Vascular Dementia and Vascular Cognitive Impairment: A Resource List

Vascular dementia, a most common form of dementia in older adults, and vascular cognitive impairment (VCI) result from injuries to vessels that supply blood to the brain, often after a stroke or series of strokes. The symptoms of vascular dementia can be similar to those of Alzheimer’s, and both conditions can occur at the same time (a condition called “mixed dementia”). Symptoms of vascular dementia and VCI can begin suddenly and worsen or improve over time.

Caregivers of people with vascular dementia or VCI face a variety of challenges. Learning more about these disorders can help. This resource list is a place to start. All resources on this list are available free online.

The items on this list are in three categories:

• Vascular Dementia and Vascular Cognitive Impairment
• CADASIL—a rare, inherited form of vascular dementia
• Binswanger’s Disease—also called Subcortical Vascular Dementia

Vascular Dementia and Vascular Cognitive Impairment

The Dementias: Hope Through Research (2017)

This booklet from the National Institute on Aging and the National Institute of Neurological Disorders and Stroke describes different kinds of dementia, including vascular dementia. It discusses brain changes, symptoms, and treatments for many dementias, as well as risk factors and diagnosis for dementia generally. It also summarizes dementia research supported by the National Institutes of Health. The booklet includes a glossary and list of resources.

Published by the National Institutes of Health. Available from the NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center. Phone: 1-800-438-4380. Email: adear@nia.nih.gov.

Vascular Cognitive Impairment

This article on memory disorders notes the varied definitions of vascular cognitive impairment (VCI). It describes symptoms, including problems with memory and executive function. The article also gives information about diagnostic tests and treatments, as well as lifestyle changes that may reduce the risk of VCI.

Published by the Memory Disorders Center at the University of Cincinnati.

Vascular Dementia

In this article, vascular dementia is defined as a decline in thinking skills caused by a major stroke or multiple minor strokes. The fact sheet notes that vascular brain changes often coexist with changes linked to other types of dementia, including Alzheimer’s disease. The fact sheet lists symptoms, such as confusion and trouble speaking, and discusses diagnosis, causes, risks, treatment, and outcomes.

Published by the Alzheimer’s Association.

Vascular Dementia (2018)

According to this article, factors that increase risk for heart disease and stroke also increase vascular dementia risk. It addresses symptoms, causes, diagnosis, treatment, and risk factors, as well as steps to reduce risk. Coping mechanisms for patients and caregivers are also covered.

Published by MayoClinic.com.

Vascular Dementia (2018)

This article discusses vascular dementia as a common after-stroke problem that makes it difficult to process information. The condition can lead to memory loss, confusion, decreased attention span, other cognitive symptoms, and movement symptoms. The article offers practical tips for managing the disease and for caring for someone with vascular dementia.

Published by the American Stroke Association.

Vascular Dementia (2018)

In this overview, vascular dementia is described as dementia resulting from a series of small strokes over a long period. The article lists risk factors for vascular dementia, such as diabetes and heart disease, and symptoms, which grow worse as the disease progresses. Also discussed are diagnosis, treatment, prognosis, possible complications, and prevention.

Published by the National Library of Medicine. Phone: 1-888-346-3656.

Multi-Infarct Dementia Information Page (2019)

This article provides an overview of multi-infarct dementia, a type of vascular dementia caused by multiple, often “silent” strokes. It describes symptoms, the difficulty of diagnosis, and treatment by preventing or controlling risk factors such as high cholesterol.

Published by the National Institute of Neurological Disorders and Stroke. Phone: 1-800-352-9424. Email: https://www.ninds.nih.gov/Contact_Us.

Vascular Dementia: What Is It, and What Causes It? (2018)

This detailed article explains that vascular dementia has several types, including stroke-related, post-stroke, single-infarct, multi-infarct, subcortical, and mixed dementias. It describes their separate, but related, causes and how the disorder affects people over time. Risk factors, diagnosis, and treatment and support are also covered. The article’s information is available in a sign-language video and an audio recording (each approximately 30 minutes). A summary is provided in a 3-minute video.

Vascular Contributions to Cognitive Impairment and Dementia

Vascular contributions to cognitive impairment and dementia (VCID) are conditions arising from stroke and other vascular brain injuries that cause significant changes to memory, thinking, and behavior. Cognition and brain function can be significantly affected by the size, location, and number of brain injuries. Two forms of VCID—vascular dementia and vascular cognitive impairment (VCI)—arise as a result of risk factors that similarly increase the risk for cerebrovascular disease (stroke), including atrial fibrillation (a problem with the rhythm of the heartbeat), high blood pressure, diabetes, and high cholesterol.

Symptoms of VCID can begin suddenly and progress or subside during one’s lifetime. VCID can occur along with Alzheimer’s disease. People with VCID almost always have abnormalities in the brain on magnetic resonance imaging scans. These abnormalities include evidence of prior strokes, often small and asymptomatic, as well as diffuse changes in the brain’s “white matter”—the connecting “wires” of the brain that are critical for relaying messages between brain regions. Microscopic brain examination shows thickening of blood vessel walls called arteriosclerosis and thinning or loss of components of the white matter.

What are the Different Types of VCID?

Vascular dementia refers to progressive loss of memory and other cognitive functions caused by vascular injury or disease within the brain. Symptoms of vascular dementia may sometimes be difficult to distinguish from Alzheimer’s disease. Problems with organization, attention, slowed thinking, and problem solving are all more prominent in VCID, while memory loss is more prominent in Alzheimer’s.

Vascular cognitive impairment involves changes with language, attention, and the ability to think, reason, and remember that are noticeable but are not significant enough to greatly impact daily life. These changes, caused by vascular injury or disease within the brain, progress slowly over time.

Post-stroke dementia can develop months after a major stroke. Not everyone who has had a major stroke will develop vascular dementia, but the risk for dementia is significantly higher in someone who has had a stroke.

Multi-infarct dementia is the result of many small strokes (infarcts) and mini-strokes. Language or other functions may be impaired, depending on the region of the brain that is affected. The risk for dementia is significantly higher in someone who has had a stroke. Dementia is more likely when strokes affect both sides of the brain. Even strokes that don’t show any noticeable symptoms can increase the risk of dementia.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an extremely rare inherited disorder caused by a thickening of the walls of small- and medium-sized blood vessels, which reduces the flow of blood to the brain. CADASIL is associated with multi-infarct dementia, stroke, and other disorders. The first symptoms can appear in people between ages 20 and 40. CADASIL may have symptoms that can be confused with multiple sclerosis. Many people with CADASIL are undiagnosed.

Subcortical vascular dementia, previously called Binswanger’s disease, involves extensive microscopic damage to the small blood vessels and nerve fibers that make up white matter in the brain. Cognitive changes include problems with short-term memory, organization, attention, decision making, and behavior. Symptoms tend to begin after age 60, and they progress in a stepwise manner. People with subcortical vascular disease often have high blood pressure, a history of stroke, or evidence of disease of the large blood vessels in the neck or heart valves.

Cerebral amyloid angiopathy is a buildup of amyloid plaques in the walls of blood vessels in the brain. It is generally diagnosed when multiple tiny bleeds in the brain are discovered using magnetic resonance imaging.

How is VCID Treated?

Vascular contributions to cognitive impairment and dementia are often managed with drugs to prevent strokes or reduce the risk of additional brain damage. Some studies suggest that drugs that improve memory in Alzheimer’s might benefit people with early vascular dementia. Treating the modifiable risk factors, such as high blood pressure, can help prevent additional stroke.

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