Dementia - Vascular Dementia

Question 1

Types of Vascular Dementia (3).

Answer 1

1. Stroke-Related (Multi-Infarct/Single-Infarct).
2. Subcortical (Small Vessel Disease).
3. Mixed (Both VD and AD).

Question 2

Aetiology of Vascular Dementia.

Answer 2

Impaired blood flow to areas of the brain due to vascular damage.

Question 3

Risk Factors of Vascular Dementia.

Answer 3

1. Stroke/TIA.
2. AF, HTN, Hyperlipidaemia, DM.
3. Smoking, Obesity, CHD.
4. Family History.

Question 4

Clinical Features of Vascular Dementia.

Answer 4

Step-Wise Progression due to progressive infarcts over time.

Question 5

Investigations of Vascular Dementia (2).

Answer 5

1. Diagnosis - Clinical.

2. Imaging : Evidence of Significant Small Vessel Disease (MRI).

Question 6

Diagnostic Criteria of Vascular Dementia (3).

Answer 6

NINDS-AIREN Criteria :

1. Presence of Cognitive Decline that Interferes with Activities of Daily Living (not due to Secondary Effects of Cerebrovascular Events).
2. Cerebrovascular Disease (Neurology/Brain Imaging).
3. Explainable Relationship e.g. Onset within 3 Months of Stroke, Abrupt Deterioration in Cognitive Function, Fluctuating STEPWISE Progression.

Question 7

Management of Vascular Dementia.

Answer 7

1. Treat Underlying Risk Factors.
2. Cognitive Stimulation Programmes, Multisensory Stimulation, Music & Art Therapy, Animal-Assisted Therapy.
3. Manage Challenging Behaviours.

Question 8

When can AChE inhibitors or Memantine be considered in Vascular Dementia?

Answer 8

Suspected Comorbid :

1. Alzheimer’s Disease.
2. Parkinson’s Disease.
3. Dementia with Lewy bodies.