Beyond Alzheimer’s disease, having one or more strokes is also a common cause of dementia.

During a stroke, blood flow to the brain is disrupted by a blocked artery or hemorrhage, causing damage to the brain. Sometimes this damage can bring on symptoms of memory loss, poor judgement and planning and other cognitive issues.

This is referred to as vascular dementia.

While strokes cause this type of dementia, not every person who has a stroke will develop vascular dementia. That depends on the severity and location of the damage in the brain.

There are also a few other conditions that can block or reduce blood flow to the brain, resulting in vascular dementia.

The Ohio State University Wexner Medical Center is not only a leader in treating strokes, allowing us to limit brain damage and prevent recurrent strokes, but our dementia care and expertise in memory disorders is unmatched in the state and region.

Where you go for dementia treatment matters. Whether you think you may be at risk for vascular dementia or are looking for help in managing symptoms, the Ohio State Wexner Medical Center is an ideal partner for that care.

What causes vascular dementia?

Vascular dementia is a general term given to dementia symptoms a person might experience after inadequate blood flow to the brain deprives cells of oxygen, damaging and killing them.

Causes of blood flow blockage include:

• Stroke – This event cuts off blood flow to the brain suddenly. Not all strokes cause vascular dementia, but experiencing multiple strokes increases your chances of developing it. Vascular dementia caused by multiple strokes is sometimes called multi-infarct dementia.
• Brain hemorrhage – A type of stroke, this occurs when a blood vessel that supplies the brain ruptures or leaks, bleeding into the brain and blocking it from getting the oxygen and nutrients it needs.
• Narrowing and chronic damage of blood vessels in the brain – Conditions that cause long-term damage to brain blood vessels can also cause vascular dementia. These include conditions, like high blood pressure, elevated cholesterol, and diabetes, that as we age cause many issues.
• Transient ischemic attacks – These are events that can cause stroke-like symptoms that may resolve or lead to a stroke. Numerous “mini strokes” can cause blockage of small blood vessels and widespread damage over time without us knowing.

You can control many of the risk factors for these conditions, thus reducing your chances of developing vascular dementia. Risk factors you can manage through lifestyle changes, such as diet and exercise, include:

• high blood pressure
• obesity
• diabetes
• sleep apnea
• smoking
• high cholesterol
• a history of stroke

Symptoms of vascular dementia

Like other forms of dementia, symptoms can vary depending on what area of the brain has been affected. What’s more, these signs often overlap with other dementia conditions, like Alzheimer’s disease.

It can be difficult to differentiate vascular dementia from other similar cognitive disorders, but hallmarks of this disease tend to involve speed of thinking and problem solving, rather than severe memory loss.

Also, these symptoms can come on suddenly — like right after a stroke event — so the link to the stroke can be clear, whereas cognitive decline with Alzheimer’s disease is much more gradual.

Symptoms of vascular dementia include:

• confusion
• slowness in thinking or decision making
• trouble concentrating
• inability to organize thoughts or make a plan
• changes in behavior, such as depression, apathy or agitation
• difficulty walking or poor balance
• other physical issues, such as headaches and uncontrollable bladder
• problems with memory and language (not as common)
• Sometimes vascular dementia occurs by itself, but oftentimes it is present along with Alzheimer’s disease or another type of dementia. This is called mixed dementia.

Diagnosing vascular dementia

Sometimes identifying vascular dementia might be obvious if symptoms appear right after you have a stroke. Other times it can be more difficult, and the condition goes undiagnosed in many people.

That’s why our dementia doctors at Ohio State Wexner Medical Center have a number of screening and diagnostic tools at our fingertips to help identify what’s causing your symptoms and ways to best address them.

To diagnose vascular dementia, we’ll use a combination of:

• Mental status testing
• Neuropsychiatric and neuropsychological assessment
• Medical history and physical exam
• Blood and other laboratory tests
• Imaging studies including:
• Computed tomography (CT)
• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET) scan, including amyloid PET and fludeoxyglucose (FDG) PET, a technique that enables us to diagnose degeneration in the brain
• Interviews with patient and family members

Treatment for vascular dementia

When treating vascular dementia, we often focus on managing the risk factors for the condition.

By controlling underlying causes of damage to your heart and blood vessels, such as high blood pressure and diabetes, we can slow the progression of dementia or in some cases prevent further damage.

We might prescribe medications and recommend lifestyle changes to:

• Lower your blood pressure
• Reduce your cholesterol level
• Prevent blood clotting and keep your arteries clear
• Help control your blood sugar if you have diabetes

Also, we’re actively studying at Ohio State Wexner Medical Center other forms of therapy that might impact your vascular dementia symptoms, allowing you to have access to the latest treatments.