Vascular dementia

Vascular dementia is a neurological condition that develops when narrowed or blocked arteries prevent blood flow to the brain. It’s the second most common type of dementia after Alzheimer’s disease and may exist along with other forms of dementia. Vascular dementia is often triggered by a stroke or conditions like hypertension. It leads to cognitive issues that affect reasoning, memory, judgment, and other mental processes. The extent of cognitive impairment depends on the size and location of the affected areas in the brain.

Vascular dementia is treated by a doctor who specializes in neurological disorders called a neurologist. Neurologists at Penn Medicine are among the leading neurology providers that specialize in dementia and memory disorders in the greater Philadelphia and South Jersey region.

There are several types of vascular dementia, each with different causes and symptoms. 

• Mixed dementia results from a combination of conditions, most commonly Alzheimer’s disease and vascular dementia. 
• Multi-infarct dementia (MID) is a subtype of mixed dementia characterized by numerous small strokes or transient ischemic attacks (TIAs) that cause brain damage over time. 
• Stroke-related dementia occurs because of strokes, where blood supply to parts of the brain is suddenly interrupted. One in five patients who experience a stroke develop this type of vascular dementia within six months. 
• Subcortical vascular dementia is caused by diseases that affect small blood vessels deep in the brain and lead to a lack of oxygen and nutrients in certain regions of the brain. 

Symptoms of vascular dementia include a range of cognitive, emotional, and physical changes that vary depending on the region of the brain affected. These symptoms can include: 

• Confusion 
• Difficulty concentrating 
• Difficulty walking 
• Memory problems 
• Restlessness 
• Slowed thinking 
• Trouble with speech 

Additionally, patients living with vascular dementia may experience challenges in performing daily tasks, language difficulties, changes in sleep patterns, and shifts in mood or behavior, such as depression or irritability. Vascular dementia symptoms may appear suddenly after a stroke or develop gradually over time.

These symptoms typically progress through seven stages, each marked by distinct changes in cognitive function and daily living abilities. From the initial phases, where symptoms may go unnoticed, to the advanced phases requiring around-the-clock care, the journey through vascular dementia stages varies for each patient affected by the condition.

Penn Medicine’s memory and cognitive disorder physicians are committed to supporting patients throughout their journey with vascular dementia, from diagnosis to recovery. 

Vascular dementia can be caused by conditions that disrupt blood flow and oxygen supply to the brain leading to damage in the brain blood vessels. This damage can result from various conditions including:

• Atherosclerosis (thickening or hardening of the arteries)
• Brain hemorrhage
• Chronic narrowing of blood vessels due to aging
• Diabetes
• High blood pressure
• Stroke

Rare genetic disorders like Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) can also contribute to vascular dementia by affecting white matter in the brain. The disruptions in blood flow that cause vascular dementia are closely linked to cardiovascular and cerebrovascular diseases, highlighting the importance of managing risk factors like smoking, high blood pressure, and diabetes.

Since there is no cure for vascular dementia, treatments primarily focus on managing symptoms and the underlying health conditions that contribute to the disease to prevent further damage. This may include controlling blood pressure, cholesterol, blood sugar levels, and clotting to reduce the risk of additional brain damage. While there are no FDA-approved medications specifically designated to treat vascular dementia, some medications used for Alzheimer’s symptoms may offer some relief from symptoms.

Patients at Penn Medicine receive treatment plans tailored to their individual needs by neurology experts in one of the largest cognitive neurology groups in the nation. We’re dedicated to finding the best path forward for patients with vascular dementia to enhance their quality of life.