The Role of Vascular Dementia in Stroke and Memory Loss
Medically reviewed by Smita Patel, DO
There is an important overlap between memory loss and risk factors for stroke that might suggest a condition called vascular dementia. What is vascular dementia? Learn about the symptoms and treatment of this condition and how it might affect sleep among those afflicted.
What Is Vascular Dementia?
Dementia refers to a disorder characterized by the chronic and progressive impairment of memory, loss of reasoning, and personality changes that result from various causes.
One of the potential causes of this perceived memory loss is the accumulation of numerous small strokes within the brain. A stroke is the sudden loss of blood flow to an area of the brain that may lead to symptoms of weakness, numbness, vision loss, and speech difficulty.
Strokes may also impact cognitive function, affecting language, memory, and organization. Dementia may occur in about 25% of people following a stroke.
Vascular dementia is characterized by a subtle and progressive worsening of memory that occurs in a stepwise fashion due to atherosclerosis or stroke. Deficits may begin suddenly and then remain stable during a plateau period before more insults to the brain occur.
It can be difficult to distinguish from Alzheimer’s disease clinically, which occurs three times more often and is due to a different disease process. The conditions may overlap in some people.
Risk factors for vascular dementia are the same as those for stroke. These include:
Hypertension
High cholesterol (hyperlipidemia)
Cardiac disease
Diabetes
Male gender
Smoking
Alcohol use
These problems may lead to narrowing of the blood vessels supplying the brain, a process called atherosclerosis. Decreased blood flow can lead to sudden occlusion and damage to the area of the brain that was formerly supplied. The condition can be effectively diagnosed with magnetic resonance imaging (MRI) that will reveal these areas of damage.
Symptoms and Treatment
Individuals with vascular dementia experience significant memory problems that impair their ability to live independently. This can include:
Difficulties with organization and problem-solving
Mood changes, such as depression, irritability, and apathy (lack of interest)
Word recall impairment
Hallucinations or delusions (less common)
If strokes are impacting areas of the brain responsible for sensation, movement, balance, or vision, further symptoms may be present.
Evaluation by a neurologist is important to document the deficits and arrange additional testing, such as an MRI, as appropriate. Blood tests to assess B12, thyroid function, cholesterol levels, and glucose control are often done.
There is no cure for vascular dementia. Medications known as cholinesterase inhibitors may be prescribed to treat symptoms of dementia. These include:
Aricept (donepezil)
Exelone (rivastigmine)
Razadyne (galantamine)
In addition, healthcare providers focus on treating the underlying risk factors to prevent further damage to brain tissue. This may involve taking medicine for hypertension, high cholesterol, diabetes, and blood clotting disorders.
Procedures are sometimes needed to improve blood flow to the brain, such as carotid endarterectomy, angioplasty, and stenting.
Lifestyle changes may also be recommended. This includes following a heart-healthy diet, regular physical activity, quitting smoking, and decreasing alcohol intake.
Vascular Dementia and Sleep
There is evidence that vascular dementia can lead to disruption of the normal cycles of sleep and wakefulness. This can lead to poor sleep quality.
There does not seem to be a correlation between the degree of sleep disruption and the severity of intellectual deterioration. In other words, sleep may not be worse among those with more severe vascular dementia.
It is important to note that vascular dementia is more strongly associated with obstructive sleep apnea. This condition can contribute to mood and cognitive complaints, as well as excessive daytime sleepiness.
Fortunately, if sleep apnea is present, effective therapy with continuous positive airway pressure (CPAP) may reduce the risk of further strokes. Depending on the degree of impairment, some people with dementia may be unable to comply with the treatment.
If you are concerned that you or a loved one may be suffering from vascular dementia, speak with your healthcare provider and a sleep specialist about the required evaluation and potential ways to reduce the risk of further damage.
Read the original article on Verywell Health.
