Help with Vascular dementia in later life.
Out at lunch with a friend, you suddenly can’t find the right words to say. You also find yourself fumbling with your fork. After a few minutes you’re back to normal but, over time, you notice your memory is not as sharp as it used to be. The sudden, brief loss of speech and weakness in the arm could be a sign of a mini-stroke, and this can sometimes lead to a type of dementia called vascular dementia.
Vascular dementia is the second most common form of dementia. It is due to poor blood supply to the brain, sometimes caused by a single large stroke, sometimes by lots of mini strokes. It can even develop with no history of stroke at all.
With well-coordinated care, people with vascular dementia can be greatly helped, and the symptoms controlled.
There are a wide variety of symptoms depending on which parts of the brain are affected. The common symptoms are:
- memory loss, particularly of recent events
- difficulty finding the right words and following conversations
- trouble with recognising people or places
- changes in personality and behaviour
- problems carrying out everyday tasks like cooking or driving
What causes it?
The brain stays healthy by receiving up to one third of the blood pumped from the heart. Reduction to the blood supply to the brain, caused by narrowing of the arteries to the brain, stroke or other reasons may result in vascular dementia.
Key facts about vascular dementia
- Vascular dementia is common; up to 200,000 people in the UK have it
- It can often occur alongside Alzheimer’s disease
- The symptoms may not progress for a long time and then get suddenly worse- known as step-wise progression
- Looking after your heart (eg by not smoking and keeping fit) may reduce the risk of vascular dementia
Unlike Alzheimer’s disease, vascular dementia can begin quite suddenly. Vascular dementia can affect your memory, your ability to recognise people or objects, and your use of language. It can also lead to changes in personality and behaviour. You may notice changes yourself more than in other types of dementia. The confusion and memory problems may fluctuate over time so you may notice you have good days and bad days.
How is it diagnosed?
Some of the symptoms of vascular dementia may also occur in other conditions (like depression, anxiety or Parkinson’s disease), so it is important to be diagnosed by a doctor with the appropriate skills.
The doctor will begin by taking a full account of your symptoms and how they developed, how they have affected your life day-to-day and will also want to know about any medical conditions you have. In addition the doctor will want to organise some brain-function tests (called cognitive tests) and probably want you to have a brain scan.
How is it treated?
Although there are no specific drug treatments recommended for vascular dementia a lot can be done to help. Sometimes the doctor may prescribe drugs normally used for Alzheimer’s disease.
Maintaining heart health is really important. If you are a smoker, you should receive help to stop. Your blood pressure and heart rhythm should be checked. You may be advised to lose weight or exercise more. People with vascular dementia usually have other long-term medical conditions (such as type-2 diabetes, hypertension) and making sure these are carefully treated is an important part of medical management.
Cognitive stimulation therapy is often helpful – this helps keep your brain active.
Vascular dementia may also cause depression, anxiety, loss of motivation and sometimes hallucinations. It is important to look out for and treat these symptoms.
For these reasons people with vascular dementia really benefit from carefully coordinated care.
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