What is vascular dementia?
Vascular dementia, also called multi-infarct dementia or vascular cognitive impairment, is the second most common form of dementia in the United States and Europe, after Alzheimer’s disease. In Asia it is more common. It is more common in men than in women and its prevalence increases with age.
Vascular dementia is not one single disease but rather a name given to a group of syndromes associated to different vascular mechanisms.
This condition can be prevented, so it is very important to diagnose it in its early stages.
Risk factors include stroke, obesity, high cholesterol, hypertension, alcoholism, smoking, family history of dementia, Down syndrome. The progression of vascular dementia can be very quick. It is believed that vascular dementia has higher mortality compared to Alzheimer, probably because it carries more cardiovascular risk factors.
This condition shortens the life expectancy by 50 percent in men, in persons with lower educations and in those who had poor results on neuropsychological tests.
Death results from complications of dementia and cardiovascular disease.
Vascular dementia can be diagnosed following several different criteria. Most commonly, the screening used is Folstein Mini-Mental State Examination, where the patient is asked to perform a series of tasks to test his or her orientation, recall, language, and registration.
The treatment for vascular dementia mostly aims to prevent further cerebrovascular lesions, which are responsible for this disease, with antiplatelet drugs, and similar. The patients at later stages require constant care and supervision by their family, spouse, partner or another caregiver, or by medical professionals in specialized homes.
Patients with vascular dementia may have behavioral problems, they may be disorientated and wander or get lost, they may suffer from hallucinations and delusions and poor judgment. Depression may also occur.
Patient may be likely to fall due to problems with movement, so injury is a possible complication.
Physically, the patient may become more prone to aspiration pneumonia. Because of the limited mobility, vascular dementia patients often suffer from decubitus or bedsores, which are lesions at the parts of the body where the pressure is most intense. Another possible complication is infection of bedsores.
Patients may neglect their personal hygiene as well as their eating routine. Dehydration is possible if a person keeps forgetting to drink water or if he or she is neglected by the caregiver. Weight loss is fairly common in dementia patients.
A particular aspect in dementia complications is the caregiver burden and stress. It can be very difficult to take constant care of a dementia patient and it may result in medical and psychological problems in caregiver.
There is also the risk of caregiver abuse, which can be financial, emotional or physical.