Is vascular dementia curable and how long do they live with such a diagnosis? Vascular dementia - symptoms and treatment

Vascular dementia or dementia is an acquired disease that is diagnosed mainly in people over 60 years of age. Although, sometimes, it is detected even in young people. According to statistics, men are more prone to it than women. The main reason for its development is a violation cerebral circulation associated with vascular damage separate area brain.

Varieties of pathology

Vascular dementia is a violation of intellectual abilities and memory of an acquired nature. The development of this condition is preceded by circulatory disorders in the brain. If its cells begin to experience a lack of oxygen and nutrients, they begin to gradually die.

There are such types of vascular dementia:

With a sharp start. In this case, the change in behavior occurs suddenly, usually several months after a stroke, embolism, or cerebrovascular thrombosis.
Multi-infarction (cortical) occurs gradually (usually over six months) after ischemic disorders.

Subcortical (subcortical) dementia of vascular origin is characterized by lesions white matter V deep layers brain.
Mixed (subcortical or cortical).
Vascular dementia, unspecified.

Stages of pathology

There are 3 stages that precede the development of the disease:

The emergence of risk factors. Among them, the patient's predisposition to the development of vascular pathologies is usually distinguished.
initial stage ischemic injury. External symptoms on this stage it is impossible to identify, although some diagnostic methods make it possible to detect changes in the brain that have begun.
The onset of symptoms. The lesions at this stage are still minor and the patient's behavior has not changed much. Neuropsychological tests help detect violations.

The therapist Elena Vasilievna Malysheva and the cardiologist German Shaevich Gandelman tell more about the disease:

Vascular dementia goes through several stages of development:

The initial stage, when the patient can detect minor cognitive changes of vascular origin.
emergence clinical manifestations. At this stage, the symptoms of dementia are already clearly visible. A person is able to fall into apathy or, conversely, behave too aggressively. He has memory lapses.

Difficult stage. Now the patient needs to be observed by others, on whom he is completely dependent.
Death of a patient. Usually death is not directly related to vascular dementia, but is a consequence of a stroke or heart attack.

Signs of pathology

Dementia in the elderly does not have a single symptomatology, since each person who develops dementia may behave differently. However, there are some signs that will be the same for everyone. Most often, the patient comprehends such symptoms:

Violation of gait (lameness, instability of the body when walking, etc.).
The occurrence of epileptic seizures.

How to recognize epileptic seizure and how to help the patient tells the neurologist Dmitry Nikolaevich Shubin:

Violation of urination.
Deterioration of attention, memory and other cognitive impairment.
Violation of physical functions.

Also, the symptoms depend on the stage of development of the pathology.

initial stage

It is difficult to identify manifestations of vascular dementia at this stage, since such symptoms can be characteristic of many diseases. Among them:

The appearance of apathy, irritability or other neurosis-like disorders.
emotional instability and frequent change moods.
Depressive state.

Psychiatrist Mikhail Alexandrovich Tetyushkin talks about the signs and treatment of depression:

Carelessness.
Disorientation in space on the street or in an unfamiliar room.
Sleep disorders (frequent nightmares, insomnia, etc.).

middle stage

Now the symptoms are becoming clearer, and doctors are able to diagnose vascular dementia using them:

Sudden mood swings, when apathy suddenly changes to aggressive behavior.
Memory lapses, so far only short-term.
Violation of the orientation of the house.

Violation of the vestibular apparatus or other physical disorders.
Difficulty in communication. A person may forget the names of objects, the inability to keep up a conversation, etc.

severe stage

At this stage, all the symptoms of vascular dementia become pronounced:

A person cannot navigate in space.
The occurrence of hallucinations or delusions.
The appearance of aggression without any reason.

Memory losses. The patient cannot say what happened a minute ago, does not recognize relatives, etc.
Difficulty moving or even inability to get out of bed.
The patient needs round-the-clock supervision by loved ones.

There are signs that most likely indicate the development of pathology:

Slight recovery of cognitive activities. Doctors have not yet been able to find out what this may be due to. Usually, this is preceded by mental stress. In this case, the patient's condition may return to normal level However, the pathology itself does not disappear anywhere and after a while, vascular dementia will again begin to manifest itself.
Gradual development that often prevents diagnosis. In most cases, relatives admit that they noticed some changes in the patient, but they focused on this already when irreparable changes occurred. After a stroke, vascular dementia develops in only 20-35% of cases.
The transferred surgical operations or treatment with coronary artery bypass grafting.

Diagnostics

If vascular dementia was detected at the initial stage of development, then timely treatment gives the patient a chance for a full recovery and a normal life. If the pathology has managed to develop, then treatment can slow down this process. For diagnosis, the doctor needs:

To study the history of the development of dementia and the characteristics of the patient's life.
Monitor blood pressure regularly.

More about the specifics of diagnosing the disease tells the neurologist Alexei Valerievich Alekseev:

Conducting psychological testing, which allows you to identify various violations cognitive nature.
Donate regularly clinical analysis blood and control sugar levels.
Control of cholesterol and lipid levels in the blood.

TO instrumental methods diagnosis of vascular dementia include:

Radioisotope examination of the brain.
Magnetic resonance or computed tomography.
Ultrasound of the brain.

Echocardiography - method ultrasound diagnosing morphological and functional changes in the heart and its valvular apparatus

Electroencephalogram.
Angiography.

The results of the studies carried out make it possible to identify vascular dementia and begin its treatment.

Treatment

Vascular dementia is a serious pathology that can lead to disability. Therefore, it is so important to identify the pathology in a timely manner and begin its treatment. The therapeutic course is prescribed individually for each patient and depends on the stage of dementia and the nature of the pathology. At the same time, it is imperative to treat those factors that contributed to the onset of the disease ( elevated level sugar, high blood pressure, etc.).

Treatment should be based on measures that can restore impaired cerebral circulation and compensate for disorders that have already occurred. Usually the course of treatment includes:

Taking antiplatelet drugs, the action of which is to prevent platelets from sticking together ("Aspirin", "Ticlopidine").
The use of drugs that stimulate cellular metabolism (Piracetam, Nootropil).

Psychotherapist Alexander Vasilyevich Galushchak answers questions about the drug piracetam:

Statins (Atorvastatin, etc.).
Reception of neuroprotectors.
Khavinson peptides.

The most effective drugs used in the treatment of vascular dementia include:

"Cerebrolysin" is a drug that has a pronounced neuroprotective property, leads to the normalization of cellular metabolism, restores cognitive capabilities and has no side effects.
"Cavinton" is an antiplatelet agent that is used to improve blood circulation in the smallest vessels of the brain. The active components of the drug improve vascular tone and accelerate the breakdown of glucose.
"Revastigmine", "Memantine" - drugs that are used to normalize a person's mental activity. With regular intake, the patient improves cognitive abilities and normalizes concentration.

The average price in pharmacies for 5 ampoules of 5 ml of Cerebrolysin injection solution is 1000 rubles

If, as a result of vascular dementia, the patient has a sleep disorder, depression and other psychological disorders, he is prescribed antipsychotics and sedatives used in psychiatry. In some patients, the use of such drugs can cause paradoxical reactions. In this case, the medicine must be canceled and consult a doctor who can choose an analogue.

In addition to drug treatment of vascular dementia, the doctor may prescribe drugs to the patient plant origin(ergot alkaloids, etc.). Additionally, the patient is shown:

Compliance special diet based on fresh fruits and vegetables, dairy products, beans, nuts, vegetable oils, seafood, etc.
Occupational therapy.
Permanent qualified patient care.

Herbalists offer their methods of treatment of vascular dementia. However, their effectiveness has not yet been scientifically proven. Doctors do not prohibit the use of folk remedies, however, they note that they can only be taken together with drug treatment. For this you can use:

Gingko biloba medicine.
Decoction of elecampane.

Adding turmeric to food.
A decoction of flaxseed and Irish moss.

Prevention

The danger of vascular dementia lies in the fact that the pathology at the initial stage, when it responds well to treatment, is not easy to identify. Therefore, the disease is often detected already when serious changes have occurred in the brain, and the pathology has led to disability. Therefore, it is so important to engage in disease prevention. After all, it is much easier to prevent its development than to treat it later.

Doctors also note several methods of monitoring their condition, which will make it possible to reduce the risk of developing vascular dementia. These include:

Blood pressure control. For older people and those who have a tendency to increase it, it is important to constantly monitor indicators. When it increases, it is important to immediately apply for medical care and start timely treatment of hypertension.
Lead an active lifestyle, wisely distributing physical exercise. Regular exercise has a positive effect on the condition of cardio-vascular system, increasing the capacity of myocardial muscles. However, it must be taken into account that too much physical activity can worsen the patient's condition.
Correction mental state. Each person should monitor the state of his psyche. To do this, avoid stressful situations and negative emotions, constantly walk on fresh air undergo psychological training and consultations.

Give up bad habits and eat right, thereby supporting correct exchange substances in the body.
Monitor the level of sex hormones. This is especially true for women.
Engage in the prevention of infection, injury and poisoning of the body with toxic substances.

Forecast

How many live with such a diagnosis? Life expectancy depends on the stage at which the disease is diagnosed and the correctness of the treatment. However, in most cases, this period does not exceed 5-6 years.

If we talk about complete recovery, then this was observed only in 15% of patients who managed to start treatment at the very beginning of the development of the pathology. Predicting the exact life expectancy is almost impossible.

If the disease develops slowly, and the victim himself retains the ability to care for himself, then he can live with dementia up to 10 or even 20 years. How the situation is more difficult, the shorter this period. The constant care of loved ones can prolong the life of the patient.

The condition can be aggravated by a second stroke or heart attack. Also, the cause of death can be pneumonia, sepsis and other comorbidities. Negative consequences have depression and psychological disorders. Therefore, doctors note that in each case, the patient's life expectancy will be different and can range from several months to several years.

Unfortunately, despite the rapid development modern medicine, scientists have not yet been able to create a drug that could effectively fight vascular dementia at any stage of its development. The disease can progress rapidly, causing irreversible processes in the body. Therefore, the only in an efficient way is considered prevention and regular passage medical examination, which will allow to identify vascular dementia at the initial stage of development and start its treatment in a timely manner.

Vascular dementia is a complex of signs (syndrome) characterized by a deterioration in the mental capabilities and practical and behavioral abilities of a person as a result of damage to the cerebral vessels. A person undergoes complete or partial disintegration mental functions. The syndrome affects the behavior of the individual, his adaptive abilities and the ability to serve himself are deteriorating. At the same time, vascular dementia does not affect consciousness in any way.

Causes

The main cause of development is a stroke, which occurs due to blockage of the duct blood vessel thrombus (clot) or due to atherosclerosis of the vessels. As a result, part of the brain cells die, which were fed through a thrombosed vessel.

According to medical statistics, the likelihood of developing vascular dementia is 5-10 times higher after a stroke. And in patients older than 60, dementia develops in 60% of cases in the first months after a stroke.

The second most important cause of the development of the syndrome is chronic form cerebral ischemia. Its development is associated with long-term blockage of the lumen and a decrease in the tone of smaller vessels (capillaries). Ischemia most often develops as a consequence of hypertension and atherosclerosis. And also as a complication of the course of diabetes. Concomitant factors in the progression of cerebral ischemia to the level of vascular dementia are bad habits, unbalanced diet and insufficient exercise.

Recent studies have shown that dietary deficiencies in the elderly folic acid increases the likelihood of developing dementia by almost 3 times.

Another reason for the development of vascular dementia is heart failure and various heart defects, accompanied by low blood pressure. Due to low pressure, insufficient blood flows to the cells. As a result, the brain receives little oxygen and nutrients. Which leads to the gradual death of neurons (cells of nervous tissue).

The course of forms of dementia of the vascular type often has a mixed form. That is, the causes of the development of the syndrome are not one, but several at once. Each of the root causes only exacerbates the process of disease development.

In addition to these factors, the cause of the development of the syndrome can be a number of infectious diseases(Lyme disease, neuronal form of syphilis and others).

Most often, signs of a decrease in cognitive (cognitive) functions of the brain are observed in patients who have recently had a stroke. These signs include:

Memory impairment.
Disorders of coordination of movements.
Delay of thought processes.
Disorders of abstract thinking.

Concomitant symptoms of manifestation acute form syndromes are:

Weakening of the tone of the muscles of the limbs.
Violation of walking (slow movement and instability).
Different manifestation of the strength of reflexes in the right and left limbs.

In addition to the acute course, the gradual development of vascular dementia is possible. It is observed in the ischemic form of the disease, which is characterized by a gradual increase in the manifestation clinical signs.

On average, the gradual development of the disease takes place within 3-5 years. The manifestation of dementia begins with a sharp change in personality characteristics:

Aggravated manifestations of certain character traits (thrift, conservatism, stubbornness).
Development of a conservative view in judgments.
Deterioration of thought processes.
Loss of moral standards.

Then there is a deterioration in memory, temporal-spatial orientation. At the same time, the features of behavior, speech and gestures remain unchanged for a long time.

In the last stage of the development of the ischemic form, there is a tremor (trembling) of the fingers, impaired coordination and walking, exhaustion. Further development the disease is characterized by abrupt speech, fragmentation of information about one's own personality. The patient cannot take care of himself without outside help and observe the rules of personal hygiene.

The symptomatology of the manifestation of vascular dementia depends on the area of the lesion of the cerebral cortex:

Damage to the midbrain - episodic and confusion, hallucinations, drowsiness.
Hippocampus - a violation of the ability to remember and reproduce information about current events.
Frontal lobes - manifested by the patient's apathetic behavior, repeated repetition of words and actions.
Subcortical regions - weakening of concentration, misunderstanding of the significance of what is happening.

In most patients, there is a violation of the process of urination (congestive processes, involuntary urination).

Diagnosis of vascular dementia occurs according to the data:

Diagnostics of the patient's mental state is carried out using special psychological tests.
The results of computer and magnetic resonance topography (CT and MRI) - the affected areas of the brain are detected, and the degree of degenerative processes in them is established (change in their structure).
Comparison of research results among themselves.

Risk group

At the first stage of the risk group, those who have had one or more strokes are found. The probability of development and manifestation of the disease depends entirely on the area of brain tissue damage.

On the second stage are those who suffer chronic ischemia. In this case, the development of the disease occurs imperceptibly. And it can only be diagnosed with an MRI.

Men suffer from vascular dementia more often than women (1.5 times). The risk of developing the disease after 60-65 years is 4 times higher.

Treatment

Treatment medications is aimed at eliminating the signs of the primary disease that caused the development of vascular dementia:

Drugs for the treatment of arterial hypertension.
Preparations for stabilizing glucose levels (for diabetes).
Antiplatelet medicines(against the formation of blood clots).

Early on in dementia good results gives the use of drugs to improve blood circulation and metabolic processes inside neurons.

Prevention

Balanced diet.
Psychological health.
Control of blood pressure and blood cholesterol levels.

According to the results of studies conducted by Indian doctors, it was found that knowledge of two or more languages reduces the risk of developing vascular dementia by 4.5 times.

Forecast

Complete cure is possible only in 10-16% of cases. Poor prognosis for acute course diseases. A large percentage of mortality is observed already at 4-5 years of dementia.

In the ischemic form, in most cases, it is possible to slow down the development of pathogenesis with the help of drug treatment of the initial disease (hypertension, ischemia).

The video shows an excerpt from the "Live Healthy" program about this disease:

Vascular dementia is an acquired impairment of memory and intellectual abilities of a person due to diseases of the cerebral vessels. With a lack of oxygen, the brain cells responsible for behavior and perception die, changing the patient beyond recognition. Most often, signs of dementia appear in old age, and it must be clearly understood that it is not directly a disease.

Types and causes of vascular dementia

The International Classification of Diseases (10th revision) assigned the code F01 to DM and distinguished its types:

With acute onset (F01.0). Behavioral disturbances occur quickly, within 1-3 months after the first or subsequent strokes. May result from hemorrhage, cerebrovascular thrombosis, or embolism.
Multi-infarction (F01.1). Mostly cortical. Signs appear within 3-6 months, gradually, usually followed by ischemic episodes. In this case, heart attacks seem to accumulate in certain parts of the brain.
Subcortical (F01.2). Doctors call it subcortical. With this type of disturbance, for the most part, they affect the deep sections of the white matter.
Mixed cortical and subcortical (F01.3).
Unspecified (F01.9).
Other (F01.8). This includes dementia after a stroke.

However, it is impossible to talk about a clear division into cortical (cortical) and subcortical, because on late stages SD affects all parts of the brain.

Brain diseases are considered the most dangerous diseases, since most often their consequences are irreversible. So extremely heavy is, which usually has a fairly large size.

Its consequence may be post-traumatic encephalopathy and disability.

Stages of vascular dementia

Dementia is preceded by 3 stages:

The emergence of risk factors for development. For example, predisposition to vascular diseases.
ischemic injury in initial stage. At this stage, brain lesions can be diagnosed, however, they do not appear outwardly. In this case, leukoaraiosis and "silent" heart attacks are observed.
The beginning of the symptomatic stage. It is difficult to make a diagnosis at this stage because the lesions are small and do not greatly affect the behavior and perception of the patient. Violations can be detected only on neuropsychological testing.

The history of the development of vascular dementia includes several stages and proceeds as follows:

initial stage or the appearance of moderate cognitive impairment of vascular origin.
Clinical diagnosis of SD. At this stage, the signs of dementia are already clearly expressed, the patient behaves either aggressively or apathetically, memory lapses appear.
Pronounced or severe DM. The patient needs constant supervision and is completely dependent on others.
Death. Basically, death does not occur due to dementia (with rare exceptions such as accidents), but as a result of a heart attack or stroke.

Symptoms of vascular dementia

Since dementia is not a single disease, but a syndrome that affects a person's behavior in different ways, it is difficult to specify the exact changes that accompany it.

But we can talk about the symptoms that occur in most cases, as well as the most basic signs.

According to statistics, the most common symptoms vascular dementia is:

Epileptic seizures (in 20-34% depending on the disease).
Walking disorders (30-95%). This includes unsteadiness, slight lameness, shuffling steps, and similar signs.
Urination disorders (almost 90%).
Deterioration of cognitive functions, for example, memory, orientation, attention (in 100%).
Decrease in physical functions, without impairment of motor skills (100%).

The rest of the features depend on overall picture diseases, type and stage of development of dementia.

initial stage

Symptoms at the initial stage are characteristic of many diseases, therefore they are poorly distinguishable.

These include:

The appearance of neurosis-like disorders (lethargy, apathy, irritability);
Distractedness and inattention.
The appearance of nightmares and other sleep disorders.
Depression.
Disorientation outside the home.
emotional instability, sharp drops moods.

middle stage

At this stage, the symptoms become noticeable and easily diagnosed:

Mood swings become more severe. Appears aggressiveness, replaced by deep apathy.
Brief memory lapses.
Orientation disorders within the home.
Difficulties in communication associated with forgetfulness of even frequently used words and unwillingness to make contact.
Violation of physical functions, for example, the vestibular apparatus, and, as a result, the need for self-care.

severe stage

At the last stage, all previous symptoms become extreme:

Lost in space and time.
Delusions and hallucinations.
Memory losses. This also applies to close relatives, events that occurred a few minutes ago.
Unreasonable aggression.
Difficulty moving, including the inability to get out of bed.
The need for constant self-care.

Signs of DM

In addition to the main symptoms, there are signs by which you can more accurately determine the disease.

For vascular dementia, these are:

Short recovery of cognitive functions. The reasons for this effect are not fully understood. Most often occurs with intellectual loads. The patient's condition may improve almost to a normal level, but the vascular dementia itself will not go anywhere.
Smooth development. It is the smooth and slow development of DM that prevents its diagnosis, especially in the elderly. Relatives of patients often admit that they noticed minor changes, but paid attention to them when it was already too late.
After a single stroke, the behavior of a patient with dementia may not change at all until the middle stage. Acute development of diabetes takes only 20-38% of cases.
Previous abdominal or trauma surgery, and coronary artery bypass surgery.
In patients, especially the elderly, new vascular foci appear:
- After cerebral angiography in 15-26% of cases.
- After surgery carotid arteries at 17-54%.
- After heart surgery and other cardiac surgery 31-48%.

Diagnosis of vascular dementia

Diagnosis of diabetes is made by a doctor based on the above signs and symptoms.

For diagnosis can be used:

NINDS-AIREN working group criteria
International classification of diseases in the 10th revision.
ADDTC Criteria.
DSM-IV Criteria.
Khachinsky ischemic scale.

It all depends on the training of the specialist and the theories that he follows. In fact, they differ slightly, and at the medium and severe stages they practically repeat each other.

If the patient has severe neurological symptoms or cerebrovascular disease, then a thorough examination for stroke is necessary.

During the diagnosis, CT and can be prescribed, allowing to identify:

multiple heart attacks;
lacunar cysts;
white matter damage.

Treatment of vascular dementia

Most often, vascular dementia cannot be cured, since changes in the brain are irreversible. But it is possible to overcome changes that are not functional in nature (do not affect physical and mental abilities).

The need for treatment is clearly indicated by a graph showing the effect of therapy:

It should be noted here that the type of therapy can only be prescribed by a doctor. Measures taken independently can worsen the patient's condition and literally lead him to the grave. if you prefer any specific treatment, discuss with your specialist before using it.

Treatment Methods

It is a mistake to treat dementia as a disease, since dementia is a syndrome that includes several versatile symptoms. The easiest way to treat dementia is while still healthy, trying to prevent dementia.

But, despite this, there are several methods of treatment that are used in combination:

medication;
Preventive;
Folk means.

Medical treatment

The effectiveness of this method has not been fully proven. However, careful studies have been carried out on some drugs and it was possible to confirm the improvement in the condition of patients with dementia.

Mostly, drug treatment Helps reduce risk factors for stroke.

For this, it is used in small doses:

Warfarin;
aspirin;
ticlopidine;
cloppdogrel.

The rest of the medicines are aimed at partially eliminating the symptoms of the patient.

So, to improve cognitive (intellectual) abilities, the doctor may prescribe:

Pentoxfillin;
memantine;
cholinesterase inhibitors;
pentoxpfillin.

In cases of depression and post-stroke anxiety, antidepressants may be prescribed. And when it appears acute psychosis neuroleptics.

If the patient has been diagnosed with post-stroke mania (while it is confirmed that its cause is dementia), then an appointment will be required serious drugs, For example:

Lithium;
carbamazepine;
valproic acid;
gabapeptin.

Prevention and prognosis in vascular dementia

Prevention of vascular dementia is to prevent cardiovascular diseases. But it often happens that a person learns about this possibility too late, when dementia has reached the middle stage.

In any case, this is not a reason to refuse preventive measures, because in most cases, patients get better if the following recommendations are followed:

Refusal of alcohol and smoking.
Refusal of fatty foods.
Daily physical activity. You don’t need to make a bodybuilder out of your grandmother, but she can also allocate 2 times for 5-10 minutes for a light workout.
Daily intellectual loads. This includes crossword puzzles, reading, memory exercises, and the like.
Control of blood pressure and cholesterol levels.

Folk remedies

Efficiency folk remedies also not proven, however, patients in rare cases may become better with the use of some of them, for example:

Turmeric. It can be added to dishes as a condiment.
Elecampane.
A decoction of Irish moss and flaxseed. Take 1 tbsp. spoon each and boil in 0.5 liters of water for 20 minutes.
Preparation from the plant Gingko Biloba.

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Life expectancy in vascular dementia

Since the development of vascular dementia is more difficult than in other types, life expectancy depends on measures taken and the stage at which dementia was diagnosed. But unfortunately, it does not exceed 5-6 years with rare exceptions.

Prevention of vascular dementia is easier than cure because there is no universal cure for dementia. And although life expectancy with diabetes is short, it is in your power to improve the quality of life of the patient, not only with the help of medications and timely diagnosis.

It is very important for patients with dementia to communicate with loved ones.

vascular dementia. How to save memory and mind, TV show "Live Healthy":

Vascular dementia is a syndrome that is characterized by a deterioration in mental abilities, human behavior, which is caused by damage to the vessels of the brain. There is a partial or complete disintegration of mental functions. This is a very dangerous condition that leads to disability, so it is very important to pay attention to the symptoms and start treatment as soon as possible.

How does this disease develop? When blood vessels are affected in certain brain areas, nerve cells stop getting oxygen nutrients necessary for their full functioning. Because of this, they begin to die. For a while, the brain copes with this, so the situation does not outwardly make itself felt. But after the potential is depleted, negative changes begin to affect the state of memory, thinking and speech. These cognitive disorders affect a person's behavior, even his independence is reduced.

The prognosis is very poor, especially if the disease progresses rapidly. It also affects the life expectancy of the patient. This shows the importance of timely investigation and treatment. It is important not only to determine the stage, in order to understand how the disease will develop further, it is necessary to slow down this process.

Causes

In many states it is believed that main reason dementia - Alzheimer's disease, diseases that are associated with the death of nerve cells. It has been found that the signs of this dangerous disease can be caused by circulatory problems in the brain. It is in this case that we are talking about dementia of vascular origin.

Such a disease in pure form occurs in approximately 15% of all cases of dementia in the elderly. But there are many patients who have mixed type diseases. They are based just on a combination with Alzheimer's disease. There are several reasons for the development of the disease, the code of which according to ICD 10 is F01.

. There is an opinion that the main reason why vascular dementia develops is acute cerebrovascular accidents, as the brain cells that are left without food die. Indeed, a stroke increases the risk of dementia by several times. Statistics show that during the first year after an attack, it develops in about 30% of patients. Much depends on the location of the stroke and the size of the affected area. It is noted that dementia of vascular origin begins its development if the lesion has affected more than 50 ml of the brain. In the event that the violation affected the main area for cognitive functions, this number may be less.

Stroke increases risk of dementia

. According to scientists, it is not necessary that the development of dementia should be preceded by an acute violation, blockage of small vessels may be enough. The cause may not be obvious, then dementia is called subcortical. Despite the secrecy, this type of ischemia can be detected using modern methods research.
Decreased blood flow in the brain. The background for this is heart failure, a reduced volume of circulating blood, strong. Due to the weakness of the blood flow, the peripheral areas of the vascular pools do not receive the necessary amount of blood, so the nerve cells begin to die.

It can be concluded that there are two pathogenetic mechanisms due to which vascular dementia develops:

acute circulatory disorders in the brain;
chronic insufficiency blood supply in the brain.

These disturbances may occur together, resulting in clinical picture disease becomes more pronounced.

There are several forms, stages of development of the disease, which is reflected in the ICD-10 and affects the diagnosis, as a result, the treatment process. Since this disorder has an impact on the life expectancy of the elderly due to a poor prognosis, it is important to detect symptoms in time and monitor the treatment of the patient.

Today, the problem of vascular dementia is both medical and social. This is due to the fact that as a result of this disease, not only the quality of life of people becomes worse. Because of it, considerable economic losses occur, since patients need constant monitoring, especially if they have a pronounced form of such a serious illness.

Often, the main burden due to the patient's disability falls on relatives, who also strongly feel the terrible consequences of the disease. The duration of its duration cannot be predicted, but life expectancy is in any case less, which also often brings a lot of pain.

In no case should anyone who cares for such a patient independently prescribe any drugs. It is important to follow the doctor's prescription exactly and conduct all studies and take tests on time.

Symptoms

Symptoms of vascular dementia in the elderly appear depending on various factors. According to certain signs, the form of the disease is revealed.

For dementia with acute onset, the ICD-10 code of which is F01.0, the appearance of a cognitive impairment is characteristic within the first month after a stroke occurs. Usually the time of appearance of such signs does not exceed three months after the attack.
The development of multi-infarct dementia (ICD-10 code - F01.1) occurs gradually within six months after several ischemic episodes have occurred. With this form of the disease, there is an accumulation of infarcts in the parenchyma of the brain of the head.
The subcortical form appears. There are symptoms of damage to the deep zones of the white matter of the cerebral hemispheres of the head.

Subcortical form of vascular dementia raises blood pressure

Increasingly, they began to focus on forms of dementia that are not directly related to. This is due to the fact that patients are sometimes given an inaccurate diagnosis, after which they are prescribed wrong treatment. It is noted that sick people are given Alzheimer's disease, in the treatment of which other drugs are used. In this case, the vascular lesion continues to develop more and more actively.

Even if the exact cause of the deteriorating condition of the patient is subsequently revealed, the prognosis still remains extremely unfavorable, which, first of all, affects life expectancy. Therefore, it is extremely important to conduct thorough research, accurately diagnose, and identify the stage of the disease. To do this, you need to be examined by qualified specialists, and even take tests in a good clinic.

Vascular dementia is characterized by a variety of clinical disorders. Patients may have coexisting neuropsychological and neurological syndromes. Patients with dementia have the following symptoms:

slowing down of psychological processes;
narrowing the range of interests;
cognitive decline;
problems with the implementation of household functions, self-service;
loss of an adequate assessment of the state of one's health.

Cognitive disorders primarily include disorders of attention and memory. They are observed at the beginning of the development of the disease and continue to develop actively. If you do not take the prescribed drugs, the prognosis will be even worse. More than 50% of patients have emotional incontinence, such as faintheartedness or violent crying. Some patients have depressive disorders.

Symptoms of the disease are also considered depending on the stage.

At the first stage, a person is very irritated, emotionally unstable. There is dizziness, headache, insomnia or drowsiness.
worsening in the second stage psychopathological symptoms develop anxiety-depressive syndrome. Consciousness may be disturbed, hallucinations, delusional states occur.
At the third stage, memory disorders and cognitive disorders develop even more. At this stage, dementia is strongly activated. Some patients cannot control their appetite, become indifferent, and may lie or sit for hours. Visual or auditory hallucinosis may occur.

Diagnostics

How is vascular dementia diagnosed? In addition to clinical signs, a diagnosis of the patient's mental state is carried out, which is carried out using special tests.

Also important are the results of studies such as MRI and CT, which help to detect affected areas of the brain and establish the stage of degenerative processes. Everyone surrenders necessary tests, all the results are compared with each other and carefully studied.

As a result of the research, a diagnosis is made on the basis of the 10th international classification diseases:

F01.0 - dementia with acute onset;
F01.1 - multi-infarction form;
F01.2 - subcortical dementia;
F01.3 Mixed cortical and subcortical dementia.

According to ICD-10, other types of the disease are designated as F01.8. If the type is not specified, the code F01.9 is set. After a diagnosis is made in accordance with the ICD-10, and for this it is necessary to undergo all the prescribed studies and pass tests, treatment is prescribed.

Treatment

The treatment of vascular dementia is complicated because it is impossible to draw accurate conclusions about the cause of the disease. Today it has become common differentiated approach because dementia is caused by a complex of syndromes.

The drugs prescribed by the doctor are aimed at preventing and slowing down the negative process that occurs in the patient's brain. Antiplatelet drugs are used to prevent cerebral infarctions. If available pathological changes in the heart, anticoagulants are used

Peptidergic drugs, nootropics, calcium channel antagonists contribute to the improvement of cognitive functions. It is very important to strictly follow the dosage prescribed by the doctor. You can not take drugs on your own, which you have read or heard about somewhere, you need to consult specialists.

If there is the slightest suspicion of dementia, you should immediately take the person to the hospital. They will conduct research, take tests, make an accurate diagnosis, on the basis of which decisions will be made regarding treatment, prescribing drugs, disability groups. Treatment of vascular dementia will improve the quality of life and possibly prolong it.