Much has been said about the various stages of dementia; very little has been said about the stages of dementia that is constant in every case. Every little misstep, especially by an older person, causes that older person, family members, and friends to ask, “Is this the start of dementia?”
Vascular dementia is a type of dementia that affects the brain’s blood vessels and causes cognitive impairment. It is a condition that occurs when the blood supply to the brain is reduced or interrupted, leading to damage or death of brain cells. This can result in problems with memory, thinking, language, and other cognitive functions.
Vascular dementia and Alzheimer’s Disease
It is important to understand the difference between vascular dementia and Alzheimer’s disease, another common type of dementia. Vascular dementia and Alzheimer’s disease can have similar symptoms, but they have different causes and may respond differently to treatments.
Alzheimer’s disease, the number one cause of dementia, is caused by the buildup of abnormal protein deposits called amyloid plaques and neurofibrillary tangles in the brain, which interfere with the communication between brain cells.
Vascular dementia, the second most prevalent type of dementia, is caused by narrowing and blockage of the small blood vessels inside the brain. This can be caused by a single stroke or multiple small strokes, also called transient ischemic attacks (ITA), that cause tiny but widespread damage to the brain. A patient may not remember ever having a TIA because it was so limited in its effect at the time of its occurrence. However, the repeated occurance of ITAs can result in a gradual decline in mental cognizance that affects a person’s daily life.
Vascular dementia is a serious and widespread health issue. In an article published in March 2023 by the Alzheimer’s Association, about 5% to 10% of individuals with dementia show evidence of vascular dementia alone. Vascular dementia can have a significant impact on the quality of life, independence, and mortality of people with the condition and their caregivers.
Three stages of vascular dementia
The following information was taken from the pages of the Alzheimer’s Association. The addresses of the association as well as other organizations can be found in the Resources section of this site.
Vascular dementia can be classified into 3 stages: mild, moderate, and severe. The stages reflect the degree of cognitive impairment and functional decline that people with vascular dementia experience. The progression of vascular dementia may vary depending on the location and extent of the brain damage, as well as other factors such as age, health conditions, and medications.
Mild stage: People with mild vascular dementia may have some difficulties with memory, attention, planning, organization, or problem-solving, but they can still perform most of their daily activities independently. For example, they may forget recent events or appointments, have trouble following instructions or directions, or make errors in calculations or spelling. They may also have some changes in their mood, personality, or behavior, such as being more irritable, apathetic, or depressed. They may lose interest in hobbies or activities they used to enjoy or become more withdrawn or isolated from others.
Moderate stage: People with moderate vascular dementia may have more noticeable and frequent problems with memory, language, reasoning, judgment, or orientation, which may affect their ability to work, socialize, or manage their finances. For example, they may have difficulty finding words or expressing themselves clearly, understanding complex information or concepts, making decisions or solving problems, or remembering where they are or what day it is. They may also have more pronounced mood and behavioral changes, such as being more anxious, agitated, or paranoid. They may experience mood swings, delusions, hallucinations, or compulsive behaviors. They may need some assistance or supervision with their daily activities such as dressing, bathing, eating, or taking medications.
Severe stage: People with severe vascular dementia may have severe cognitive impairment that makes them unable to communicate coherently, recognize familiar people or objects, or remember basic facts about themselves or their surroundings. For example, they may not be able to speak at all or only utter a few words or sounds; they may not recognize their family members or friends; they may not know their name, age, address, or phone number; they may not be aware of their surroundings or current situation. They may also have severe mood and behavioral disturbances such as being more aggressive, restless, or hallucinatory. They may become violent, wander away, or harm themselves or others. They may need constant care and support with their daily activities such as toileting, feeding, or moving around.
All of the stages are fluid. There may be daily symptom changes that seem to be a move into a more advanced stage; and then, those symptoms vanish for awhile and the patient settles back into a milder stage. Don’t make decisions about the dementia person until the next stage behaviors become constant.
Hello Lydia, thank you for sharing this information. My mother has vascular dementia and she is somewhere between late moderate to early severe. She recognizes me,, my sister, loved ones but forgets basic facts about herself, and needs constant support with toileting and stand-by assistance with her walker if she isn't in her wheelchair. She is 87, and after 10 months of caring for her all on my own along with working full time from home, I realized my life quality was seriously deteriorating alongside hers and that fortunately, because she had the savings, we could afford a memory care place nearby where she is getting good care and I can visit her along with my sister as often as we like. She is safe and I can now also take care of myself. This is so hard. There are hard choices to make all the time. Thank you for helping carers out with important information on vascular dementia.