Vascular Dementia
Results from death of neurones as a result in disruption of blood flow
Blood flow disruption can result from haemorrhage, clot, and watershed infarcts due to hypotensive episodes
Diseased blood vessels greatly pre-disposes to vascular dementia
T2DM
HTN
Hypercholesterolaemia
Size of vessel effected plays a role in symptoms seen
Large vessels with associated stroke symptoms
Smaller vessels acting as small stroke or TIA
Stroke symptoms may be so small they are not noticed, or resolve as in TIA, but with dementia symptoms persisting
Sub-cortical small vessels giving no stroke symptoms but if extensive gives dementia
Early symptoms
Memory loss less prominent than Alzheimer’s
Mental retardation and fluctuating attention
Problem solving and complex task issues
Later symptoms
Memory loss, visuospatial difficulties, word-finding problems
Harder to distinguish from Alzheimer’s
Frequent overlap with Alzheimer’s
Diagnosis relies on PMH of risk factors, step-wise deteriorations seen in dementia symptoms, CT head commonly shows white matter changes and evidence of infarcts
