Vascular Dementia often comes into our thinking when we’re looking at some patients with dementia. And what we’re seeing with Vascular Dementia is a little bit different to Alzheimer’s and Frontotemporal Dementia where we see cells dying because of some degenerative process.
In Vascular Dementia what we’re really looking at is insults – little bits of the brain dying because of, if you like small stroke disease. You’ll know that when patients have a stroke not only can they have physical deficits such as weakness, they also can struggle with aspects of memory and cognition. Well with Vascular Dementia what we’re really looking at is tiny areas of the brain being affected by small blood vessels being blocked off over time. This usually presents with people getting stepwise decline, so that they’re this sort of level and then they seem to be a little bit worse, hold that level, get a bit worse and so the pattern is different to Alzheimer’s, where it’s one of forgetting information.
With Vascular Dementia it’s more a problem with processing speeds, so thinking and working things out in the normal speed of things. And that’s where we see the big difference. In Vascular Dementia the pathology is a little bit different. As I said, and that allows us to see more of it when we do brain scans, because you can see the damage on brain scans. Of course in Vascular Dementia we can look for the risk factors such as high blood pressure, cholesterol, diabetes and therefore that hones our thinking towards how we treat people with Vascular Dementia, because in actual fact, what we try and do is to limit those risk factors for cerebrovascular disease damage –those small blood vessels in the brain.