Vascular dementia is a condition caused by a blockage preventing blood flow or reduced blood flow to the brain. Once brain cells are deprived of oxygen and nutrients carried by the blood, they die. Brain cell death causes dementia.
Recent research goes further and is recommending a “life-course” shift to maximize your ‘windows of opportunity,” in preventing vascular dementia.
Doctors are stressing that mid-life patients:
- Manage Hypertension:
- Studies suggest increased dementia risk for people with hypertension.1
- manage their Body Mass Index,
- explore hormone replacement therapy and
- treat depression.
Other evidence suggests that:
- cognitive stimulation and social activities,
- head injury,
- diet, and
- and oral health should be explored in making a plan for Vascular dementia risk reduction.
The connection between vascular disease and dementia has been well documented by science and the connection between the two is something we explore in our patients.
Young-onset dementia is a neurologic syndrome that affects behavior and cognition of patients younger than 65 years of age. Although frequently misdiagnosed, a systematic approach, reliant upon attainment of a detailed medical history, neuropsychological testing, laboratory studies, and neuroimaging, may facilitate earlier and more accurate diagnosis with subsequent intervention.
The differential diagnosis of young-onset dementia is extensive and includes early-onset forms of adult neurodegenerative conditions including:
- Alzheimer’s disease, vascular dementia,
- frontotemporal dementia,
- Lewy body dementias,
- Huntington’s disease,
- and prion disease.
Late-onset forms of childhood neurodegenerative conditions may also present as young-onset dementia.
Potentially reversible etiologies including inflammatory disorders, infectious diseases, toxic/metabolic abnormalities, transient epileptic amnesia, obstructive sleep apnea, and normal pressure hydrocephalus (intracranial pressure) also represent important differential diagnostic considerations in young-onset dementia. 3
Cardiovascular and Vascular dementia treatment
“Cardiovascular disease and dementia are common in the elderly and are major causes of disability in the general population. Epidemiological studies suggest that these once believed unrelated conditions, heart disease and dementia, may be linked by shared common risks and pathogenic elements.
These observations have sparked the notion that prevention or modification of certain vascular risk factors and proper management of cardiovascular disease may prevent the development or progression of dementia including Alzheimer’s disease.” 4
“Vascular disease is associated with increased risk of dementia. Vascular health worsens with age….The findings (of this study) support the view that cerebral small vessel disease and cardiovascular disease are inter-related…the findings add weight to the argument for strategies to improve general cardiovascular health as a potential preventative strategy against cognitive decline in later life.”5
In research at the British Medical Journal, University College London health care professionals followed more than 7,000 men and women ages 45 to 70 over a 10-year period to rate their brain decline as they aged.
The study showed that men aged 65-70, there was a 9.6% decline in mental reasoning while women suffered a decline of 7.4%. However, what they found most alarming was in both men and women between the ages of 45-49 showed a 3.6% decrease in brain function.
This is what the researchers said “Adverse cognitive outcomes like dementia are now thought to be the result of long term processes over at least 20-30 years leading some authors to argue for the importance of approaches during life.
Despite much research on early diagnosis, pathophysiological and clinical studies have yet to identify biomarkers or cognitive profiles that accurately predict dementia.
Nevertheless, there is enough evidence to show the importance of healthy lifestyles and cardiovascular risk factors in adulthood for dementia.
For some of these risk factors, such as obesity, hypertension, and hypercholesterolaemia, it is mid-life levels that seem to be more important than those measured at older ages.
There is emerging consensus that “what is good for our hearts is also good for our heads,” making aggressive control of behavioural and cardiovascular risk factors as early as possible key targets for clinical practice and public health.”6
What the British researchers are stressing is not that brain decline occurs, but the surprise at the rate of decline that begins in the mid 40’s and the lifestyle and dietary lifestyles that need to be addressed to help patients have both a health heart and mind.
Below is reprinted from materials from Methodist Neurological Institute
Managing and treating vascular disease risk factors are not only beneficial to preventing heart disease and stroke, but also common forms of dementia.
managing and treating vascular disease risk factors are not only beneficial to preventing heart disease and stroke, but also common forms of dementia
Research shows that managing and treating vascular disease risk factors are not only beneficial to preventing heart disease and stroke, but also common forms of dementia.
Hypertension: Controlling blood pressure reduces the risk of stroke and heart disease. Studies are also beginning to show that hypertension increases the likelihood that people with mild cognitive impairment will eventually have dementia later in life.
Hyperlipidemia: Epidemiological studies show that in addition to cardiovascular disease, high blood pressure and diabetes, high blood cholesterol is an important risk factor for dementia, including Alzheimer’s.
Smoking: Not only is smoking associated with increased risk of lung cancer, cardiovascular disease and emphysema, but it also adversely affects blood flow to the brain which can lead to cognitive decline and dementia.
Diabetes: Studies have already linked the obesity epidemic to increased risk of high blood pressure, metabolic syndrome, cardiovascular disease, stroke, renal failure, peripheral vascular disease, obstructive sleep apnea, and type 2 diabetes mellitus. In fact, people with this form of insulin resistant diabetes are two-to-three times more likely to face an Alzheimer’s diagnosis, in part because of vascular complications.
Diet and Exercise: An overall healthy lifestyle decreases risk of dementia as people age, particularly vascular dementia. Here, the focusis on a low body mass index (25 or lower), healthy diet (based on dairy, meat, fish, fruits, vegetables, cereals, low alcohol, and the ratio of monounsaturated to saturated fat), and aerobic exercise.
Hyperhomocysteinemia: Homocysteine is an amino acid in the blood, and high blood levels are linked to an increased risk of developing Alzheimer disease. People who already exhibit signs of dementia and test positive for high levels of homocysteine are more likely to respond well to large doses of B vitamins. Research has proven that taking large doses of B-complex vitamins can reduce the rate of brain shrinkage by half in elderly people with memory problems and slow the progression of dementia.
Do you have questions about Dementia or lifestyle changes that may help?
Call US 856-424-8222 OR email us at: info@DrMagaziner.com
1 McDonald C, Pearce M, Kerr SR, Newton JL. Blood pressure variability and cognitive decline in older people: a 5-year longitudinal study. J Hypertens. 2017 Jan;35(1):140-147.
1. [Dementia and diabetes: Casual or causal relationship?] Med Clin (Barc). 2014 Mar 12. pii: S0025-7753(14)00119-5. doi: 10.1016/j.medcli.2014.01.026. [Epub ahead of print]
2. Rooney RF. Preventing dementia: how lifestyle in midlife affects risk. Curr Opin Psychiatry. 2014 Jan 16. [Epub ahead of print]
3. Kuruppu DK, Matthews BR. Young-onset dementia. Semin Neurol. 2013 Sep;33(4):365-85. doi: 10.1055/s-0033-1359320. Epub 2013 Nov 14.
4. Muqtadar H, Testai FD, Gorelick PB. The Dementia of Cardiac Disease. Curr Cardiol Rep. 2012 Sep 12. [Epub ahead of print]
5. Richardson K, Stephan BC, Ince PG, Brayne C, Matthews FE, Esiri MM. The Neuropathology of Vascular Disease in the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS). Curr Alzheimer Res. 2012 Apr 2.
6 Singh-Manoux A, Kivimaki M, Glymour MM et al. Timing of onset of cognitive decline: results from Whitehall II prospective cohort study. BMJ 2012; 344 doi: 10.1136/bmj.d7622 (Published 5 January 2012)