What is the difference between vascular dementia and Alzheimer’s disease?

The cause is different: Alzheimer’s is a neurodegenerative disease characterised by abnormal protein deposits; vascular dementia is the result of impaired blood flow to the brain. The course differs: Alzheimer’s progresses gradually; vascular dementia often progresses “in steps”. In practice, many older people have mixed dementia, a combination of the two forms.

Does a stroke always lead to dementia?

No. Many people have a stroke without developing dementia. Whether vascular dementia develops depends on the location, size and number of the brain lesions, but also on individual factors. Careful control of risk factors after a stroke significantly reduces the risk of later dementia.

Can I prevent vascular dementia?

Largely, yes. This is one of the few forms of dementia where prevention is realistic: control of blood pressure, diabetes and cholesterol, regular physical activity, healthy eating, stopping smoking and managing stress are all interventions with a proven impact.

My parent has seemed slower since their stroke. Should I wait for it to pass?

No. It is worth talking to a doctor: changes after a stroke can be assessed, and you can find out how to help at home.

Vascular dementia | Acord Med

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What is vascular dementia

Vascular dementia develops when blood flow to the brain is impaired, either through strokes or through chronic damage to the small blood vessels in the brain.

The lack of adequate blood flow deprives nerve cells of oxygen and essential nutrients, leading to their damage and death. The seriousness and location of the damage determine the type and severity of the symptoms.

Unlike Alzheimer’s disease, vascular dementia:

often progresses in steps (a sudden decline, then a period of stability, then a new decline), especially when it is caused by repeated strokes
affects the executive functions (planning, organisation, attention) more visibly than memory, especially in the early stages
can be largely prevented and slowed down by controlling vascular risk factors
has a prognosis that depends significantly on the management of associated cardiovascular diseases

Vascular risk factors

Vascular dementia is, to a large extent, the result of cardiovascular problems. The main risk factors are:

Untreated or poorly controlled high blood pressure
Poorly controlled diabetes mellitus
High cholesterol
Atrial fibrillation and other heart rhythm disorders
Carotid artery disease
Smoking
A sedentary lifestyle
Obesity
Excessive alcohol consumption

Most of these factors are modifiable. Controlling them, especially blood pressure, blood sugar and cholesterol, can go a long way towards preventing or slowing down vascular dementia.

When to see a specialist

An assessment is worthwhile if any of these apply to you or someone close to you:

a history of stroke, transient ischaemic attack or other significant cardiovascular problems
new difficulties with concentration, planning or organisation
slower thinking, noticed by the family
episodes of confusion or disorientation
recent changes in personality or mood
persistent weakness on one side of the body
new difficulties with walking or balance

Important: if weakness on one side of the body, trouble speaking or confusion come on suddenly, call 112 at once: it may be a stroke.

The doctor can help you understand the changes and find what helps your loved one day to day.

See also: The brain and inflammation

The first step

If you recognise the signs in the list above, book a conversation with one of our specialists. Together, we’ll look at what’s going on and what your options are.

For the assessment, we recommend that the patient comes with someone close to them, with the patient's agreement. If that is you, what you have noticed at home helps us understand the changes.

Besides the psychiatric consultation, the assessment can include tests of memory and thinking, carried out by the team’s clinical psychologists. If getting to the clinic is difficult, the psychiatrist can also do the consultation as a paid home visit in Bucharest and Ilfov.

Services: Psychiatry · Psychological assessment
See our team and pricing.

This information is for educational purposes and does not replace a specialist consultation.

Vascular dementia