Vascular dementia

Definition

Dementia is a loss of brain function that occurs with certain diseases. It affects one or more brain functions such as memory, thinking, language, judgment, or behavior.

Vascular dementia is caused by a series of small strokes over time.

Dementia may also be referred to as major neurocognitive disorder.

Alternative Names

MID; Dementia - multi-infarct; Dementia - post-stroke; Multi-infarct dementia; Cortical vascular dementia; VaD; Chronic brain syndrome - vascular; Mild cognitive impairment - vascular; MCI - vascular; Binswanger disease

Causes

Vascular dementia is the second most common cause of dementia after Alzheimer disease in people over age 65.

Vascular dementia is caused by a series of small strokes.

Risk factors for vascular dementia include:

Symptoms of dementia may also be caused by other types of disorders of the brain. One such disorder is Alzheimer disease. Symptoms of Alzheimer disease can be similar to those of vascular dementia. Vascular dementia and Alzheimer disease are the most common causes of dementia, and may occur together.

Symptoms

Symptoms of vascular dementia may develop gradually or may progress after each small stroke.

Symptoms may begin suddenly after each stroke. Some people with vascular dementia may improve for short periods, but decline after having more silent strokes. Symptoms of vascular dementia will depend on the areas of the brain that are injured due to the stroke.

Early symptoms of vascular dementia can include:

As dementia worsens, symptoms are more obvious and the ability to take care of oneself declines. Symptoms may include:

Nervous system (neurologic) problems that occur with a stroke may also be present.

Exams and Tests

A skilled health care provider can often diagnose vascular dementia using the following:

Tests may be ordered to help determine whether other medical problems could be causing dementia or making it worse, such as:

Other tests may be done to find out what parts of thinking have been affected and to guide other tests such as neuropsychological testing.

Tests that can show evidence of previous strokes in the brain may include:

Treatment

There is no treatment to repair damage to the brain caused by small strokes.

An important goal is to control symptoms and correct the risk factors. To prevent future strokes:

The goals of helping someone with dementia in the home are to:

Medicines may be needed to control aggressive, agitated, or dangerous behaviors.

Medicines used to treat Alzheimer disease have not been shown to work for vascular dementia.

Outlook (Prognosis)

Some improvement may occur for short periods, but the disorder will generally get worse over time.

Possible Complications

Complications include the following:

When to Contact a Medical Professional

Contact your provider if symptoms of vascular dementia occur. Go to the emergency room or call 911 or the local emergency number if there is a sudden change in mental status, sensation, or movement. These are emergency symptoms of stroke.

Prevention

Control conditions that increase the risk of hardening of the arteries (atherosclerosis) by:

References

Budson AE, Solomon PR. Vascular cognitive impairment and vascular dementia. In: Budson AE, Solomon PR, eds. Memory Loss, Alzheimer's Disease, and Dementia. 3rd ed. Philadelphia, PA: Elsevier; 2022:chap 7.

Knopman DS. Cognitive impairment and dementia. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 371.

Peterson RC, Graff-Radford J. Alzheimer disease and other dementias. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 95.

Seshadri S, Caunca MR, Rundek T. Vascular dementia and cognitive impairment. In: Grotta JC, Albers GW, Broderick JP et al, eds. Stroke: Pathophysiology, Diagnosis, and Management. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 18.



Review Date: 4/29/2023
Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School of Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Internal review and update on 02/23/24 by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
© 1997- adam.comAll rights reserved.