Vascular dementia

Question 1

Roughly what percentage of dementia cases are vascular dementia?

Answer 1

20

Question 2

What is vascular dementia a result of?

Answer 2

Multiple cerebrovascular events/ chronic ischaemia

Question 3

True or false: there is stepwise deterioration in cognitive function with vascular dementia

Answer 3

True

Question 4

What are causes of vascular dementia?

Answer 4

Cerebral artery atherosclerosis
Carotid artery / heart embolization
Chronic hypertension leading to cerebral arteriole sclerosis
Vasculitis

Question 5

What are risk factors for vascular dementia?

Answer 5

Smoking
Hypertension
History of stroke/TIA
Diabetes
Insulin resistance
Hyperlipidaemia

Question 6

What are some symptoms of vascular dementia?

Answer 6

Gait disturbance
Urinary frequency/urgency
Personality/mood change
Mild memory deficit

Depending on which part of brain affected:
If left parietal may have aphasia, apraxia and agnosia (unable to identify things)
If right parietal may have confusion, agitation, visuospatial difficulty

Question 7

How is vascular dementia diagnosed?

Answer 7

MRI /CT scan:
Multiple cortical or subcortical infarcts

Carotid doppler ultrasound: carotid plaques

ECG: cardiogenic emboli

Question 8

What medications are given for vascular dementia?

Answer 8

Antihypertensive eg ramipril (ACE-i)
Statins eg. atrovastatin
Antiplatelets eg. clopidogrel
Anticoagulant eg. warfarin
ACh-ase inhibitors eg. Donepezil or Rivastigmine