Dementia is a general term used to describe symptoms of cognitive impairment, including memory loss and issues with judgment and reasoning.
The most common types of dementia include Alzheimer’s disease, vascular dementia, and dementia with Lewy bodies. These types have specific characteristics and causes tied to them.
Dementia progresses differently for each individual, and no two people will experience the exact same symptoms. However, most people will go through certain shared symptoms and stages on their own timeline.
As a resource for our community, The Kensington White Plains will explain the seven stages of vascular dementia and the causes, symptoms, and risk factors in this guide.
What is Vascular Dementia?
Dementia is a general term for issues with memory, reasoning, planning, and judgment. The causes for dementia vary depending on the symptoms and the underlying condition.
The most common type of dementia is Alzheimer’s disease, followed by vascular dementia.
While experts believe Alzheimer’s is caused by a buildup of abnormal proteins in the brain, vascular dementia is caused by brain damage from impaired blood flow in the brain.
This may occur after a stroke, or from any other condition such as a transient ischemic attack (mini-stroke), that damages blood vessels in the brain and deprives it of oxygen. The damage to the brain eventually results in symptoms of dementia such as memory loss, confusion, and trouble concentrating.
As with many other types of dementia, vascular dementia can develop gradually, and the progression of the disease generally falls into seven stages.
What is the difference between common dementia and vascular dementia?
Dementia is often defined as an umbrella term for a collection of symptoms including memory loss, confusion, disorientation, and issues with judgment and planning.
Dementia isn’t a disease itself, but a group of symptoms.
There are numerous types of dementia, including the following:
- Alzheimer’s disease
- Vascular dementia
- Frontotemporal dementia
- Dementia with Lewy bodies
- Parkinson’s disease dementia
- Mixed dementia
- Huntington’s disease
- Creutzfeldt-Jakob disease
The causes and treatments of each type of dementia can vary depending on the location of the damage to the brain, and the type of damage.
Vascular dementia is one type of “regular dementia,” caused by damage to the brain from reduced or blocked blood flow.
Similarly to other types of dementia, the symptoms can include memory issues and confusion, but the progression and early symptoms can vary from other types due to the specific damage.
While vascular dementia is related to blood flow in the brain, other types have various causes.
Alzheimer’s disease, for example, is believed to be caused by an abnormal buildup of proteins in and around brain cells that form plaques and tangles.
Frontotemporal dementia is a buildup of plaque in the brain mainly located in the frontal and temporal lobes, while Alzheimer’s affects the entire brain.
What are the types of vascular dementia?
We know that vascular dementia occurs as a result of issues with blood flow to the brain. But why are there issues with the blood flow in the first place?
There are a few reasons why a person may have damage to their blood vessels, which results in reduced or blocked blood flow to the brain. These reasons are considered the “types” of vascular dementia.
The most common types of vascular dementia are:
- Stroke-related dementia: Occurs after a stroke when blood supply to the brain is blocked due to a blood clot
- Multi-infarct dementia: Occurs after a series of mini-strokes, or transient ischaemic attacks (TIA)
- Mixed dementia: Occurs when the person has symptoms of vascular dementia and Alzheimer’s disease
Vascular dementia can appear differently for each person because of the area of the brain affected.
For example, some people may exhibit more forgetfulness, but still live a relatively independent life, while others may experience significant confusion or issues with balance.
Vascular dementia also will progress differently for each individual. The progression often is broken down into certain defined stages of dementia, which many people use as a guideline for their loved one’s care needs.
What Are the 7 Stages of Vascular Dementia?
The progression of dementia most often falls into three stages, depending on the source.
Sometimes it is categorized as mild, moderate, and severe, while other times you may see it described as the early, middle, and late stages.
While the three stages are helpful in defining the main progression of cognitive decline, many medical experts and families alike prefer the extensive seven-stage model, which dives deeper into the symptoms and care required at each stage.
The seven stages of vascular dementia are defined as follows.
1. Normal Behavior
In the first stage of vascular dementia, there may already be damage to the blood vessels in the body that eventually will cause symptoms, but the person is not yet exhibiting any symptoms. Their behavior is unchanged.
2. Mild Changes
In the second stage, the changes occurring in the brain are beginning to manifest externally. You may notice mild confusion, slowed thinking, or issues with your loved one’s problem-solving skills, but because they are mild, they may be dismissed as normal signs of aging.
3. Mild Decline
At this point, family members and friends may begin to notice changes in the loved one experiencing symptoms, and know that something isn’t right. This stage is often noted as the longest, because the changes and progression may be gradual for a while before symptoms worsen.
These symptoms may include:
- Confusion
- Difficulty paying attention or concentrating
- Trouble organizing thoughts
- Trouble making plans and communicating them
- Slowed thinking
- Memory loss
Vascular dementia symptoms can occur suddenly, such as after a stroke or a series of strokes, but this type of dementia also can develop as gradually as other types.
Alzheimer’s disease and vascular dementia also often occur together.
The mild or middle stage can last for several years before symptoms begin to worsen. It’s recommended to transition your loved one to an assisted care community before their symptoms worsen and they’re in the midst of the disease. This way they can still be a part of the conversation and the transition can be smooth.
4. Moderate Decline
When your loved one reaches this stage of dementia, their symptoms become more obvious, and new symptoms may also appear.
Safety may become a concern as your loved one struggles with daily tasks such as cooking, cleaning, paying bills, or taking medication, and they may be unable to properly care for themselves.
If your loved one has not yet received a dementia diagnosis, it often will occur at this stage.
5. Moderately Severe Decline
Your loved one often will need an increasing amount of daily living assistance at this stage, including help with dressing themselves and receiving support throughout the day to remember important facts and details. They may still be able to eat and toilet independently but are experiencing enough confusion that they require reminders to do these things.
6. Severe Decline
At this stage, your loved one will need a high level of care and support for severe cognitive decline.
They likely will need constant supervision to ensure their safety, plus help with dressing, meals, using the bathroom, and washing themselves.
They also may have an increased risk for developing infections.
Caregivers will need extra support at this stage as well, because a loved one may experience personality and behavior changes that can be troublesome for all involved.
Family members can try soothing their loved ones with their favorite activities and comforts, including music, scents, movies, and old photos.
7. Very Severe Decline
In late stage dementia, around-the-clock care from loving professionals is essential as your loved one experiences very severe cognitive decline.
Your loved one will need help with basic activities such as eating and drinking. They may be unable to tell when they’re hungry or thirsty, and they may lack the ability to communicate.
The focus shifts to preserving quality of life through comfort and pain management techniques, as well as other medical and spiritual supports.
What are the causes of vascular dementia?
Vascular dementia most often occurs as a result of conditions that disrupt blood flow to the brain.
These conditions include:
- Blood clots
- Strokes
- Bleeding due to a ruptured blood vessel
- Damaged blood vessels due to high blood pressure, heart disease, infections, autoimmune disorders, diabetes, or atherosclerosis
Not all of these conditions will result in vascular dementia. However, it’s important to watch for the symptoms of vascular dementia following a stroke or any incident where blood flow to the brain is impaired.
Sometimes, symptoms of vascular dementia appear suddenly after a stroke or surgery. Other times, it may occur after several mini-strokes or develop gradually like Alzheimer’s disease.
Common symptoms of vascular dementia
Similarly to other forms of dementia, the symptoms of vascular dementia can vary depending on which area of the brain was affected.
Vascular dementia symptoms may be similar to other types of dementia, including Alzheimer’s disease. Alzheimer’s disease and vascular dementia also can occur at the same time.
The main difference in the symptoms between vascular dementia and other types of dementia most often involves problem-solving and thinking skills.
The most common symptoms of vascular dementia are:
- Confusion
- Difficulty concentrating and communicating
- Slowed thinking abilities
- Memory issues
- Depression or irritability
- Urinary issues
- Issues with balance and movement
Symptoms may start out mild, and gradually worsen over time.
How quickly does vascular dementia progress?
The speed of progression for any type of dementia, including vascular, varies from person to person.
Some seniors with vascular dementia may be able to live with a family member or in-home care for several years before requiring additional care.
Eventually, those with vascular dementia may require a high level of care in an assisted living or memory care community, such as the specialized, loving memory care provided at The Kensington White Plains.
To help you prepare for your loved one’s care, we’ll share the general expectations for each stage of vascular dementia, including how long the stage may last and how your loved one’s symptoms may progress.
Generally, in the early stages of vascular dementia, your loved one will progress from having no symptoms to mild forgetfulness and decline.
In the middle stages of dementia, your loved one may advance to more significant symptoms and require more daily assistance.
In the late stages, your loved one may require around-the-clock care and assistance as the disease progresses and they experience severe cognitive decline.
Let’s take a look at each stage.
What to expect in early-stage vascular dementia
In early-stage vascular dementia, damage to the blood vessels or disruption of blood flow to the brain may already have occurred, yet symptoms are relatively mild.
While memory loss is a common first sign of mild cognitive decline in those who are developing dementia, memory issues are often not the first sign of vascular dementia.
Instead, those developing vascular dementia may experience confusion more often, issues with communication, and trouble making decisions, planning, or problem-solving.
The early stages often are the best time to make a care plan for your loved one, because they can be involved in the decisions.
It’s difficult to estimate how long the first stage of dementia lasts because many experts say the brain changes involved in dementia are occurring for several years prior to the appearance of symptoms.
However, each stage of dementia lasts an average of two years. It’s important to always keep in mind that each person will progress on their own timeline because there are numerous factors involved.
What to expect in middle-stage vascular dementia
In the middle stages of dementia, you can expect your loved one’s symptoms to advance.
They may begin to experience changes in their behavior and develop increasing confusion and communication issues.
Symptoms of depression and anxiety may appear as your loved one grapples with moderate cognitive decline, loss of independence, and frustration with communication.
Your loved one will require an increasing level of care, emotional support, and compassion as they experience these changes.
It may be wise in the middle stage to bring on additional in-home care or make the move to an assisted living community with memory care.
The Kensington White Plains offers two memory care communities designed to meet your loved one’s exact level of care.
We offer a robust life enrichment program and numerous onsite services to help residents maintain their highest quality of life through social, physical, and wellness activities.
What to expect in late-stage vascular dementia
In the later stages of dementia, your loved one will require significant support with their activities of daily living (ADLs), including assistance with eating, dressing, and using the bathroom.
The final stage of dementia is usually the shortest stage, lasting around one to two years.
The goal in the final stages of vascular dementia is maintaining comfort, routine, and indulging the senses.
Learning how to communicate and interpret your loved one’s needs is essential, as they may turn mainly to nonverbal communication.
At any stage of dementia, it’s important to focus on what the person is still able to do, rather than the abilities they have lost.
Developing a routine will help your loved one feel more comfortable. Surround them with their favorite hobbies and items, including old photographs, and beloved movies, games, and music.
The Kensington White Plains uses cognitive-stimulating programs, music therapy, pet therapy, robo-pets, and pocket programming as some of our enhanced care programs designed to foster connection and decrease anxiety.
Vascular dementia risk factors, prevention, and treatments
If a loved one has recently been diagnosed with vascular dementia, you may have many questions.
The following are some of the most frequently asked questions about vascular dementia including the risk factors, diagnosis, and prevention.
What are the risk factors for vascular dementia?
The risk factors for vascular dementia are similar to the risks for stroke and heart disease since these conditions all affect the blood vessels and blood flow in the body.
Risk factors include:
- If a heart attack or stroke has occurred
- High blood pressure, high cholesterol, or diabetes
- If you’re over the age of 65
- Atherosclerosis, or a buildup of plaque and cholesterol in your arteries
- Smoking, obesity or an abnormal heart rhythm
How do you prevent vascular dementia?
Improving your overall health and well-being may help prevent or ease the symptoms of vascular dementia.
This includes participating in regular exercise, avoiding smoking and alcohol, and properly managing any current health issues, such as high blood pressure or diabetes.
It also includes a heart-healthy and brain-healthy diet, such as the MIND diet, which is rich in green leafy vegetables, whole grains, nuts, berries, and healthy fats.
How is vascular dementia diagnosed?
Diagnosing dementia involves a series of tests and exams to rule out other causes, such as a medication side effect or vitamin deficiency, and zero in on the type of dementia based on medical history.
Your doctor will likely perform a neurological exam, lab work, and a brain scan to officially make their diagnosis.
What treatments are available for vascular dementia?
Treatment for vascular dementia usually is focused on a person’s heart and blood vessel health.
This may mean working on blood pressure, and cholesterol, and keeping the arteries healthy and clear.
Treatments also may involve boosting a person’s overall health and well-being with physical activity and nutritious meals, and certain types of therapy.
Physical therapy, occupational therapy, and speech therapy are usually involved in a person with dementia’s care plan.
The Kensington White Plains offers onsite rehabilitation services. These services help improve our residents’ quality of life with exercises and tools to build strength and adapt to any life changes.
How to Support a Loved One Experiencing Dementia Symptoms
As your loved one’s dementia worsens, it can become increasingly difficult for family caregivers to keep up with the levels of care your loved one needs.
Creating a care plan soon after your loved one’s diagnosis is the best way to address their care needs over time.
Finding a loving community should be a part of your care plan, to ensure your loved one has a place to receive the type of advanced, loving care they need.
The Kensington was proud to partner with Jennie Clark of Stanford’s Aging Adult Services at Stanford Health Care for this virtual presentation. During this open and honest discussion, Jennie guides you through common questions that caregivers have when caring for their loved ones with dementia.
The Kensington White Plains offers two specialized memory care neighborhoods
The Kensington White Plains is an enhanced assisted living and memory care community located in the heart of White Plains, New York.
We are led by a simple yet powerful Promise: to love and care for your family as we do our own.
As part of this Promise, we offer a full spectrum of clinical support — including high acuity care — so that no matter how a resident’s care needs change over time, they have a home with us.
Acuity care takes into account a resident’s individual care needs and treatment plan. A resident’s acuity levels are examined to ensure they are receiving the proper care for their specific needs.
As these needs change, our residents are consistently re-evaluated to ensure they are receiving the right level of support.
We welcome residents with all levels of memory care needs
The Kensington White Plains offers two specially designed memory care neighborhoods, Connections, and Haven that accommodate specific stages of memory loss.
Connections is for residents in the early to middle stages of dementia, while Haven is for those in the middle to late stages.
Each neighborhood offers fully secured, intimate, home-like spaces with the appropriate resident-to-caregiver ratio.
We are able to care for those in all stages of memory loss and all types of dementia, including vascular dementia.
We also welcome seniors with all types of physical needs, including those on intermittent feeding tubes, IVs, those who require wound care, oxygen, catheters, and much more.
If you’re interested in learning more about our safe, loving community, reach out to our team today.
Tell us about your loved one’s specific needs and learn about all the ways we are able to accommodate them.