AN OVERVIEW OF THE 7 STAGES OF VASCULAR DEMENTIA<< Go Back
Vascular dementia is the second most common type of dementia after Alzheimer’s disease. According to Dementia Care Central, approximately 1.5% of the population in Western countries has this type of dementia. Like other types, vascular dementia is progressive. To learn about the causes, treatments, prevention, and 7 stages of vascular dementia, keep reading below.
What is Vascular Dementia?Vascular dementia is a cognitive disorder that affects reasoning, planning, judgment, memory, and other thought processes. A person runs the risk of developing vascular dementia when there’s brain damage resulting from a blockage or lack of blood flow. When the brain is deprived of oxygen, brain cells begin to die. This can result in signs and symptoms of vascular dementia. Typically, a series of small strokes can be the catalyst for developing this condition. At times, “silent strokes” may also occur without noticeable clinical symptoms. Keep in mind that not all cases of vascular dementia are due to strokes. It could result from any number of other conditions that damage the brain due to the deprivation of blood flow and oxygen. Vascular dementia symptoms can vary depending on which parts of the brain are damaged. However, there are some commonalities with other types of dementia. These include:
- Slowness of thought
- Trouble with understanding
- Problems with concentration
- Mood or behavioural changes
- Difficulty with planning
- Memory loss
Risk Factors for Vascular DementiaAccording to Mayo Clinic, the risks for developing vascular dementia are the same as those for heart disease and stroke. Both men and women are susceptible to developing this type of dementia, especially if they smoke or are overweight. High cholesterol and blood pressure are also contributing risk factors. Others include:
- Being over the age of 65: your risk for vascular dementia increases with age. It especially rises in your 80s and 90s.
- Diabetes: those with diabetes are susceptible to damaged blood vessels (including in the brain) due to high glucose levels.
- Atherosclerosis: a condition wherein plaque and cholesterol build up in arteries and narrow blood vessels.
- Atrial fibrillation: a condition wherein your heart beat has an abnormal rhythm that can lead to poor blood flow to your brain.
- History of heart disease or stroke: those with a history of heart disease or stroke have an increased risk of having damaged blood vessels in the brain. ‘Silent strokes’ may also not exhibit symptoms of dementia immediately.
Treatment and Prevention of Vascular DementiaUnfortunately, the damage a stroke causes to the brain is permanent and irreversible. Having said that, treatment protocols can help prevent further damage and slow the progression of vascular dementia. Patients may be prescribed medications for high blood pressure and cholesterol to treat the underlying causes of vascular dementia. They may also be prescribed aspirin or anticoagulant medications such as warfarin to reduce the risk of blood clots. At this point in time, there aren’t any FDA-approved drugs to specifically treat changes in judgment, memory, and other cognitive abilities affected by vascular dementia. However, certain medications used to treat symptoms of Alzheimer’s disease may also be used to treat symptoms of vascular dementia. These may include:
- Cholinesterase inhibitors: these drugs boost levels of a brain cell chemical messenger that’s involved with memory and judgement1. Medications under this drug class include donepezil, galantamine, and rivastigmine.
- Memantine: this medication works by decreasing abnormal excitement in the brain. It helps people think more clearly and perform daily activities more easily.
The 7 Stages of Vascular DementiaDepending on the type of damage the individual is facing, vascular dementia can occur very quickly or very gradually. At times, its slow onset can resemble that of Alzheimer’s disease. It’s also important to note that vascular dementia and Alzheimer’s disease can occur simultaneously. At times, physicians may discuss dementia in stages to gain a better understanding of its progress. However, according to Dementia Care Notes, the term ‘stages of dementia’ is used to describe how “someone with dementia gets affected over the years.” Having said this, these ‘stages’ or progression can vary between individuals and types of dementia. With this in mind, the ‘7 stages of vascular dementia’ (or dementia in general) are meant to provide caregivers a rough idea of what to expect. These stages are based on the Global Deterioration Scale for Assessment of Primary Degenerative Dementia. Typically, these 7 stages can be narrowed down to three categories: early stage, mid stage, and last stage. Here’s a breakdown of each stage:
Signs and Symptoms
|1||No cognitive decline- No dementia||There are no visible signs of cognitive impairment or signs of dementia in patients.|
|2||Very mild cognitive decline- No dementia||Patients have some issues with memory such as misplacing objects and forgetting names. These signs are often viewed as normal forgetfulness that are associated with aging. Signs may also not be apparent to loved ones or physicians.|
|3||Mild cognitive decline- No dementia||At this stage, dementia is still undiagnosed. However, patients begin having increased trouble with memory and concentration. They may also misplace or lose valuables. A decline in job performance is also more noticeable. Loved ones and physicians also notice a decline in cognition.|
|4||Moderate cognitive decline- Early-stage dementia||Signs are more clear-cut in clinical interviews at this dementia stage. Patients may have trouble performing complex tasks. They may also have some trouble remembering their own personal histories. However, they may not always forget names or faces of loved ones. Often, patients are in denial of their symptoms.|
|5||Moderately severe cognitive decline- Mid-stage dementia||At this dementia stage, patients need assistance. They may have trouble remembering relevant details or their own lives such as their address or phone number. They may also forget names of family members. Patients may also frequently be disoriented.|
|6||Severe cognitive decline- Mid-stage dementia||At this point, patients may occasionally forget their spouses’ or other loved ones’ names. They’ll also have trouble recalling recent events in their lives. Patients are also unaware of the time and their surroundings. They usually require some assistance with daily activities and may have changes in behaviour.|
|7||Very severe cognitive decline- Last-stage dementia||Over the course of this dementia stage, patients lose the ability to communicate verbally. They also become incontinent and require assistance when using the bathroom. Patients also require assistance in other daily activities such as eating and getting dressed. They also have trouble with basic psychomotor skills such as walking.|
Final WordVascular dementia is a debilitating condition that can affect individuals differently depending on the level of brain damage. However, with preventative measures, it is certainly possible to avoid this condition. Be sure to talk to your doctor about taking the necessary steps to keep heart attacks and strokes at bay!
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