A Complete Guide to Vascular Dementia If You Are Worried About Vascular Dementia Or Know Someone Who Is, This Guide Can Help You Understand What You Need to Do
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stroke.org.uk A complete guide to Vascular dementia If you are worried about vascular dementia or know someone who is, this guide can help you understand what you need to do. It will tell you what vascular dementia is and how it is linked to stroke. It also explains what you should do if you or someone you know is diagnosed with vascular dementia. It’s aimed at people who have had a stroke or who think they may have vascular dementia, but there is information for family and friends as well. We have information on all aspects of stroke. If you have a question that is not answered in this guide visit stroke.org.uk or call our Stroke Helpline on 0303 3033 100. 2 Vascular dementia What’s in this guide? What is vascular dementia? 4 How is it linked to stroke? 4 What should I do if I think I have vascular dementia? 5 Will it get better? 6 Are there treatments that can help? 7 What should I do if I’m diagnosed with vascular dementia? 8 Where can I get help and support? 12 How we can help 12 Other organisations that can help 13 Tips for family and friends 14 Vascular dementia 3 What is vascular dementia? Dementia is a condition that can affect your How is it linked to stroke? memory, thinking, communication, mood and behaviour. It happens when parts of your When you have a stroke, the blood supply brain become damaged. There are different to parts if your brain is cut off and the cells types of dementia and it’s possible to have in these areas die. This can lead to vascular more than one. dementia. Vascular dementia is a common type of This can happen after a single stroke, but dementia. It happens when the blood supply it’s more likely to be caused by lots of small to parts of your brain is cut off, so it doesn’t strokes, which create lots of small areas of get the oxygen and nutrients that it needs. damage in your brain. Often, these strokes This causes brain cells to die. can be so small that you do not know you are having them. These are known as silent Vascular dementia affects different people in strokes. different ways. The symptoms you have will depend on the areas of your brain that have Symptoms of vascular dementia can appear been damaged. suddenly if they are caused by a single stroke, or if they are caused by silent strokes they Signs of vascular dementia may appear gradually over time. Vascular dementia sometimes develops in ‘steps’, so If you or the people around you notice any that symptoms will stay the same for a while of these things then you should go to see and then suddenly get worse. These steps your GP: are usually due to new strokes. • not being able to understand or respond to things very quickly Vascular dementia can also be caused by • becoming confused small vessel disease. This is when the small • not being able to remember things blood vessels deep within your brain become • finding it difficult to concentrate narrow and clogged up. This stops blood • not being able to find the right word from getting to parts of your brain. This can when you’re speaking cause damage over time (known as vascular • seeming down or depressed cognitive impairment) which can then lead to • behaving differently, especially if vascular dementia. you’re being aggressive or behaving inappropriately Many of the things that increase your risk • not being able to control your emotions of small vessel disease, such as high blood • finding it difficult to walk and keep your pressure and diabetes, also increase your risk balance of stroke. • having problems controlling your bladder Symptoms of vascular dementia can • seeing or hearing things that aren’t sometimes be confused with the effects there of stroke, as many of them are the same. • believing things that aren’t true. The difference is that vascular dementia gets worse over time. If you’re unsure, go to see your GP. 4 Vascular dementia What should I do if I think I have vascular dementia? If you’re noticing signs of vascular dementia, If your GP isn’t able to find any other causes, then you need to go and see your GP as soon they will refer you to a dementia specialist. as possible. This could be a: • psychiatrist (a doctor who specialises in Your GP will talk to you and do a number mental health conditions) of tests to see what may be causing your • geriatrician (a doctor who specialises in symptoms. It’s probably a good idea to take a the health of older people) friend or family member with you to help you • neurologist (a doctor who specialises in answer your GP’s questions. They may have the way the brain works). noticed symptoms that you haven’t or be more aware of how long you’ve had them. These doctors are often based within a memory clinic, so it’s possible that you may To help them rule out any other causes your be referred to one of these. Memory clinics GP is likely to: are services that have been set up all over the • talk to you about your symptoms UK to help people with dementia. • go through your medical history to see if you have any conditions that are linked to Your specialist will carry out further tests. vascular dementia, like heart problems, They will ask you questions to see how high blood pressure or diabetes your memory and thinking may have been • take some blood or ask for a urine sample, affected. They may also arrange for you to so that they can check for other problems have a brain scan, so that they can see how that could be causing your symptoms such much damage has been caused to your brain. as an infection or low levels of vitamins or hormones • look at the medication you’re taking to see if that could be causing any of your symptoms. Vascular dementia 5 Will it get better? Unfortunately, there is no way to cure vascular dementia. It is a progressive condition, which means it gets worse over time. How quickly it progresses is different for everyone. Your symptoms may stay the same for months, or even years, but then they will suddenly get worse. Although your dementia will not get any better, it may be possible to slow down how quickly it progresses. 6 Vascular dementia Are there treatments that can help? Unfortunately there isn’t any way to treat Whilst there aren’t any treatments for vascular dementia. However, if it’s caught vascular dementia itself, there may be things early enough you may be able to slow down that can help to improve your symptoms. how quickly it progresses. This means These could include: reducing your risk of having further strokes, which could cause more damage to your • Medication brain. Sometimes medication may be able to improve your mood if you are feeling very To do this you may need to: down or depressed. Some drugs have • take medication to lower your blood also been shown to improve confusion, pressure or cholesterol although they don’t seem to work as • take medication to thin your blood and well for vascular dementia compared to stop it from clotting as easily other types of dementia. Medication can • stop smoking also help with some behaviour problems. • eat a healthy diet However, there are risks to taking these • drink less alcohol drugs, so it’s important you talk through • do more exercise all the advantages and disadvantages with • lose weight. your family and doctor before you decide to try them. Your doctor should talk to you about all the things you need to do to reduce your risk of • Rehabilitation therapy further strokes. If your dementia is causing physical problems, then you may be able to Acetylcholinesterase or AChE work with a physiotherapist to try to inhibitors are drugs that are used to improve them. Or a speech and language treat Alzheimer’s disease – the most therapist may be able to help you with common type of dementia. But there any communication problems that you’re has not been enough evidence so far to having. An occupational therapist will also suggest that they could help to improve be able to work with you to make sure that vascular dementia. They also have side you can be as independent as possible. effects. More research needs to be done before doctors can recommend them as a • Other forms of therapy treatment for vascular dementia. There are other therapies that can help with the effects of dementia. Cognitive stimulation therapy, for example, uses group activities to help people improve their memory, concentration and ability to solve problems. Reality orientation therapy helps people to feel less disorientated and confused. These therapies are not suitable for everyone and may not be available in all areas, so it’s best to talk to your doctor about what your options are. Vascular dementia 7 What should I do if I’m diagnosed with vascular dementia? Talk to someone Get the information you need Being told that you’ve got vascular You’re going to have lots of 1 dementia can be devastating. 2 questions. You may wonder what’s Suddenly your future is not what going to happen and worry about you thought it would be. People not being able to do things for feel lots of different emotions when yourself.