Vascular dementia Q&A

What is vascular dementia?

Oxygen and nutrients are supplied through blood vessels to our brains.
If a cerebral blood vessel is blocked (cerebral infarction) or ruptured (cerebral hemorrhage), neurons in the brain region supplied by the blood vessel become damaged. As a result, the functions for which the neurons are responsible are lost, causing the development of dementia. This phenomenon is called vascular dementia.

What is the prevalence of vascular dementia?

Vascular dementia, like Alzheimer’s disease, is a common disease, occurring in approximately 2 in 100 elderly people. Formerly, vascular dementia was the most common type of dementia encountered in clinical practice in Japan, however, its prevalence has decreased due to advances in the prevention and treatment of hypertension, diabetes mellitus, dyslipidemia and other conditions.
However, vascular dementia is the most common disease causing early-onset dementia, and is relatively common in people younger than 65 years, accounting for approximately 40% of all cases of dementia in this age group.

What type of people commonly have vascular dementia?

Vascular dementia tends to be more common in people in their sixties and seventies and in males. People with underlying diseases, such as hypertension, diabetes mellitus and dyslipidemia, tend to develop vascular dementia. If these underlying diseases are not well-controlled or if the patient is a smoker, the elasticity of blood vessels in the brain is lost, resulting in poor blood flow. This condition is called arteriosclerosis. Aggravation of arteriosclerosis eventually causes blockage or rupture of the cerebral blood vessels. As a result, nutrients are not fully delivered to neurons and the neurons die, resulting in poor brain function.

Is vascular dementia inherited?

Although some types of vascular dementia are inherited, in general, this condition is not inherited.

What are the symptoms of vascular dementia?

Symptoms vary depending on which part of the brain is damaged, and how the brain is damaged. In addition, vascular dementia is characterized by a tendency to be associated with neurological symptoms, such as paralysis of the hands and feet, dyslalia, dysphagia, and sensory disturbances.

What are the imaging findings of vascular dementia?

MRI and CT reveal evidence of cerebral infarction or cerebral hemorrhage. In cases of cerebral infarction of a region with very significant functions, cerebral blood flow single photon emission computed-tomography (SPECT) may reveal damage not only at the site of the infarction, but also in regions functionally related to the site, even if the infarcted region itself is small.

What course does vascular dementia follow?

Most types of vascular dementia occur suddenly, when blockade or rupture of the cerebral blood vessel occurs for the first time. Subsequently, when further blockade or rupture occurs, the symptoms worsen further, resulting in the so-called “stepwise” progression.
However, in cases in which the vascular dementia arises from gradual blockage of fine blood vessels, the condition may not progress in a “stepwise” manner, but in a steady manner.

What are the currently available treatments for vascular dementia?

Unfortunately, once neurons are lost, they cannot be regenerated. It is most important to control the blood pressure and provide appropriate treatment for diabetes mellitus and dyslipidemia, so further blockage or rupture of the cerebral blood vessels, and thereby, further loss of brain neurons, can be prevented.

Source of reference: To know dementia to feel relieved. A guide to dementia management according to symptoms (Medical Review Co., Ltd.)
Supervised by: Masatoshi Takeda
Authors: Hiroaki Kazui, Hiromichi Sugiyama, Shioko Bando

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