Vascular dementia is relatively common, after Alzheimer's disease (AD). This article highlights characteristics of varying types of this disease.

Vascular dementia is the second most common form of dementia after Alzheimer’s disease (AD). It is a type of dementia caused by problems with the supply of blood to, or within the brain.

The stages are similar to those of Alzheimer's disease, but the decline of functions happens in steps, rather than gradually. Symptoms vary, depending on which parts of the brain have been damaged and how severe the damage is.

Researchers believe that people who have had a stroke have an increased risk of developing vascular dementia. In the early stages, the individual may not experience memory problems and the personality will be unaffected.

Subcategories of vascular dementia include (1) mild vascular cognitive impairment, (2) multi-infarct dementia, (3) vascular dementia due to a strategic single infarct, (5) vascular dementia due to hemorrhagic lesions, (6) Binswanger’s disease and (7) mixed dementia (combination of AD and vascular dementia).

Early symptoms

• Memory: problems with recognizing well-known people
• Concentration difficulty
• Mood changes
• Physical weakness or paralysis
• Problems with following a conversation or communicating properly.

Progress of the disease

This depends on the factors causing the damage to their brain and the location of the damage. Changes may often occur suddenly, or occur in steps, rather than as a gradual decline. Additional symptoms may include: incontinence, confusion, hallucinations, delusions, restlessness, aggressive behaviour, getting lost and epileptic seizures.

Multi-infarct dementia

'Infarct' means 'damaged area'. Multi-infarct dementia (MID) is a common cause of memory loss in older people, caused by multiple strokes.

Disruption of blood supply leads to damaged brain tissue. So strokes may occur without the person even being aware; they are sometimes called "silent strokes." Over time, as more areas of the brain are damaged and more small blood vessels become blocked, the symptoms of MID appear.

Confusion may become apparent, or short-term memory difficulty; wandering, or getting lost in familiar places; walking with quick, shuffling steps; losing control of the bladder or bowel; inappropriate laughing or crying; following instructions with increasing difficulty.

MID usually begins between the ages of 60 and 75, and men are more usually affected by MID than women. Because the symptoms of MID are so similar to Alzheimer's disease, it can be difficult for a doctor to make a diagnosis. Since the diseases often occur together, making a single diagnosis of one or the other is even more of a challenge.

Treatment

There is no treatment to reverse brain damage that has been caused by a stroke. Therefore, treatment for MID focuses on preventing future strokes.

Binswanger’s disease

Binswanger's disease is a very rare form of dementia that can affect an individual's thought processes (cognition). It is characterized by damage in the deep white-matter of the brain, loss of memory and cognition, and mood changes.

Individuals with Binswanger's disease often show signs of abnormal blood pressure, stroke, blood abnormalities, disease of the large blood vessels in the neck, and disease of the heart valves. Other features include urinary incontinence, difficulty in walking, tremor similar to that seen in Parkinson's disease, and depression.

These symptoms are not always present, and may sometimes appear only as a passing phase. Seizures may also occur. The disease can be triggered by a stroke or other event, such as head injury that leads to brain damage.

There is no specific treatment or cure for Binswanger's disease. Management focuses on keeping the symptoms under control. This often involves the use of medications to control high blood pressure, depression, irregular heart beats and low blood pressure.