Ask the Doctors

Dear Doctor: My dad has just been diagnosed with vascular dementia. What is it? Can it be prevented?

Dear Reader: Dementia is a general term used to categorize symptoms that relate to the decline or loss of cognitive function. These include confusion, memory loss, impaired language skills, changes in personality or behavior, and the inability to think clearly or perform everyday tasks. The most common cause of dementia is Alzheimer's disease, which accounts for between 60 and 80 percent of all dementia cases. The mental impairment of Alzheimer's disease results from a series of complex changes that take place within the structure of the brain itself.

Vascular dementia, which is also called vascular cognitive impairment, causes the majority of non-Alzheimer's cases of dementia. It occurs when the blood vessels in the body, known as the vascular system, become blocked, diseased or damaged and are unable to provide the brain with normal blood flow. This deprives the brain of adequate oxygen and nutrition, which causes brain cells to die. The resulting injury, which prevents different parts of the brain from communicating with one another, causes symptoms of dementia.

Hardening and narrowing of the arteries, a major stroke or a series of small strokes can cause vascular dementia. In the case of major stroke, symptoms of vascular dementia can appear suddenly. But quite often, the disease builds slowly. As blood flow to the brain decreases, mental impairment gradually becomes more pronounced.

At this time, vascular dementia cannot be reversed, but there are steps you can take to reduce your risk of developing it. Although the disease is rare before age 65, the cardiovascular problems that lead to it can begin to develop well before then.

One of the major risk factors for vascular dementia is high blood pressure, which also plays a role in heart attack and stroke. That's why it's important to know your numbers, and to monitor blood pressure on a regular basis.

To reduce blood pressure, maintain a healthy weight. It's wise to also keep track of your waistline measurements. Men who measure more than 40 inches at the waist and women whose waistlines measure more than 35 inches are at increased risk of developing high blood pressure.

Get moving. Regular exercise has been shown to reduce the risk of vascular dementia by 40 percent. Just 30 minutes of exercise at moderate intensity -- you'll be able to speak but not sing -- three times per week helps protect both your heart and your brain.

If you've been following this column for even a few weeks you know what's coming next -- don't smoke. If you do smoke, please stop. Yes, we know that's hard. We also know that your family doctor would love to help you.

Eat a healthy diet: lean meats, fresh fish, legumes, whole grains, seeds, nuts, and plenty of fruits and vegetables. Skip the sugar if you can. Limit simple carbs like pasta, rice, bread and processed cereals.

Limit how much alcohol you drink. Even in moderation, alcohol has been linked to dementia risk, particularly as we get older.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

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