Vascular Dementia

It is the second most common form of dementia. Probable risk factors include high blood pressure, high cholesterol, advanced age and it is commonly associated with post-stroke patients. There are a number of different types of vascular dementia, including:

• Multi-infarct dementia (MID). It can occur gradually when there have been a series of mini strokes or transient ischaemic attacks (TIAs). The person may not realise they are experiencing these episodes which cause damage to the brain. This is probably the most common type of vascular dementia.
• Single-infarct dementia. This may occur following one large stroke which leaves permanent damage to a particular part of the brain.
• Small Vessel disease related dementia ( sub-cortical vascular dementia or Binswanger’s disease). This type of vascular dementia involves damage to very small blood vessels deep within the brain, development is very gradual and cognitive problems are often accompanied by problems with walking and mobility.

Stroke related dementia can be characterised by a range of symptoms, largely dependent on which part of the brain is damaged by the stroke or the mini strokes. Not everyone will experience all of the symptoms, which can include:

• Mild weakness in leg or arm
• Slurred speech
• Dizziness
• Trouble remembering things, particularly recent events
• Difficultly following a conversation and communicating
• Confusion
• Hallucinations where the person sees or hears things which are not real.
• Depression with emotional swings, when laughter or tears can occur for no reason.

The progression of Stroke related MID is related to how often and when the strokes occur. After each mini-stroke the condition progresses with symptoms becoming more pronounced, the person may then improve slightly and the condition will stabilise until they experience the next set of mini-strokes. Sometimes the mini-strokes are so small that the progression can be very gradual, much like Alzheimer’s disease.

Small Vessel disease related dementia has a different pattern of symptoms to Stroke related MID, this is because this condition impacts a particular part of the brain, what is known as ‘white matter’ deep within the brain.
Symptoms can include:
- Slowness and lethargy in thinking and actions
- Difficultly walking
- Emotional ups and downs
- Loss of bladder control early in the condition

This symptoms will progress gradually over time.