Although Alzheimer’s disease is the most common cause of dementia, it is by no means the only cause. Many other conditions can cause dementia. For example, vascular dementia often develops as a result of a series of tiny strokes (known as infarcts) that destroy brain cells. Each small infarct may be inconsequential alone, but the cumulative effect of multiple infarcts can destroy enough brain tissue to impair memory, language, and other intellectual abilities.
Vascular dementia can also result from a major stroke or from the vasculitis caused by systemic lupus erythematosus (lupus) and other collagen vascular diseases. In these cases, it may be at least partially reversible, however. Other conditions that can precipitate vascular dementia because they make strokes more likely to occur include chronic high blood pressure, diabetes, and coronary heart disease (a narrowing of the coronary arteries that reduces blood flow to the heart).
Another cause is cerebral amyloid angiopathy (a condition in which the amyloid protein is deposited along blood vessels, causing them to rupture). If you have a diagnosis of vascular dementia, you may also have the plaques and tangles in the brain that occur with Alzheimer’s disease. In fact, Alzheimer’s disease and vascular disease frequently occur together.
Signs and symptoms of vascular dementia tend to develop suddenly and can involve parts of the body besides the brain; some such symptoms include loss of bladder or bowel control, development of a mask-like facial expression, and weakness or paralysis on one side of the body.
Results of a study reported in Alzheimer’s Disease & Associated Disorders suggest that memantine (Namenda) may have modest benefits in people with vascular dementia. Memantine belongs to a class of drugs known as NMDA receptor antagonists.