Vascular dementia: your questions answered

Vascular dementia illustration

From the stages of vascular dementia to prognosis and life expectancy, we answer common questions about vascular dementia.

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

Vascular dementia means that thinking and memory problems are caused by reduced blood supply to the brain, due to blood vessels which are either blocked or have burst. 

With Alzheimer's, on the other hand, proteins build up in the brain to form structures called plaques and tangles. This can damage the connections between nerve cells in the brain, and lead to to the death of these cells.

Both types of dementia can affect memory, thinking skills and other mental abilities. 

What are the stages of vascular dementia?

Often vascular dementia affects decision-making and thinking first, followed by memory problems. In the early stages the symptoms can include problems with thinking or confusion, difficulty with decision making and with following a series of steps (for example making a cup of tea or cooking a meal). As the condition progresses, it damages all brain functions, so the effects can be similar to those of Alzheimer's disease in the later stages. The later stages include greater levels of confusion, mood changes, and memory problems. People may also have hallucinations in the later stages.

If you have vascular dementia following a stroke, you may also experience the effects of the stroke.

There is more overlap between types of dementia than we used to think, so BHF-funded researchers are looking at whether potential treatments for one type are relevant for others.

What is the prognosis if you have vascular dementia?

Whatever your type of dementia, you will decline with time. But everyone experiences dementia differently, and in some people the decline is slower than others. There is no cure for vascular dementia, but making changes to reduce your risk factors, like exercising, eating healthily, and taking medication to control your blood pressure and cholesterol, may help to slow the progression. 

What is the life expectancy with vascular dementia?

The life expectancy will vary from person to person and what other conditions you have. On average, people with vascular dementia live for around five years after symptoms begin, less than the average for Alzheimer’s disease. Because vascular dementia shares many of the same risk factors as heart attack and stroke, in many cases, the person’s death will be caused by a stroke or heart attack. But a lot of people die of their dementia, not just with it.

Does stroke cause dementia?

Vascular dementia often follows a stroke (or series of mini-strokes). It can also be caused by white matter disease, a condition involving abnormal function of small blood vessels in the brain. These conditions are all connected. With the help of BHF funding, Professor Philip Bath at the University of Nottingham is working with experts across the UK to study stroke patients and look at how stroke can lead to dementia. This may help us find out how we could reverse the damage to blood vessels in the brain.

How common is vascular dementia?

An estimated 150,000 people in the UK have vascular dementia, but many others have it in combination with Alzheimer’s.

Professor Philip Bath

Trying to stop stroke leading to vascular dementia

At the University of Nottingham, Professor Philip Bath is working on major research, part-funded by the BHF, to find out more about why stroke can lead to dementia:

“With the help of BHF funding, I am working with experts across the UK on a large study of at least 2,000 stroke patients. They will be followed for two years or more to measure their memory and other cognitive skills. This study will allow us to see how we can intervene to help them.

"We know that people with heart attacks and strokes have damaged the lining of the blood vessels and the question is: can this be reversed? Through research with Professor Joanna Wardlaw in Edinburgh, we are trying to modify the way blood vessels decline with age, to maintain blood vessel function.

"It is so important that the BHF is getting involved in this research, because when things go wrong with your circulatory system, they can affect many parts of your body. Most people who have coronary heart disease are likely to have narrowed arteries in other parts of their body, including their brain.

We don’t have a huge number of treatments for dementia, particularly vascular dementia. The explosion in people with diabetes is going to increase it further [as diabetes leads to blood vessel damage]. These conditions are all connected; it is only by tackling them all that we will get successes with new treatments.”

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