Ask the Doctors - What is vascular dementia, and can it be prevented?


Dear Doctors: My dad has just been diagnosed with vascular dementia. What is it? Can it be prevented?

Dementia is a general term used to categorize symptoms that relate to the decline or loss of cognitive function. These include confusion, memory loss, impaired language skills, changes in personality or behavior, and the inability to think clearly or perform everyday tasks. The most common cause of dementia is Alzheimer’s disease, which accounts for between 60 and 80 percent of all dementia cases. The mental impairment of Alzheimer’s disease results from a series of complex changes that take place within the structure of the brain itself.

Hardening and narrowing of the arteries, major stroke, or a series of small strokes can cause vascular dementia. In the case of major stroke, symptoms of vascular dementia can appear suddenly. But quite often, the disease builds slowly. As blood flow to the brain decreases, mental impairment gradually becomes more pronounced.

At this time, vascular dementia cannot be reversed, but there are steps you can take to reduce your risk of developing it. Although the disease is rare before age 65, the cardiovascular problems that lead to it can begin to develop well before then.

One of the major risk factors for vascular dementia is high blood pressure, which also plays a role in heart attack and stroke. That’s why it’s important to know your numbers, and to monitor blood pressure on a regular basis.

To reduce blood pressure, maintain a healthy weight. It’s wise to also keep track of your waistline measurements. Men who measure more than 40 inches at the waist, and women whose waistlines measure above 35 inches are at increased risk of developing high blood pressure.

Get moving. Regular exercise has been shown to reduce the risk of vascular dementia by 40 percent. Just 30 minutes of exercise at moderate intensity – you’ll be able to speak but not sing – three times per week helps protect both your heart and your brain.

If you’ve been following this column for even a few weeks you know what’s coming next – don’t smoke. If you do smoke, please stop. Yes, we know that’s hard. We also know your family doctor would love to help you.

Eat a healthy diet. That’s lean meats, fresh fish, legumes, whole grains, seeds, nuts, and plenty of fruits and vegetables. Skip the sugar if you can. Limit simple carbs like pasta, rice, bread, and processed cereals.

Limit how much alcohol you drink. Even in moderation, alcohol has been linked to dementia risk, particularly as we get older.

Eve Glazier, MD., MBA, and Elizabeth Ko, MD., are internists at UCLA Health. Dr. Glazier is an associate professor of medicine; Dr. Ko is an assistant professor of medicine.

Ask the Doctors is a syndicated column first published by UExpress syndicate.