Nearly everyone gets the first stage of the Vascular Dementia — small vessel disease — as we grow older.
A wife’s question: “Can anyone help me understand? My husband is in the early stages of Vascular Dementia. We were told that tiny blood vessels in the brain have been damaged by blood clots. This makes sense to me. What I’m struggling with is why, after the damage has been done, is he still progressing? He does have Atrial Fibrillation so there’s reduced blood flow to the brain as well.”
Vascular Dementia (also known as multi-infarct dementia) is the diagnosis in about 15% of dementia cases. It is the result of brain damage due to reduced or blocked blood flow in blood vessels in your brain. This damage can be caused by stroke, infection of a heart valve (endocarditis) or other blood vessel conditions that deprive brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die.
A major cause of vascular dementia is multiple TIAs (transient ischemic attacks), sometimes called mini-strokes or silent strokes. Each one is like a stroke, producing similar symptoms, but usually lasting only a few minutes or less. A TIA may or may not produce visible symptoms, may or may not be noticed by the person having it, and may happen when they are awake or asleep. Once someone has a TIA, they are at an increased risk of having more in the future. And, left untreated, about 1 in 3 people who have a TIA will eventually have a stroke.
Multiple TIAs leave scars in the brain, often called small vessel disease, that can be seen with an MRI exam. These scars may be concentrated in one area of the brain, causing a gradual loss of function in that area. Or, they may be spread throughout the brain, causing a gradual deterioration of mental capabilities.
Even though there is no cure now for vascular dementia, potential treatments to slow its progression might include:
- beta blockers to reduce high blood pressure;
- statins to reduce bad cholesterol and triglycerides; and
- blood thinners to reduce the frequency of blood clot formation.
Check with your cardiologist or neurologist to see if these or other medications may be appropriate for you or your loved if small vessel disease is suspected.
A number of heart conditions can also contribute to the formation of blood clots. Among these are Atrial Fibrillation (AFib) and its rarer companion, Atrial Flutter (AFlutter). Both conditions cause the heart to beat more rapidly that the blood vessels can handle. The result: left-over blood in the heart that has the tendency to clot. Eventually, without appropriate medication, these clots can travel to the lungs, brain and limbs of the affected person.
On a personal note: I’ve had two cardiac procedures to stop both AFib and AFlutter. In my case, my cardiologist was very concerned that, like many other patients, I had no symptoms of either condition even though my heart rate exceeded 180 beats per minute for extended periods of time. It was found only because I’m a strong believer in regular check-ups by a physician.