Vascular Dementia And Stroke: Is There A Link?

can vascular dementia cause a stroke

Vascular dementia is caused by impaired blood flow to the brain and can be triggered by a stroke that blocks an artery in the brain. However, strokes do not always cause vascular dementia, and whether a stroke affects a person's thinking and reasoning depends on its severity and location. Vascular dementia can also be caused by a series of small strokes or silent strokes that go unnoticed.

Characteristics Values
Can vascular dementia cause a stroke? No, but a stroke can cause vascular dementia.
What is vascular dementia? Vascular dementia is a general term describing problems with reasoning, planning, judgment, memory, and other thought processes caused by brain damage from impaired blood flow to the brain.
What causes vascular dementia? Vascular dementia happens when the blood supply to parts of the brain becomes reduced. This can be due to blood vessels being clogged, a stroke, or a series of small strokes.
What are the symptoms of vascular dementia? - Trouble paying attention and concentrating
  • Reduced ability to organize thoughts or actions
  • Decline in ability to analyze a situation, develop an effective plan, and communicate that plan to others
  • Difficulty with organization
  • Difficulty deciding what to do next
  • Problems with memory
  • Restlessness and agitation
  • Sudden or frequent urge to urinate or inability to control passing urine
  • Depression or apathy | | What are the risk factors for vascular dementia? | - Diabetes
  • High blood pressure
  • High cholesterol
  • Smoking
  • Increasing age
  • History of heart attacks, strokes, or ministrokes
  • Abnormal aging of blood vessels (atherosclerosis)
  • High cholesterol
  • Obesity |

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Vascular dementia and stroke

Vascular dementia is a general term for problems with reasoning, planning, judgement, memory, and other thought processes caused by brain damage from impaired blood flow to the brain. Vascular dementia can occur after a stroke blocks an artery in the brain, but strokes do not always cause vascular dementia. The severity and location of the stroke determine whether it will affect a person's thinking and reasoning.

Vascular dementia can also be caused by other conditions that damage blood vessels and reduce circulation, depriving the brain of vital oxygen and nutrients. These conditions include atherosclerosis, cerebral amyloid angiopathy, and abnormal ageing of blood vessels.

Vascular dementia can also be caused by a series of small strokes, known as silent strokes, which create lots of small areas of damage in the brain. These strokes are often so small that a person may not know they are having them. Symptoms of vascular dementia may appear gradually over time if they are caused by silent strokes.

People who have had a stroke have a far greater risk of developing dementia than those who have not. About one in four people who have had a stroke will go on to develop signs of dementia. Vascular dementia is most common in older people, who are more likely than younger people to have vascular diseases.

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Small vessel disease and vascular cognitive impairment

Vascular dementia is caused by brain damage from impaired blood flow and other conditions that damage blood vessels and reduce circulation. Vascular dementia can occur after a stroke blocks an artery in the brain, but strokes do not always cause vascular dementia. Vascular dementia can also be caused by small vessel disease, which is when the small blood vessels deep within the brain become narrow and clogged up. This damage stops blood from getting to parts of the brain, causing signs of vascular cognitive impairment, which can eventually lead to vascular dementia.

Small vessel disease (SVD) is the leading cause of vascular cognitive impairment (VCI). SVD is associated with substantial morbidity and is the most prevalent mechanism involved in VCI, contributing to cognitive impairment irrespective of stroke. SVD is characterised by abnormalities that affect the structure and function of small vessels in the brain, with multiple neuroimaging and neurological manifestations, including cognitive decline. The prevalence of SVD increases with age, and the two most common sporadic types are arteriolosclerosis and cerebral amyloid angiopathy.

The clinical diagnosis of VCI relies on cognitive profile and neuroimaging findings. MRI is considered the gold standard for the clinical diagnosis of VCI. Conventional neuroimaging markers of SVD include white matter hyperintensities, lacunes, perivascular spaces, recent small subcortical infarcts, cortical superficial siderosis, intracerebral haemorrhage, and atrophy. Advanced imaging techniques such as diffusion tensor imaging are more sensitive to microstructural abnormalities and disruption of network connections and offer stronger cognitive associations.

Vascular risk factors such as hypertension, obesity, smoking, and diabetes are currently the most effective approach to preventing cognitive decline in the elderly. Intensive blood pressure management has been shown to reduce white matter hyperintensity progression and lower the incidence of mild cognitive impairment.

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Vascular dementia symptoms

Vascular dementia is caused by reduced blood flow to the brain, which can be due to clogged blood vessels, a stroke, or a series of small strokes. The symptoms of vascular dementia vary depending on the part of the brain that is affected, but they tend to involve problems with reasoning, planning, judgment, memory, and other thought processes.

  • Trouble paying attention and concentrating
  • Reduced ability to organize thoughts or actions
  • Difficulty with organization and planning
  • Problems with memory
  • Restlessness and agitation
  • Urinary problems, such as urgency or incontinence
  • Depression or apathy
  • Language problems (aphasia)
  • Impaired motor skills
  • Visual orientation problems, hallucinations
  • Significant slowness of thought
  • Feeling disoriented and confused
  • Difficulty finding the right words
  • Severe personality changes, such as becoming aggressive
  • Mood swings and lack of interest or enthusiasm
  • Difficulty walking and maintaining balance
  • Increasing difficulty with daily activities

The symptoms of vascular dementia can appear suddenly after a stroke or gradually over time. They tend to get worse over time, although treatment can help slow down the progression of the disease.

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Vascular dementia risk factors

Vascular dementia is caused by impaired blood flow to the brain and damage to blood vessels. The risk factors for vascular dementia are similar to those for heart disease and stroke. Here are some of the risk factors for vascular dementia:

Age

The biggest risk factor for vascular dementia is age. The risk of developing vascular dementia rises as people grow older. Vascular dementia is rare before the age of 65, but the risk doubles every five years after that. The risk rises substantially by the time a person reaches their 90s.

Cardiovascular Conditions

People with cardiovascular issues such as high blood pressure, heart disease, or diabetes have a higher risk of vascular dementia. These conditions increase the chances of a clot or bleed in the blood vessels in the brain. People with these conditions are twice as likely to develop vascular dementia.

Cerebral Amyloid Angiopathy (CAA)

CAA is a type of vascular disease that damages the small arteries in the outer regions of the brain, causing them to leak and become prone to bleeding. Many people with CAA develop vascular dementia, either from having a stroke or from gradual disease progression.

Sleep Apnoea

Sleep apnoea is a condition where a person temporarily stops breathing during sleep. This can cause small blood clots to form in the brain, increasing the risk of high blood pressure, stroke, heart attacks, and vascular dementia.

Lifestyle Factors

Lifestyle choices that increase the risk of cardiovascular diseases also increase the risk of vascular dementia. These include physical inactivity, smoking, an unhealthy diet, and excessive alcohol consumption.

Genetics

In rare cases, vascular dementia can be caused by inherited genetic disorders such as CADASIL, which is associated with a family history of stroke and dementia.

Other Health Conditions

Other health conditions that can increase the risk of vascular dementia include high cholesterol, atrial fibrillation, obesity, and language problems (aphasia).

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Vascular dementia treatments

Vascular dementia is caused by reduced blood flow to the brain, which damages brain tissue. While vascular dementia cannot be cured, there are treatments that can help to slow down its progression and prevent further damage to the brain.

Treatments for Vascular Dementia

The main goal of vascular dementia treatment is to address the underlying conditions that affect blood flow to the brain and cut the risk of further damage to brain tissue. This can involve:

  • Medicines: Medication can be used to manage blood pressure, cholesterol, diabetes, and problems with blood clotting. Antidepressants can help with depression and other symptoms. Antipsychotic medication may be given in cases of extreme distress or aggression.
  • Lifestyle changes: Doctors may recommend a healthy diet, physical activity, quitting smoking, and reducing alcohol consumption.
  • Procedures: Surgery can improve blood flow to the brain. Carotid endarterectomy, angioplasty, and stenting are procedures that can be used to improve blood flow.
  • Support and therapy: Occupational therapy, speech and language therapy, physiotherapy, and psychological therapies can help with everyday living. Relaxation techniques, such as massage, music, or dance therapy, can also be beneficial.

Preventing Vascular Dementia

Factors that increase the risk of vascular dementia include diabetes, high blood pressure, high cholesterol, and smoking. Taking steps to control these factors may help lower the chances of developing vascular dementia. Maintaining a healthy blood pressure range, preventing or controlling diabetes, quitting smoking, getting physical exercise, and keeping cholesterol in check can all help to reduce the risk of vascular dementia.

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