image by (lic)The DSM-5 made many changes in the diagnostic criteria for dementia. It now refers to all forms of dementia as neurocognitive disorders. Vascular dementia is now referred to as Vascular Neurocognitive Disorder in the DSM-5.
Vascular neurocognitive disorder is a common form of dementia. It is diagnosed in between 15-30% of all people who are diagnosed with dementia. Other names for this disorder include vascular dementia, vascular cognitive impairment and multi-infarct dementia. The term "multi-infarct" is used because in advanced stages vascular disease produces many empty spaces or infarcts in the brain. Because the majority of people that develop dementia are senior citizens, many of them display the effects of vascular disease in their brain even if they are diagnosed with other forms of dementia. The term mixed dementia is used when a person with dementia has more than one type of potential cause of dementia such as having vascular disease in the brain and Alzheimer's disease.
What Causes Vascular Neurocognitive Disorder?
The cause of this disorder is due to a blockage or disruption of the flow of blood in the brain. Areas of the brain that receive less blood get less nutrients and oxygen. This can damage tissue or even result in cell death in the area. Several vascular conditions can contribute to vascular neurocognitive disorder:
- Cerebral Vascular Accident (CVA) is the technical name for what most people refer to as a stroke. This is a major disruption of blood flow in the brain due to either a vein or artery breaking (a hemorrhage) or because of a major blockage.
- Ischemia is a term for damage to an organ that occurs as a loss of blood flow.
- Transient Ischemic Attacks (TIAs), often referred to as "mini strokes" or silent strokes, are very small strokes that individually may not produce significant effects. However, over time happen in many areas of the brain. This can produce problems with thinking, moving, etc.
- Aneurysms are weak areas of veins or arteries in the brain that form sacks that cause the blood flow to be disrupted. This can lead to ischemic damage. These blockages are not often major blockages like happen during a stroke. However, over time they can cause damage to the brain. They can also break and result in a stroke.
The factors that can result in an increased risk to develop vascular neurocognitive disorder are the same types of factors that result in an increased risk to develop heart disease. These include:
- A family history of cardiovascular or heart disease (this most often suggests genetic causes).
- Poor diet and/or a lack of exercise.
- High blood pressure.
- High levels of cholesterol.
- Other conditions like diabetes or having a previous heart attack or stroke.
The symptoms of vascular neurocognitive disorder depend on what area of the brain has been affected. Some people may display a few symptoms such as problems with forgetfulness, weakness on one side of the body, and problems with attention. Others may display several problems in several different areas. This is often referred to as a "patchy" presentation because totally different areas are affected and are affected at different levels.