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Dementia can be caused by damage to the blood vessels of the brain that ultimately leads to strokes. Some strokes are very noticeable; they occur suddenly and lead to an abrupt loss of function. However, some strokes may occur without noticeable clinical symptoms and are therefore referred to as “silent strokes.” A patient having a silent stroke may not know it is happening. Dementia develops when more and more areas of the brain are damaged over time.
Risk factors for vascular dementia include untreated hypertension, high cholesterol and diabetes. When a sudden loss of function occurs, this usually leads to a medical evaluation. The combination of a neurological examination and modern imaging techniques can easily diagnose large strokes. It is more difficult to diagnose vascular dementia when it is caused by the gradual accumulation of small strokes in the brain. The specific functions that are lost depend upon which blood vessels are damaged as a result of the strokes.
Cognitive symptoms include difficulties with retrieval of information, including remote memories, facts, names and common words. Physical symptoms may include difficulties with gait and balance; urinary frequency or urgency; and increased daytime sleepiness.
Vascular disease can also occur simultaneously with other brain disorders, such as Alzheimer’s disease. The combination of two disorders causes a worsening of symptoms. Identifying which disorder is the primary cause of the cognitive difficulties can be challenging. Symptoms of vascular dementia typically develop after the age of 65.