Vascular dementia: etiology, symptoms, diagnosis, treatment

Iveta Lasickaitė1, Danielė Jukonienė1 

1Lithuanian University of Health Sciences, Medical academy, Faculty of Medicine


Vascular dementia is a syndrome that manifests with deterioration of at least two cognitive functions and negatively affects person‘s day to day life. Memory loss, difficulty reasoning and communicating, confusion as well as personality changes are the most common symptoms of dementia. Risk factors of vascular dementia are similar to those of cardiovascular disease (high arterial blood pressure, ischemic heart disease, atrial fibrillation, diabetes mellitus, tobacco smoking, hypercholesterolemia and obesity). Latest research also show the impact of metabolic syndrome on impairment of cognitive functions. A distinctive feature of this dementia is that irreversible damage to certain areas of the brain remains after vascular events leading to focal neurological symptoms.The main cause of this condition is various cerebrovascular disorders, for instance, one large stroke in strategic brain region, multiple strokes or intracerebral hemorrhage. It has been established that elderly who have a history of stroke or other disease that affect blood flow to the brain are at a higher risk of developing cognitive impairment. Moreover, vascular dementia is the second most common type of dementia after Alzheimer‘s disease. However, the diagnostics of vascular dementia in clinical practice often faces difficulty because of comorbidity. There are also more than one established systems of diagnostic criteria which differ between each other. Nevertheless, even after the confirmed diagnosis of vascular dementia, opportunities of treatment are limited. Treatment of patients with KD involves three major strategies: correction of risk factors for cerebral blood flow disorders, improvement of cognitive function and management of comorbid (non-cognitive) symptoms. Regardless of these strategies the outcomes of the disease are usually poor. That is why prophylaxis that reduce the risk of the illness should be the main focus. In the case of diagnosed vascular dementia that focus shifts to the possibilities of slowing the progression of the condition but it is not possible to cure it.

Keywords: vascular dementia, cognitive functions, dementia syndrome