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Vascular dementia refers to abnormalities in thought processes and cognitive function brought about by blood circulation problems in the brain. Depending on the severity of blood flow interruption, the onset of the symptoms of vascular dementia may be gradual or sudden. Common symptoms of vascular dementia include impairments in thinking, including disorientation, confusion, and personality changes, and memory loss, especially involving short-term memory. Patients may also have mood and behavior changes, severe depression, and even some psychotic symptoms, such as hallucinations, delusions, and paranoia. Other physical signs associated with reduced blood flow may also accompany the symptoms of vascular dementia, including weakness or numbness on one side of the body, difficulty walking, and urinary or bowel incontinence.
Patients with vascular dementia often complain of dizziness. They may experience tremors in the upper and lower extremities. Often, they will have balance problems and walk with shuffling, quick steps. Their words may be slurred and incoherent. They may struggle to find the right words to convey their thoughts. Frequently lost even in familiar surroundings, they may become agitated and even hostile.
Second only to Alzheimer’s disease, vascular dementia is a leading cause of dementia in the United States and Europe. Unlike Alzheimer’s disease with which patients may survive for many years, vascular dementia has a high mortality rate, especially following a stroke, with the five-year survival rate being only 39 percent. Although the associated heart disease, hypertension, and diabetes contribute to the increased mortality rate, the patient’s inability to function normally in daily activities, self-care, and planning processes, no doubt impacts the quality of life for many vascular dementia patients. The symptoms of vascular dementia isolate the patients socially as they lose social skills, struggle with communication, and shift from one mood to another. Many patients with vascular dementia laugh or cry inappropriately.
The symptoms of vascular dementia result from blockage of the blood supply to the cortex, or white matter of the brain. These areas are crucial for memory formation, learning, and language. Blood flow to these key areas may be disrupted due to blood clots or cholesterol plaques either forming in the arteries or traveling in the blood stream. Brain cells die if they are robbed of oxygen and nutrients for more than a few seconds. The affected areas do not regenerate or heal, producing holes within the brain tissue called lacunae.
A major part of managing the symptoms of vascular dementia is the establishment of ways in which to cope with the effects. Patients should follow a schedule each day. They should keep essential items in the same place, post critical information, such as telephone numbers, in an easily visible location, and carry around a notepad. Furthermore, they should keep distractions, such as television or radio, to a minimum when attempting to communicate with others. It is helpful for patients to be honest with others about the vascular dementia and ask for help.
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