Q. My mom was recently diagnosed with vascular dementia. How is that different from Alzheimer's? My mom was recently diagnosed with vascular dementia. How is that different from Alzheimer's?
Dan, La Cañada
Vascular dementia is widely considered the second-most-common type of dementia. It develops when impaired blood flow to parts of the brain deprives cells of food and oxygen.
The diagnosis may be clearest when symptoms appear soon after a single major stroke blocks a large blood vessel and disrupts the blood supply to a significant portion of the brain. This situation is sometimes called “post-stroke dementia.”
There is also a form in which a series of very small strokes, or infarcts, block small blood vessels. Individually, these strokes do not cause major symptoms, but over time their combined effect becomes noticeable. This type is referred to as vascular cognitive impairment, or multi-infarct dementia.
Symptoms of vascular dementia can vary, depending on the specific brain areas deprived of blood. Impairment may occur in steps, where there is a fairly sudden, noticeable change in function, rather than the slow, steady decline usually seen in Alzheimer's disease.
The person may have a past history of heart attacks. High blood pressure, high cholesterol, hardening of the arteries, diabetes, or other risk factors for heart disease are often present.
Symptoms of vascular dementia may or may not mimic those of Alzheimer's and include:
•?Memory problems may or may not be prominent, depending on whether brain regions important in memory are affected.
•?Confusion, which may get worse at night.
•?Difficulty concentrating, planning, communicating and following instructions.
•?Reduced ability to carry out daily activities.
•?Physical symptoms associated with strokes, such as sudden weakness, difficulty speaking or confusion.
Magnetic resonance imaging of the brain may show characteristic abnormalities associated with vascular damage.
Because vascular dementia is closely tied to diseases of the heart and blood vessels, many experts consider it the most potentially treatable form.
Monitoring of blood pressure, weight, blood sugar and cholesterol should begin early in life. Managing these risk factors, avoiding smoking and excess alcohol, and treating underlying diseases of the heart and blood vessels could play a major role in preventing later cognitive decline for many individuals. In some cases, active management of these factors in older adults who develop vascular dementia may help symptoms from getting worse.
Once vascular dementia develops, there are no drugs currently approved by the U.S. Food and Drug Administration to treat it.
Most of the drugs used to treat cognitive symptoms of Alzheimer's disease have also been shown to help individuals with vascular dementia to about the same extent they help those with Alzheimer's. There are associated risks with these medications which you will want to be sure the doctor fully explains.
Get in touch ? NANCY TURNEY received a bachelor's degree in social work and a certificate in gerontology. If you have a specific question you would like answered in this column, e-mail it to email@example.com or call Turney at the Crescenta-Cañada YMCA, (818) 790-0123, ext. 225.