Causes and Diagnoses

Causes and Diagnoses of Vascular Dementia

Vascular dementia results from conditions that damage your brain's blood vessels, reducing their ability to supply your brain with the amounts of nutrition and oxygen it needs to perform thought processes effectively. Your risk for vascular dementia rises as you grow older. The disorder is rare prior to age 65, yet your risk rises significantly when you reach your 80s and 90s.

Medical conditions that may lead to vascular dementia include:

• Stroke (infarction) blocking a brain artery: Strokes that block a brain artery usually cause a range of symptoms that may include vascular dementia. But some strokes don't cause any noticeable symptoms. These "silent brain infarctions" still increase dementia risk. With both silent and apparent strokes, the risk of vascular dementia increases with the number of infarctions that occur over time. Multi-infarct dementia is one type of vascular dementia involving many strokes.
• Narrowed or chronically damaged brain blood vessels: Conditions that narrow or inflict long-term damage on your brain's blood vessels can also lead to vascular dementia. These conditions include the wear and tear associated with aging, high blood pressure, hardening of the arteries, diabetes, lupus brain hemorrhage and temporal arteritis.

Risk factors

Risk factors for vascular dementia are similar to those for heart disease and stroke, and include:

• Advancing age
• Atherosclerosis
• Atrial fibrillation
• Diabetes
• Elevated levels of low-density lipoprotein (LDL), also called "bad" cholesterol
• High blood pressure
• High cholesterol
• History of heart attack, strokes or mini strokes
• Obesity
• Smoking

Diagnoses and testing

While physicians can almost always determine if you have dementia, there are currently no specific tests available to confirm if you have vascular dementia. Instead, your physician will make a diagnosis about whether vascular dementia is causing your symptoms based on the information you provide, your medical history for stroke, and a combination of lab tests and a neurological exam.

Lab tests of your blood pressure, blood sugar and cholesterol levels will allow your physician to rule out other possible causes of memory loss and confusion. A neurological examination of your reflexes, coordination and balance may help your physician determine your neurological health. Testing your muscle tone and strength, particularly how it compares from one side of the body to the other, will also help determine whether there is vascular dementia.

Imaging technologies, such as CT scan, MRI and carotid ultrasound can also help your physician diagnose visible abnormalities caused by stroke, tumors, trauma or other diseases of the blood vessels that may be affecting your reasoning. You may also be referred to a specialist who will conduct neuropsychological tests to assess your ability to speak, write and understand language, solve problems and work with numbers.