Vascular dementia

  • Around 17% of people diagnosed with dementia will have vascular dementia. It is the second most common form of dementia in the over 65 age group.
  • Although you can have vascular dementia under the age of 65, it is comparatively rare.

What causes vascular dementia?

Vascular dementia is an umbrella term for a group of conditions caused by problems with blood circulation to the brain.

  • It is caused by small blood clots preventing oxygen reaching the brain tissue. The small clots are sometimes known as Transient Ischaemic Attacks or TIAs.
  • Damage to the blood supply can also be caused by blocked arteries (atherosclerosis) or bursting of blood vessels in the brain (haemorrhage).

What happens?

  • The progression of vascular dementia can be quite erratic as the person may not have a series of TIAs for some time.
  • After a series of TIAs the person will also experience a very small amount of recovery so appear to be ‘getting better’. This is a temporary situation, as the damage to the brain could eventually lead to difficulties e.g with daily living, attention, memory, decision making and motivation. The term ‘step wise progression’ is often used to describe this. 

Possible risk factors

  • Age: people diagnosed with vascular dementia tend to be over the age of 65.
  • Gender: vascular dementia is diagnosed in slightly more men than women.
  • Genetics: a family history of stroke, heart disease or diabetes can increase the risk of vascular dementia.
  • Poor physical health, or inadequately controlled physical disorders such as diabetes or heart disease. A person who has had a stroke, diabetes or heart disease is twice as likely to have vascular dementia.
  • Lifestyle choices e.g. smoking; lack of exercise; excessive use of alcohol.
  • When a medical history is taken as part of a diagnostic assessment the person will often have a history of high blood pressure, high cholesterol, obesity, heart disease, smoking and/or diabetes.

Preventing vascular dementia

Individuals can reduce their risk factors by: 

  • Having regular health care checks with your GP, if you have a long term condition like diabetes or thyroid problems, is important to keep these conditions well managed.
  • Take advantage of ‘well-person health checks’ at your GP surgery so that your blood pressure, weight and cholesterol levels are well managed.
  • If you are prescribed medication make sure you understand what it is for, you are compliant with the dosage and that you have regular reviews with your GP.
  • If your weight has changed over the years seek support with your diet and monitoring of weight loss to ensure you are eating healthily and the weight loss is maintained.
  • If you smoke ask your GP about a smoking cessation programme so you have some support and care and are successful in giving up.    
  • Keeping physically fit is very important, so taking regular exercise like walking, swimming and group activity like tennis and fitness classes.
  • Making sure you keep socially active is important, so that you are talking to people in a group situation as well as one to one.
  • Hobbies like art, woodwork, needlework, knitting, puzzles and listening to music help stimulate different areas of the brain and help with attention and concentration.

Managing the effects of vascular dementia

Symptoms of vascular dementia can vary depending on which area of the brain has been affected. Changes in mood, behaviour, ability to perform daily activities can be affected. Our Admiral Nurse Dementia Helpline can offer advice on managing these symptoms. Call 0800 888 6678.

Diet and brain health

Recent studies have concluded that the MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) can aid brain health. It is a combination of a diet to reduce blood pressure (DASH) and the Mediterranean diet.

10 “brain healthy” foods

  • Green leafy veg
  • Other colourful veg
  • Nuts
  • Berries – e.g. blueberries, strawberries
  • Beans, lentils, soya
  • Wholegrains
  • Fish
  • Poultry
  • Olive oil
  • Red wine – in moderation!

5 “unhealthy” foods

  • Red meats
  • Butter and margarines
  • Cheese
  • Pastries and sweets
  • Fried and “fast foods”

Should you follow the MIND Diet?

We understand it may be hard to follow it rigidly, however in the studies even those people who partly followed the diet obtained some benefit. Making your diet more “MIND like” will make it easier to follow long term. Diet is important, but it is only one aspect of lifestyle changes associated with reduced risk.

Planning ahead if you have received a diagnosis   

  • Talk to your family and the people close to you about the future. Think about what help you would like. 
  • You may also like to think about things you would really like to do, people you would like to meet, holidays you would like to plan. Having some plans in place helps with a positive outlook on the future and opens up conversations with people who care about you and would like to support you.
  • Thinking about your future health needs can be difficult and feel like an unnecessary step but it will help you and the people who know you well to choose treatments and services that you would prefer in the future. You can put a Health and Welfare Power of Attorney in place and an Advance Care Plan. Putting these things in place will give you and your family time to look at treatments and support that is available and make sure you are aware of all the choices that are available to you for the future.
  • Gaining some financial advice as soon as you can will help you get your finances in order and make sure your finances are protected. A Lasting Power of Attorney is an important safeguard for you and anybody who is helping you with your finances. It is best to get support from a solicitor or an organisation like Age UK to help you with this.
  • Financial support is available to you regardless of you financial status. You can claim for Attendance Allowance (which is non-means tested) if you are over 65 years or Personal Independence Payment if you are under 65 years. If you live with another person you can also claim a 25% council tax reduction from your local authority.
  • There are a variety of housing options to choose from. If you are renting you can get support from you local authority housing department. There are also choices of housing in the assisted living and sheltered housing options.

Support

If you suspect you have vascular dementia make an appointment with a GP so they can ask you questions about your concerns, and perform a physical examination to rule out any other potentially treatable conditions that could give similar symptoms e.g. infections, side effects of medication.

If your GP suspects vascular dementia they will make a referral to a memory clinic or other specialist clinic for further tests and diagnosis.

Contact our Admiral Nurse Dementia Helpline for support and advice: 0800 888 6678.

Research

Over the last couple of years more money has been pledged by the UK government and other countries world wide to research into the causes and find a cure for dementia. Subject to research processes and certain criteria, there are opportunities to be part of a research studies. To find out more or register your interest, see: Join Dementia Research.

Page to be reviewed on 01/04/2017