What's the Difference Between Alzheimer's and Vascular Dementia?

A Comparison Between These Two Kinds of Dementia

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The Amazing Brain: Alzheimer's vs. Vascular Dementia
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Alzheimer’s disease and vascular dementia (sometimes called vascular cognitive impairment or vascular neurocognitive disorder) are both types of dementia. They have several symptoms and characteristics that overlap, but there are also some clear differences between the two.

Prevalence

Vascular: Statistics vary widely as to the prevalence of vascular dementia, but it's estimated that between one and four percent of people over the age of 65 develop vascular dementia.

That percentage doubles every five to 10 years after age 65.

Alzheimer’s: Alzheimer's disease is by far the most common kind of dementia. There are more than 5 million Americans with Alzheimer’s disease.

Causes

Vascular: Vascular dementia is often caused by an acute, specific event such as a stroke or transient ischemic attack where the blood flow to the brain has been interrupted. It can also develop more gradually over time from very small blockages or the slowing of blood flow.

Alzheimer’s: While there are several ways to decrease the chance of developing Alzheimer’s such as exercise and maintaining an active mind, we’re still not sure what causes Alzheimer’s to develop. There appear to be many components that may contribute to developing Alzheimer's disease such as genetics, lifestyle and other environmental factors.

Risk Factors

Vascular: Common risk factors include diabetes mellitus, high blood pressure, high cholesterol, coronary heart disease, and peripheral artery disease.

Alzheimer's: Risk factors include age, genetics (heredity) and general health.

Symptoms

Cognition

Vascular: Cognitive abilities often seem to decline more suddenly related to an event like a stroke or a transient ischemic attack (TIA) and then remain more stable for a time. These changes are often described as step-like since in between them, brain functioning may hold steady.

Alzheimer’s: While cognition can vary somewhat in Alzheimer’s, the person’s ability to think and use his memory gradually declines over time. There is not usually a sudden, significant change from one day to the next.

In contrast to the step-like decline in vascular dementia, Alzheimer's is typically more like a slight, downward slope of a road over time. 

Walking and Physical Movement

Vascular: Vascular dementia is often accompanied by some physical challenge. For example, if your loved one had a stroke, she may have limited movement on one side of her body. Both the cognitive and physical impairments related to vascular dementia usually develop at the same time since they are often the result of a sudden condition like a stroke.

Alzheimer’s: Often, mental abilities like memory or judgment decline initially, and then as Alzheimer's progresses into the middle stages, physical abilities like balance or walking show some deterioration. 

Diagnosis

Vascular: Several tests can help evaluate your loved one's memory, judgment, communication and general cognitive ability. Along with those tests, an MRI can often clearly identify a specific area in the brain where a stroke or a transient ischemic attack affected his brain.

Alzheimer's: Similar cognitive tests are used to evaluate brain functioning, but Alzheimer's is often diagnosed by ruling other causes out, rather than being able to pinpoint the diagnosis through a brain scan. There's not one clear test to diagnose Alzheimer's at this time, so physicians generally eliminate other reversible causes of confusion such as vitamin B12 deficiency and normal pressure hydrocephalus, as well as other types of dementia or delirium.

Disease Progression

Vascular: Since there is such a variety of causes and different amounts of damage, it's difficult to predict survival time for vascular dementia.

Progression of vascular dementia depends on a number of factors including the extent of the damage in the brain, in addition to your overall health condition.

Alzheimer’s: The median survival time for individuals with Alzheimer’s is 84.6 years old, and the survival rate after the beginning of symptoms is 8.4 years.

A Word from Verywell

Understanding the differences between vascular dementia and Alzheimer's disease can help you better understand what to expect from a diagnosis. 

Additionally while there are clear differences between the two diseases, research has found that some similar strategies can be used to reduce their risk. These include a heart-healthy diet and physical activity

Sources:

Alzheimer's Association. Risk Factors. http://www.alz.org/alzheimers_disease_causes_risk_factors.asp

Alzheimer’s Association. Vascular Dementia. http://www.alz.org/dementia/vascular-dementia-symptoms.asp">http://www.alz.org/dementia/vascular-dementia-symptoms.asp

Geriatrics and Aging. 2007;10(1):36-41. Vascular Dementia and Alzheimer's Disease: Diagnosis and Risk Factors. http://www.medscape.com/viewarticle/555220_1

O’Brien, J. and Markus, H. (2014). Vascular risk factors and Alzheimer’s disease. BMC Medicine, 12(1).

Ozbabalık, D, Arslantaş, A and Elmacı, NT (2012). The Epidemiology of Vascular Dementia, Geriatrics, Prof. Craig Atwood (Ed.), ISBN: 978-953-51-0080-5, InTech. https://cdn.intechopen.com/pdfs-wm/29296.pdf

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