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Meet the Dementias: Vascular Dementia

What is vascular dementia? How is it different from Alzheimer’s Disease? Read on for more information.

What Causes Vascular Dementia

Years of HEAVY traffic can cause a highway to get damaged and develop potholes. Years of heavy traffic in the blood vessels can do sort-of the same thing in people’s brains.

High Blood Pressure

High blood pressure often results because blood vessels tighten, or constrict. Cigarette smoking causes blood vessels to become smaller. The smaller the vessel, the longer it takes for blood cells to deliver oxygen and take away waste. Think about it. Would you rather be part of a large group walking through a giant door, or part of  a large group of people are trying to get through a small doorway? In this case, the crowd bunches up and a line forms because people can only move through the small door single-file. If the doorway was double or triple the size, the people could move through it more quickly.

High Cholesterol

High levels of cholesterol result in “sludge” along the sides of your blood vessels. The blood cells bump into the sides of the vessels and cause damage. Some get stuck in the sludge can create clots. This damage plus the clots cause blood vessels to close off. If brain cells cannot get oxygen, they die.


Uncontrolled blood sugar “candy-coats” the red blood cells. These cells get a hard shell on them, and they rip into the blood vessels as the cells travel through the body. The body tries to repair the rips in the blood vessels by creating clots. Sometimes, the clots do the trick and absorb, leaving some scar tissue. Sometimes, the clots break off and lodge in smaller downstream blood vessels. The brain cells being fed by the smaller vessel die off.

Brain Damage Over Time

High blood pressure, high cholesterol, and diabetes, if not controlled, create problems with oxygen-rich blood coming to various parts of the body, including the brain. When someone has a stroke, the reason is either a blood vessel blockage (this happens the majority of the time) or a brain bleed from a burst blood vessel. Depending on the part of the brain that is damaged, and the size of the damage, and you may see memory problems plus problems with making and understanding speech.

Vascular dementia can show up after decades of silent damage. Little bits of the brain are cut off from the blood supply and die off. Depending on how much “cognitive reserve” is present, the damage is not noticeable. The person’s memory is fine, he or she is working and productive, life is great. At some point,  however, the damage builds up until the brain can no longer compensate or adjust to the changes. Then, you begin to see signs like short-term memory loss, repeating the same questions over and over again, and trouble finding words.

Vascular Dementia and Alzheimer’s Disease

Alzheimer’s Disease causes different changes to happen in the brain. The changes in memory and ability to do things can be similar in both diseases.To make it even more confusing, a person may have both Vascular Dementia and another type of dementia together, such as Alzheimer’s Disease. Some experts believe that the cardiovascular (heart and blood vessel) damage brings on the memory loss from Alzheimer’s Disease (or another dementia) sooner than if the person had never had any cardiovascular disease. For more information about Vascular Dementia, click here.

Members of minority groups who are at higher risk for diabetes and high blood pressure are at higher risk for vascular dementia.

Many of the behaviors that family and formal caregivers deal with are present regardless of the type of the dementia. While it is good to know what type of dementia you are dealing with, because some medications are better for one dementia over another type of dementia, it does not really matter when you are dealing with behaviors.

Categories: Vascular Dementia

Dr. Rita Jablonski

Rita Jablonski, PhD, CRNP, FAAN, FGSA is a nurse practitioner, researcher, tenured professor, and former family caregiver. Her research and practice involve all aspects of dementia management; she is best known for non-drug strategies to address dementia-related behaviors.

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