Vascular Dementia

Question 1

What is vascular dementia (VD)?

Answer 1

Cognitive decline to to the limit of blood flow to the brain

Question 2

What are the main causes of VD?

Answer 2

Anything that limits bloodflow to the brain

1. Stroke
2. Atherosclerosis
3. Ruptured aneurysm
4. Space occupying lesion
5. Amyloidosis - (amyloidosis is a consequence of Alzheimer’s) VD may occur as a consequence

Question 3

What are the risk factors for vascular dementia?

Answer 3

Same for atherosclerosis

• smoking
• hypertension
• hyperlipidaemia
• DM
• Age

Question 4

Which parts of the brain are affected?

Answer 4

1. Anterior cerebral artery
2. Parietal lobes
3. Cingulate gyrus

Question 5

What are the signs and symptoms of VD?

Answer 5

1 .Cognitive
Cognitive impairment 
Slower processing
2. Motor
Hemiparesis, bradykinesia
hyperresflexia etc
Dysarthria

3. Behavioural
apathy
aboulia
lack of attention
orientation

Question 6

What disease is often associated with VD?

Answer 6

Alzheimer’s Disease as it often causes VD due to amyloid plaque development

Question 7

In small vessel disease in VD which lobe is mostly affected? What is the function of the frontal lobe?

Answer 7

Frontal lobe - involved in tasks such as Emotional expression, problem solving, memory, language, judgement and sexual behaviours

Question 8

How do we diagnose VD?

Answer 8

Work up

1. Bloods tests (exclude metabolic cause, anaemia vitamin deficiency, thyrotoxicosis, infection)
2. Chest X-ray
3. ECG
4. Neuroimaging - PET/SPECT used to confirm infarcts.
5. Mental status exam
6. Confirm using DSM

Question 9

What is involved in prevention?

Answer 9

Controling Risk factors

1. BP
2. Hyperlipidaemia
3. Weight
4. Diet
5. Exercise
6. Smoking cessation