The Connection Between Stroke and Dementia

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There is a recognized connection between stroke and dementia. Certain types of stroke cause dementia and there are also many similarities and differences between stroke and dementia.

What is Dementia?

Dementia is a condition in which multiple aspects of brain function decline, interfering with a person's normal everyday functioning. There are a number of diseases which can lead to dementia, and each one is characterized by a different pattern of behavioral changes.

Types Of Dementia

  • Alzheimer Disease (AD): AD, the most well-known dementia of all, normally becomes noticeable between the ages of 65 to 85 and progresses slowly. Its most prominent symptoms include memory loss, delusions, hallucinations, anxiety, sleep disturbances, and depression. The brains of people afflicted with AD have a specific appearance under the microscope, which is mainly due to the widespread presence of neuritic plaques and neurofibrillary tangles. Scientists are studying whether these abnormalities may guide research into the treatment of Alzheimer's dementia. So far, there are few medical treatments available, and they do not reverse the disease. In general, AD is not believed to be associated with strokes, although people with AD who have had strokes generally experience more severe symptoms of their AD than people with AD who have not had strokes.
  • Frontotemporal Dementia: This is a group of disorders in which the frontal and temporal lobes of the brain are selectively affected. Frontotemporal dementias start off earlier in life than AD (between the ages of 50-60) and although they still progress slowly, they progress a little more rapidly than Alzheimer disease. Their most prominent features include personality changes such as loss of insight, loss of empathy for others, poor self-care, emotional explosiveness, and impulsiveness. Like AD, frontotemporal dementias are not considered to be caused by strokes. They typically include the following subtypes of dementia:
    • Pick’s disease
    • Primary progressive aphasia
    • Motor neuron disease and frontotemporal degeneration
  • Dementia with Lewy Bodies: A type of dementia characterized by at least two of the following three symptoms. 1) A waxing and waning level of consciousness; 2) visual hallucinations and 3) spontaneous movements suggestive of Parkinson's disease.
  • Parkinsonian Dementias: This is a group of dementias which always occur along with the progressive movement abnormalities typical of Parkinson's disease. There are several different types of dementia that can develop along with Pakinson's disease. The common Parkinsonian dementias are:
    • Degenerative (sporadic) dementias
    • Degenerative familial dementias
    • Secondary Parkinsonian dementia syndromes
    • Dementia pugilistica
    • Dementia due to inherited metabolic disorders
  • Vascular Dementia: This is the type of dementia caused by strokes,  ministrokes, silent strokes, and other forms of cerebrovascular disease. Vascular dementia describes behavioral and cognitive decline that occur when someone has experienced a number of small strokes that may or may not have been noticeable when they occurred. The symptoms of vascular dementia are caused by the brain damage that occurs as the result of a stroke. Symptoms may include forgetfulness, inappropriate behavior, personality changes, emotional instability, and even losing one's sense of humor. People who have vascular dementia often have reduced ability to care for themselves, and this may be a risk factor for having a larger, more significant stroke. 

Preventing Vascular Dementia

The risk factors that make people susceptible to stroke can also increase the risk of developing vascular dementia. Once these stroke risk factors are identified, often by routine medical check up, a number of strategies can be used to reduce the risk of stroke.

Preventing vascular dementia is an important strategy for people who do not have vascular dementia, as well as for people who already have signs of vascular dementia because stroke prevention can prevent vascular dementia from getting worse.

A Word From Verywell

Living with vascular dementia is challenging and stressful. Many people who develop this condition are at least partially aware of their own cognitive decline, yet also unable to process information and plan out actions as well as they had in the past. Loved ones observe, and may be overwhelmed with both the emotional uncertainty and with the practical everyday burden of being a caregiver.

It is useful to regularly follow up with your medical team to maintain optimal health and prevent further decline. Many patients and family members also feel that it is useful to connect with resources and support for dementia that are available in your community, as this can reduce the burden of living with the condition of vascular dementia.

Source:

Chronic cerebral hypoperfusion induces post-stroke dementia following acute ischemic stroke in rats, Back DB, Kwon KJ, Choi DH, Shin CY, Lee J, Han SH, Kim HY, J Neuroinflammation. 2017 Nov 9;14(1):216. doi: 10.1186/s12974-017-0992-5.