Vascular dementia and Alzheimer’s disease are two types of dementia. Both conditions can affect cognitive function, behavior, and the ability to carry out everyday tasks.
Alzheimer’s disease occurs through the formation of amyloid plaques and tangles of fibers in the brain. These changes affect memory, thinking, and the ability to carry out everyday activities.
Many symptoms and risk factors for vascular dementia and Alzheimer’s disease overlap. It is possible for people to have both Alzheimer’s disease and vascular dementia. Healthcare professionals refer to this as mixed dementia.
This article compares vascular dementia and Alzheimer’s disease.
Vascular dementia is the term for any changes in cognition or brain function that occur from damage to the blood vessels in the brain. The condition affects memory, thinking, and behavior.
It develops as a result of conditions that affect the blood flow to the brain, such as a stroke. A lack of blood flow and oxygen to the brain can damage the blood vessels in the brain.
Changes in cognitive function can depend on the severity of the damage and which region of the brain vascular changes affect.
Symptoms of vascular dementia include:
- difficulty performing everyday tasks
- difficulty following instructions or taking in new information
- forgetting past or current events
- misplacing items
- getting lost in familiar places or routes
- language problems, such as difficulty finding the right words
- difficulty reading and writing
- changes in sleeping patterns
- mood or personality changes, such as feeling depressed, angry, or agitated
- losing interest in people or hobbies
- hallucinations or delusions
- a lack of judgment and inability to perceive danger
The symptoms of Alzheimer’s disease happen due to changes in the brain. A buildup of proteins forms plaques, called amyloid plaques, and tangles of fibers, called tau tangles. Neurons, which send messages between areas of the brain, stop working correctly and cannot connect with other neurons.
Symptoms of Alzheimer’s disease can occur in stages, which may be mild to begin with and gradually worsen over time. They can include:
- memory problems
- difficulty finding words
- impaired reasoning or judgment
- wandering and getting lost
- difficulty with everyday tasks, such as paying bills and handling money
- personality and behavioral changes
- repeating questions
- difficulty recognizing friends and family
- difficulty coping with new situations or learning new information
- hallucinations, delusions, or paranoia
- impulsive behavior
- being unable to communicate or care for themselves
The following are similarities and differences between the two types of dementia.
According to the Alzheimer’s Association, both vascular dementia and Alzheimer’s disease have connections with conditions that damage the blood vessels and heart. These include:
Blood vessel and heart health are important for brain health, as these supply blood and oxygen to the brain. Damage to the heart and blood vessels may increase the risk of Alzheimer’s disease and vascular dementia.
Stroke, or damage to blood vessels in the brain, may increase the likelihood of plaques and tangles, leading to symptoms of Alzheimer’s disease.
Depending on where vascular changes occur, symptoms of both conditions may overlap.
If vascular dementia occurs after a stroke, changes in thinking and behavior may occur very suddenly. If damage to blood vessels happens deeper within the brain, cognitive changes may occur more gradually.
Early symptoms of vascular dementia may include:
- impaired judgment
- difficulty speaking
- physical symptoms of a stroke, such as paralysis or numbness on one side of the body
Depending on where damage occurs, memory loss may or may not be a key symptom of vascular dementia.
If changes occur in the area of the brain that helps store and retrieve information, people with vascular dementia may experience memory loss similar to that typically seen in Alzheimer’s disease. Alzheimer’s symptoms
To diagnose vascular dementia, a doctor may carry out a range of tests and investigations, including:
- assessing symptoms and a person’s medical history and lifestyle
- asking the person, or people who know the person well, about changes in their everyday behavior and ability to carry out everyday activities
- tests to assess memory and thinking skills
- brain imaging scans
To diagnose Alzheimer’s disease, doctors may carry out a variety of examinations, such as:
- taking a full medical history and assessing symptoms
- asking the person and their friends or family about:
- overall health
- the person’s ability to carry out everyday tasks
- any changes in their personality or behavior
- tests to check memory and attention, problem solving, counting, and language skills
- blood and urine tests to rule out other conditions
- MRI, CT, or PET scans to provide images of the brain
Factors that may increase the risk of vascular dementia include:
- high blood pressure
- conditions affecting the typical rhythm of the heartbeat
- high cholesterol
Managing risk factors may reduce the risk of developing dementia.
A combination of genetic, environmental, and lifestyle factors may cause Alzheimer’s disease. Risk factors for Alzheimer’s disease
- genetics, including having a certain gene that is a type of apolipoprotein E gene
- being an older adult
- a family history of Alzheimer’s disease
- head injury
- heart disease
- high blood pressure
- high cholesterol
- having obesity
Having Down syndrome can also increase the risk of developing Alzheimer’s disease. This is because the additional copy of chromosome 21 (which causes Down syndrome to occur) also contains the gene that creates amyloid.
Older adults who are Latino or African American may have an increased risk of Alzheimer’s disease compared with older adults who are white. Although the reason for this is not understood, it may be due to increased rates of vascular disease.
The following sections outline the treatment options for both types of dementia.
Treatment for vascular dementia may help to manage symptoms and prevent the condition from worsening. It can include medications to help prevent strokes and further damage to the brain.
Medications healthcare professionals prescribe to treat Alzheimer’s disease may help to treat early vascular dementia in some cases.
Treatment includes managing any underlying health conditions that are risk factors for a stroke.
Treatment for Alzheimer’s disease may help to manage behavioral and cognitive symptoms, as well as treating the underlying process that causes the disease.
Treatments may include:
- medications such as donepezil, rivastigmine, and galantamine, to help manage symptoms
- medications such as aducanumab to help treat the underlying disease process
- nondrug and drug-based options to help manage symptoms such as agitation and difficulty sleeping
- making adjustments to manage behavioral symptoms, such as creating a calm environment and allowing sufficient time to rest
Early diagnosis and treatment of Alzheimer’s disease may help maintain how well a person can function for longer, as well as help people plan for the future.
Research and clinical trials for dementia treatments are ongoing. To find out more about clinical trials, speak with a healthcare professional.
Evidence suggests that there are steps people can take to reduce their risk of cognitive decline and dementia. These include:
- taking part in regular physical exercise that elevates heart rate, as this increases blood flow to the brain and improves cardiovascular health
- continuing to learn through reading, taking a class at a local center, or taking an online course
- quitting smoking
- taking steps to keep the heart healthy and reduce the risk of obesity, high blood pressure, and stroke
- protecting the head from brain injury by:
- wearing a seatbelt
- using a helmet for contact sports and cycling
- taking measures to help prevent falls
- eating a nutritious, balanced diet full of vegetables and fruits
- practicing good sleep hygiene for quality sleep
- managing stress and any mental health conditions such as depression and anxiety
- connecting socially with others
- challenging the brain with puzzles, learning a new skill, or doing something creative
Both vascular dementia and Alzheimer’s disease are types of dementia that can affect thinking, behavior, and the ability to carry out everyday tasks.
Vascular dementia occurs through damage to blood vessels in the brain. Alzheimer’s disease occurs through plaques and tangles forming in the brain.
Memory loss may be a major symptom of Alzheimer’s disease. It may also occur in vascular dementia, depending on which area of the brain the damage affects.
Treatments for both conditions may help to manage symptoms and slow down cognitive decline. Managing risk factors may also help to prevent further damage to the brain.