Introduction[edit | edit source]
Vascular dementia is a heterogeneous category of brain disorders that cause cognitive impairment, and are attributable to problems with the brains blood supply. It is responsible for at least 20% of cases of dementia, second in occurrence following Alzheimer’s disease. It usually occurs in patients with atherosclerosis and chronic hypertension that over time cause multiple white matter lesions or cortical infarcts. Patients with vascular dementia have a shortened life expectancy.
Vascular dementia is cognitive impairment caused by damaged or blocked blood vessels in the brain. The symptoms of vascular dementia can vary from person to person, depending on what part of the brain is damaged and other health factors. Watch this 3 minute informative video.
Epidemiology[edit | edit source]
Incidence is hard to discover but is strongly matched with age, occurring in 1% of patients greater than 55 years and in greater than 4% of patients over 71 years. To add to this uncertainty Alzheimer disease often co-occurs with vascular dementia. Also accelerated vascular changes occur in some people due to specific underlying disease not shown on vascular dementia studies. Risk factors for the development of vascular dementia include hyperlipidemia, hypertension, diabetes mellitus, and tobacco use.
Pathophysiology[edit | edit source]
Vascular dementia is an integral part of Alzheimer's and other geriatric neurodegenerative conditions associated with dementia, All form of vascular dementia have a similar pathogenic origin, resulting from hypoperfusion, oxidative stress and inflammation, which contribute to hemispheric white matter alterations. Demyelination and axonal loss also play a part in the wide ranging functional brain changes that underly cognitive impairment and the associated atrophy of the cerebral hemispheres.
Management[edit | edit source]
Dementias have no single treatments, with the focus being on treating individual risk factors (e.g. hypertension, smoking, hypercoagulation, atherosclerosis).
Alongside drug interventions, non-pharmacological interventions are used to treat the symptoms of dementia.
- Non-pharmacological Management eg Cognitive stimulation therapy; reminiscence therapy for mild to moderate dementia; cognitive rehabilitation or occupational therapy (working on functional goals of the individual and/or their carers).
- Lifestyle Modifications: Regular exercise and an active lifestyle; stimulating, personalised daily activities.
Prevention[edit | edit source]
In the absence of successful therapies, promoting and maintaining vascular health is critical to prevent both the vascular and neurodegenerative components of the vascular dementia. Vascular health is addressed by treating the risk factors eg. diabetes, hypertension, smoking, and hyperlipidemia. Mant studies proving that using antihypertensive medications reduces the risk of vascular dementia. 
Physiotherapy Management[edit | edit source]
See Dementia main page
References[edit | edit source]
- Iadecola C. The pathobiology of vascular dementia. Neuron. 2013 Nov 20;80(4):844-66. Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3842016/ (accessed 15.1.2023)
- Uwagbai O, Kalish VB. Vascular dementia. InStatPearls [Internet] 2022 Jan 14. StatPearls Publishing. Available:https://www.ncbi.nlm.nih.gov/books/NBK430817/ (accessed 15.1.2023)
- Radiopedia Vascular dementia Available:https://radiopaedia.org/articles/vascular-dementia (accessed 15.1.2023)
- Dementia Australia. What is Vascular Dementia?. Available from: https://www.youtube.com/watch?v=hcgT9KaPtAY [last accessed 15.1.2023]