Vascular dementia - what you need to know

Around 150,000 people in Britain are believed to have vascular dementia, the second most common form of dementia, after Alzheimer's disease. Read on to discover what causes it, how to lower your risk, symptoms and treatment options.

See also: Eight hidden signs of dementia

See also: People 'frequently misdiagnosed with common types of dementia'

What causes vascular dementia?
Vascular dementia is caused by restricted blood flow to the brain, which damages and eventually destroys the brain cells, affecting a person's mental and physical abilities.

This can be the result of a stroke, when blood flow to part of the brain is cut off, or can occur following a series of smaller 'mini strokes' that causes widespread damage to the small blood vessels of the brain.

Although people who have a stroke won't necessarily go on to have vascular dementia, around 20% of those who have a stroke go on to develop vascular dementia within the next six months.

If you're concerned that you've had a mini stroke (transient ischaemic attack), it's essential to see your GP immediately. Though the symptoms of a mini stroke may be mild and go quickly, many people who have a mini stroke go on to have bigger strokes, which significantly increases your risk of vascular dementia.

There are some forms of vascular dementia that are not linked to having a stroke. It's also worth noting that around 10% of people with dementia have both Alzheimer's and Vascular dementia.

People who have high blood pressure, diabetes, or atrial fibrillation (a type of irregular heartbeat) are more at risk of having vascular dementia in later life. In addition, we know that those who smoke, drink alcohol excessively, are overweight or obese, eat an unhealthy diet and don't exercise are more likely to be affected by stroke and vascular dementia.

Symptoms of vascular dementia
Symptoms can start suddenly or develop gradually, and depend on the part of the brain that's affected The extent of damage will depend on where the blood clot occurs in the brain, and how long blood flow is restricted for.

In the early stages, symptoms can be subtle and may be hard to diagnose/confused with something else, such as depression. Early symptoms can include:

• slowing down of thought processes
• problems with planning and understanding
• trouble concentration
• mood, personality or behavioural changes
• feeling disorientated and confused
• difficulty walking and keeping balance
• Forgetfulness and problems with language (though this is typically less common that those with Alzheimer's disease)

Later symptoms
Vascular dementia tends to get progressively worse over time, and people can go downhill every few years or even months. Later stage symptoms can include:

• Severely impaired thought, memory loss and problems concentrating
• feeling disorientated and confused
• problems with language, such as inability to remember words for common objects
• dramatic personality changes, such as becoming aggressive
• depression, mood swings and lack of enthusiasm, wanting to be alone
• problems with walking and balance, resulting in falls
• loss of bladder control

These issues can make daily life increasingly difficult and someone in the later stages of the condition are unlikely to be able to look after themselves.

Treatment
While there is no cure for vascular dementia, it's important to be see your doctor as soon as you notice symptoms, as there are ways to slow down progression of the condition.

Treating conditions such as high blood pressure, high cholesterol levels and diabetes, can help to reduce the risk of having another stroke and slow down the progression of vascular dementia. For example, your doctor may prescribe beta blockers, statins, or warfarin.

In addition, making lifestyle changes can help. Experts recommend eating a healthy diet with plenty of fruit and vegetables, stopping smoking and cutting back on alcohol.

Exercising regularly not only helps to lower your risk of vascular dementia in the first place, it can help to delay the progression of the condition once diagnosed. A 2017 study published in The British Journal of Sports Medicine found that people with vascular dementia who walked for one hour three times a week had better thinking skills than those with the condition who didn't exercise.