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About Vascular Dementia
Vascular dementia is widely considered the second most common
type of dementia. It develops when impaired blood flow to
parts of the brain deprives cells of food and oxygen.
The diagnosis may be clearest when symptoms appear soon after
a single major stroke blocks a large blood vessel and disrupts
the blood supply to a significant portion of the brain. This
situation is sometimes called “post-stroke dementia.”
There is also a form in which a series of very small strokes,
or infarcts, block small blood vessels. Individually, these
strokes do not cause major symptoms, but over time their combined
effect becomes noticeable. This type used to be called “multi-infarct
dementia.”
Symptoms of vascular dementia can vary, depending on the
specific brain areas deprived of blood. Impairment may occur
in “steps,” where there is a fairly sudden, noticeable
change in function, rather than the slow, steady decline usually
seen in Alzheimer’s disease.
The person may have a past history of heart attacks. High
blood pressure, high cholesterol, hardening of the arteries,
diabetes, or other risk factors for heart disease are often
present.
Symptoms
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Memory problems may or may not be a prominent symptom,
depending on whether brain regions important in memory
are affected.
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Confusion, which may get worse at night.
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Difficulty concentrating, planning, communicating and
following instructions.
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Reduced ability to carry out daily activities.
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Physical symptoms associated with strokes, such as sudden
weakness, difficulty speaking or confusion.
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Magnetic resonance imaging (MRI) of the brain may show
characteristic abnormalities associated with vascular
damage.
Treatment
Because vascular dementia is closely tied to diseases of the
heart and blood vessels, many experts consider it the most
potentially treatable form.
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Monitoring of blood pressure, weight, blood sugar and
cholesterol should begin early in life. Managing these
risk factors, avoiding smoking and excess alcohol, and
treating underlying diseases of the heart and blood vessels
could play a major role in preventing later cognitive
decline for many individuals. In some cases, active management
of these factors in older adults who develop vascular
dementia may help symptoms from getting worse.
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Once vascular dementia develops, there are no drugs
currently approved by the U.S. Food and Drug Administration
(FDA) to treat it.
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Most of the drugs used to treat cognitive symptoms of
Alzheimer’s disease have also been shown to help
individuals with vascular dementia to about the same extent
they help those with Alzheimer’s. However, in March
2006, Eisai Co. Ltd., manufacturer of donepezil (Aricept),
reported that in a clinical trial of donepezil for vascular
dementia, a significantly greater number of deaths occurred
in study participants receiving donepezil than in those
taking the placebo.
Vision statement
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