unfortunately occur quite often in seniors.

The second most common form of dementia is vascular dementia. It is estimated that it accounts for up to 15% of all cases of dementia that occur in elderly patients.

Vascular dementia: causes

The main causes of vascular dementia are disturbances in the blood supply to the structures of the central nervous system. They can actually have various backgrounds.

The condition most associated with vascular dementia is stroke - this type of dementia can be caused by both ischemic stroke and hemorrhagic stroke. When dementia is associated with a stroke, its symptoms appear fairly shortly after the stroke occurs.

The situation is different in the case of one of the forms of vascular dementia, which ismulti-infarct dementia . It is said about it when dementia disorders appear after the patient has had multiple, minor degree of cerebral ischemia.

Experiencing individual of them may not even cause any discomfort. Eventually, however, as a result of the many minor strokes, the patient may develop an accumulation of differentdamage between important brain structures, causing symptoms of vascular dementia.

The above listed common causes of vascular dementia, however, may also be caused by other types of pathology.

We can mention here, for example, diseases in which the developing inflammation, leading to damage to blood vessels, may also result in the development of dementia - such entities are, among others, polyarteritis nodosa and moya-moy disease.

It also happens that vascular dementia is genetically determined in some way. Here, as an example of a disease in which the above-mentioned problem may occur, we can mention the CADASIL team.

Vascular dementia: risk factors

Vascular dementia occurs due to various abnormalities in the cerebral blood circulation - risk factors that favor the occurrence of such phenomena include:

  • age (the older the patient is, the greater the risk of developing vascular dementia; it is estimated that this risk doubles every 5 years from the age of 65)
  • male gender
  • hypertension
  • diabetes
  • hypercholesterolemia
  • heart rhythm disturbances (especially in the form of atrial fibrillation)
  • having had a stroke in the past

Vascular dementia: symptoms

As in the case of Alzheimer's disease, various types of memory disorders may occur in patients with vascular dementia.

These diseases, as already mentioned at the very beginning, differ in some features. Well, just as in Alzheimer's disease, memory disorders dominate in patients, and in the case of vascular dementia, slightly different ailments may come to the fore.

Symptoms of vascular dementia can be:

  • affective symptoms (mood disorders), such as e.g. irritability, significant depressed mood or mood swings, may also appear in patients with apathy
  • personality disorders (e.g. the patient may suddenly become extremely explosive or show a tendency to aggressive behavior)
  • executive dysfunction (a patient with vascular dementia may have difficulty making various decisions, but may also suddenly find it difficult to perform even relatively simple tasks, such as eating meals, brushing her hair or getting dressed)
  • slow downthinking
  • difficulty speaking
  • concentration disorders

Various neurological dysfunctions are also characteristic of vascular dementias. They appear due to ischemia-induced damage to the central nervous system and can include:

  • paresis
  • ataxia
  • swallowing disorders
  • gait disturbance

Different patients with vascular dementia may have different neurological abnormalities - the type of abnormality depends on which parts of the brain will be damaged.

As the symptoms of vascular dementia vary, the course of this type of dementia also varies. In the case of a large-scale stroke, the symptoms may appear suddenly in a very short time after the onset of the disease.

And then, when dementia is caused by multiple brain injuries that occur over time, a very gradual increase in symptoms is possible - initially the patient may have only a slight degree of dementia symptoms, which will not intensify for a long time, until after some time it may lead to - with the appearance of subsequent ischemic changes - a marked deterioration of its condition.

Vascular dementia: diagnosis

In the diagnosis of vascular dementia, the most important thing is to identify the patient's symptoms of dementia and damage to the nervous system caused by vascular pathology.

It is also important to find a clear temporal relationship between the occurrence of both problems.

Unfortunately, it is a fact that a reliable diagnosis of vascular dementia is only possible through a neuropathological examination.

Generally, in the diagnosis of vascular dementia, neuropsychological tests are used (in which it is possible to identify cognitive disorders characteristic of this individual), as well as imaging tests (such as computed tomography or magnetic resonance imaging of the head - they enable the detection of, among others, ischemic changes in the nervous system).

Tests that are typically carried out in the diagnosis of dementia - such as the MMSE test or the clock drawing test - are less important in the diagnosis of vascular dementia than in Alzheimer's disease, but it is worth doing in patients nevertheless.

It happens that in one patient vascular dementia coexists with Alzheimer's disease - recognizing such a problem is very important because it mayinfluence the choice of therapy implemented in the patient.

Vascular dementia: treatment

In fact, there are no treatments that could reverse ischemic changes in people with vascular dementia, and thus help to resolve dementia symptoms - these changes are irreversible.

Basically, patients may be offered two types of interactions, which are the prevention of subsequent ischemic changes and the use of drugs reducing the level of already present cognitive disorders.

In the case of the former, the management depends on the patient's risk factors for stroke. If, for example, he suffers from atrial fibrillation, he may need anticoagulant treatment.

Certain difficulties arise in the case of attempts to control cognitive dysfunctions in patients with this form of dementia.

In the treatment of vascular dementia, agents such as in the case of Alzheimer's disease (such as, for example, cholinesterase inhibitors) are sometimes used, but the data on their effectiveness are often divergent and, as some authors suggest, that these preparations may have a beneficial effect on the condition of patients with vascular dementia, others have already reported that these measures are simply ineffective in this type of dementia.

Vascular dementia: prevention

The prevention of vascular dementia is based primarily on reducing the risk factors for ischemia of the central nervous system.

We simply cannot influence certain risk factors - such as age, gender or inherited genes, but others can definitely be influenced.

Conditions have previously been mentioned that exacerbate the possibility of this problem occurring. In patients who suffer from hypertension, diabetes or hypercholesterolaemia, proper treatment of these diseases is the most important factor in the prevention of vascular dementia.

It is also important to simply lead a he althy lifestyle. A varied diet with limited simple carbohydrates and saturated fats is recommended, regular physical activity can also reduce the risk of vascular dementia - leading a he althy lifestyle significantly reduces the risk of vascular dementia.

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. At work with patientsfocusing on always listening to them and spending as much time as they need.

Category:

Psychiatry