VASCULAR DEMENTIA

Description

  • Gradual and permanent loss of brain function
  • Affects memory, thinking, language, judgment, and behavior
  • Caused by a series of small strokes

Symptoms

  • Confusion
  • Trouble paying attention and concentrating
  • Reduced ability to organize thoughts or actions
  • Decline in ability to analyze a situation
  • Difficulty deciding what to do next
  • Problems with memory
  • Restlessness and agitation
  • Unsteady gait
  • Sudden or frequent urge to urinate
  • Inability to control passing urine
  • Having delusions, depression
  • Difficulty doing basic tasks
  • Withdrawing from social contact

Causes

  • Stroke (infarction) blocking a brain artery
  • Narrowed or chronically damaged brain blood vessels

Risk Factors

  • Increasing age
  • History of heart attack, strokes or mini-strokes
  • Atherosclerosis
  • High cholestrol
  • High blood pressure
  • Diabetes
  • Smoking
  • Obesity
  • Atrial fibrillation
  • Excessive alcohol consumption

Diagnostic Tests

Lab tests:

  • Blood pressure
  • Cholesterol
  • Blood sugar
  • Thyroid disorders
  • Vitamin deficiencies

Neurological exam to check for:

  • Reflexes
  • Muscle tone and strength
  • Ability to get up from a chair and walk across the room
  • Sense of touch and sight
  • Coordination
  • Balance

Brain Imaging:

  • Computerized tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Carotid ultrasound

Neuropsychological tests to assess the ability to:

  • Speak, write and understand language
  • Work with numbers
  • Learn and remember information
  • Develop a plan of attack and solve a problem
  • Respond effectively to hypothetical situations

Treatment

  • Currently no cure is available
  • Underlying conditions and risk factors are treated
  • Alzheimer’s Medications
  • Cholinesterase inhibitors
  • Memantine

Medications

  • donepezil (Aricept)
  • galantamine (Razadyne)
  • rivastigmine (Exelon)
  • Memantine (Namenda)

Prevention

  • Maintain a healthy blood pressure
  • Keep cholestrol in check
  • Control or prevent diabetes
  • Quit smoking
  • Exercise regularly
  • If obese, lose weight

Lifestyle Management

  • Keep a calm environment
  • Join support groups
  • Learn as much as possible about the disease
  • Take small breaks throughout the day
  • Make time for friends
  • Make and follow a time-table