Vascular Dementia vs Alzheimer’s – What are the Differences?

Alzheimer’s disease and vascular dementia are both common forms of dementia and collectively make up approximately 70% of all dementia diagnoses in the UK (Alzheimer’s Society). Whilst they are both types of dementia and share some common symptoms, Alzheimer’s disease and vascular dementia are different conditions caused by separate issues. 

The outlook for patients and treatments can vary, making it important to understand the differences between the two conditions. In this blog, our dementia specialists detail the key differences between Alzheimer’s and vascular dementia, as well as how each is caused and what the treatment options are. 

What is Alzheimer’s Disease? 

Alzheimer’s disease is the most common form of dementia and affects between 50-75% of people with dementia in the UK. It’s thought that 1 in 14 people over the age of 65 have it, and 1 in 6 people over the age of 80. Generally speaking, patients diagnosed with Alzheimer’s will survive their disease for several years, with most people dying as a result of a separate health issue. 

The disease mostly progresses slowly over time, resulting in the steady decline of a person’s cognitive and physical abilities. During the later stages of the disease, people with dementia will require round-the-clock care, and may experience more severe physical symptoms such as incontinence. 

What is Vascular Dementia?

Vascular dementia affects approximately 150,000 people in the UK, making it the second most prevalent form of dementia behind Alzheimer’s. It can reduce a person’s life expectancy drastically, but like Alzheimer’s, most people with vascular dementia die of a separate cause. 

Over time, a person with vascular dementia will see their symptoms get worse, though the speed at which the disease worsens varies from person to person. Eventually, full time care will be required in the later stages as vascular cognitive impairment and physical symptoms become more debilitating. 

What are the differences between Alzheimer’s vs Vascular Dementia?

Though the outlook and symptoms for Alzheimer’s disease and vascular dementia overlap to a degree, there are some fundamental differences between the two conditions, as detailed below.

Cause 

The first difference between Alzheimer’s disease and vascular dementia is the cause. There is no known cause of Alzheimer’s disease, but research shows that your lifestyle, genetics, and a number of other environmental factors may increase your chances of developing Alzheimer’s disease later in life. 

In contrast, vascular dementia is caused by blood flow to the brain being restricted which can damage blood vessels and result in the eventual death of brain cells. There are a few ways blood flow to your brain can be impacted, including a stroke, lots of transient ischaemic attacks (mini strokes), high blood pressure, diabetes, and lifestyle issues like being overweight or smoking. These can all affect blood flow and cause issues with the brain’s blood vessels.

Symptoms

Both Alzheimer’s and vascular dementia can affect a person’s cognitive abilities, though the onset of vascular dementia symptoms are often more noticeable and become prevalent more quickly. In terms of physical symptoms, Alzheimer’s patients usually experience cognitive issues before physical issues, with balance and walking problems generally deteriorating as the disease progresses into the later stages. 

Unlike Alzheimer’s disease, patients who develop vascular dementia may experience physical symptoms like coordination problems and difficulty walking early on. This is because if they’ve suffered a stroke or had a brain injury, their physical abilities may be impacted immediately. 

Progression 

Both diseases worsen over time, but the speed at which that happens is variable. Patients with vascular dementia tend to see a sudden decline in their cognitive abilities. This is sometimes called ‘stepping’ because in between the sudden changes, symptoms tend to remain stable for a period of time. 

In comparison, Alzheimer’s disease tends to progress slowly and there are rarely significant changes from day to day. It generally starts with mild cognitive impairment that gets worse over a number of years, though the changes might be difficult to spot in real time.

Diagnosis 

Diagnosing Alzheimer’s can take time because the symptoms mirror many other conditions, and some symptoms, such as a mild cognitive decline and minimal memory loss in the earliest stages, can mimic natural ageing. In order to diagnose Alzheimer’s disease, tests are often undertaken that rule out other conditions. 

Vascular dementia tends to be slightly easier to diagnose because damage incurred to parts of the brain is easier to identify on an MRI scan. That being said, cognitive, memory, and communication tests are carried out for both Alzheimer’s and vascular dementia. 

Outlook 

Predicting an outlook for any form of dementia can be difficult, due to the fact that every patient is different. On average, Alzheimer’s patients survive their disease for around eight years as it progresses relatively slowly. 

Vascular dementia can be even more difficult to predict an outlook for. This is because it depends on the part of the brain that was impacted by the blood flow issue and how severe the damage is. If a patient continues to have mini strokes or has another blood flow issue, this could cause further damage and affect their overall life expectancy. 

Treatment 

Vascular dementia and Alzheimer’s are both treated differently. There are medications available that can slow the progression of vascular dementia, and patients may also be put on other medications to treat the cause of the vascular dementia, such as aspirin to prevent blood clots and strokes. Patients may also be given a lifestyle plan to work alongside medications to reduce the risk of further damage, such as eating a low salt diet which will help to manage high blood pressure, or exercising and losing weight. 

Alzheimer’s disease can be temporarily managed with medications such as memantine or acetylcholinesterase inhibitors. In the later stages of Alzheimer’s disease, many patients experience challenging behaviours such as anxiety, agitation, aggression, and hallucinations. Coping strategies may be employed, but sometimes, antipsychotic medications may be prescribed by a consultant psychiatrist. 

Diagnosing and Treating Dementia at Dementech Neurosciences

At Dementech Neurosciences, we have a team of leading neurologists specialising in diagnosing and treating dementia, as well as a range of other neurological disorders. Our team consists of consultants and therapists who work with patients and their families to create bespoke treatment plans that aim to intervene and treat the disease as early as possible. We strive to enable patients to maintain a high quality of life for as long as possible. 

We also offer support to patients and their families on how to come to terms with and learn to live with dementia. As well as vascular dementia and Alzheimer’s disease, we also diagnose and treat frontotemporal dementia, dementia with Lewy bodies, and Parkinson’s dementia. On top of this, we provide cutting edge treatment and support for stroke patients and those at an increased risk of developing dementia.

We endeavour to provide same-day consultations where possible and have access to the latest diagnostic and treatment technologies, making us best placed to provide outstanding care to patients with dementia. To find out more about dementia treatment at Dementech, please get in touch with us today.