What is Vascular Dementia in plain English?
Vascular Dementia (VD) is related to a poor supply of blood to the brain. Why is this important? As we all know blood contains nutrients and Oxygen, it’s what keeps our brain healthy and functioning normally.
There are three types of Vascular Dementia, they stem from different causes and progress differently too.
Stroke Related Dementia
When someone has a large stroke, they become 20% more likely to develop VD within 6 months.
Strokes deprive the brain of oxygen and nutrients by causing severe blockages in blood vessels. These can last for long periods of time, causing brain cells to die off.
Progression of Stroke Related VD varies like all forms of dementia from person to person. However in many cases, a stepped progression can occur, certain symptoms develop at once but they hold for a period of time, and then another step is taken, with new symptoms that hold for a while and so the story goes on.
A myriad of symptoms can be expected, the physical and mental side effects of a stroke can coincide with those of VD. This will affect progression too.
Single/ Multi Infarct Dementia
Caused by one or more small strokes over a period of time- clots occur in medium or large blood vessels within the brain. These clots can last for just a few minutes or for up to 24 hours. The latter is referred to as a mini stroke or Transient Ischaemic Attack (TIA), often portrayed as a ‘Funny Turn’.
If a stroke lasts for just a few minutes, a clump of brain cells deprived of oxygen can die, this is known as an infarct- If this infarct is within a key part of the brain single infarct dementia can follow.
In many cases, though it is more likely that numerous mini strokes over a few months lead to multiple infarcts dotted around the brain. The collective of the few cause dementia.
Like Stroke related dementia the progression is stepped over time, so there may well be periods of relative stability.
The focus here is on the small blood vessels at the heart of the brain that are affected by Small Vessel Disease.
Vessel walls become thick causing them to stiffen and twist. Thereby diminishing the levels of blood to the brain, injuring nerve fibres and killing off cells. Therefore deep set infarcts occur in the base of the brain.
Known to be the most common form of VD, Subcortical Dementia progresses gradually over time. There is no set path, it will vary on an individual basis.
Most forms of vascular dementia cause brain deterioration over 5 years. It is likely that a stroke or heart attack will have a final say, causing loss of life rather than the dementia itself.
What are the key symptoms?
The first and most obvious symptom is having had a stroke previously. As you will have read having a stroke makes you more likely to develop this type of Dementia, along with heart conditions that can affect the vascular system. So while the stroke itself isn’t a symptom of Vascular Dementia, it is in many cases a cause and therefore a pre-cursor. If yourself or a loved one have had a stroke previously look out for some of the symptoms below, so that you may be able to diagnose VD more quickly.
They say that things are as simple as ABC, 123, but what happens when you forget the ABC and start struggling with the 123. Many notice that with Vascular Dementia processes become confused and muddled, things like following a recipe become really difficult, the brain just can’t organise the way that information comes out and in what order. Likewise the ability to take instructions can become trickier, even if you hear the instruction the response may be something entirely different to the command.
Quite often it is found that people with Vascular Dementia have a far shorter concentration span than before, so whilst it may seem that the person you are talking to who seems uninterested in what you are saying, it could be that they can’t fixate their mind and concentration on you for as long as they should be. In some cases these periods of distraction can be followed by some sudden confusion, from an inability to understand where you are or what you are doing to muttering sentences that make no sense at all. This is a similar symptom to that of a stroke or TIA which can make it tricky to isolate as a symptom of Vascular Dementia.
We all know what it’s like to not be able to make our mind up about something, but if this is particularly uncommon and becomes a regular occurrence with simple decisions such as wanting a tea or a coffee, or being undecided about standing up or sitting down, it is worth consulting your GP about Vascular Dementia. As it becomes harder to process information correctly and act out a typical response, the mind stalls, and we are left in limbo about what we should or shouldn’t do, therefore highly indecisive.
With Thanks to: NHS Choices, Alzheimer’s Research UK, Alzheimer’s Society, The Stroke Association
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