Vascular dementia refers to changes to memory, thinking, and behavior resulting from conditions that affect the blood vessels in the brain. Cognition and brain function can be significantly affected by the size, location, and number of vascular changes.

Symptoms of vascular dementia can begin gradually or can occur suddenly, and then progress over time, with possible short periods of improvement. Vascular dementia can occur alone or be a part of a different diagnosis such as Alzheimer’s disease or other forms of dementia. When an individual is diagnosed with vascular dementia, their symptoms can be similar to the symptoms of Alzheimer’s.

What causes vascular dementia?

Vascular dementia is caused by different conditions that interrupt the flow of blood and oxygen supply to the brain and damage blood vessels in the brain.

People with vascular dementia almost always have abnormalities in the brain that can be seen on MRI scans. These abnormalities can include evidence of prior strokes, which are often small and sometimes without noticeable symptoms. Major strokes can also increase the risk for dementia, but not everyone who has had a stroke will develop dementia.

Other abnormalities commonly found in the brains of people with vascular dementia are diseased small blood vessels and changes in “white matter” — the connecting “wires” of the brain that are critical for relaying messages between brain regions.

Researchers are investigating how these changes in the brain — and their underlying causes — are involved in the onset and progression of dementia. Research has shown a strong link between cardiovascular disease, involving the heart and blood vessels, and cerebrovascular disease, involving the brain, and subsequent cognitive impairment and dementia. This area of research is referred to as “vascular contributions to cognitive impairment and dementia,” or VCID. It is helping researchers better understand this connection and whether the methods used to prevent and treat cerebrovascular disease and heart disease could also help prevent dementia.

Researchers investigating VCID are exploring diverse conditions that affect blood flow to and within the brain, including infarcts (an area of dead tissue resulting from a lack of blood supply), hemorrhages (bleeding from ruptured or damaged blood vessels), cerebral hypoperfusion (reduced blood flow), and small vessel disease in the brain such as that thought to be associated with white matter hyperintensities (white patches seen on brain MRI scans), and stroke.

Because many different disease processes can result in different forms of vascular dementia, there may not be one treatment for all. However, vascular dementia is often managed with medications to prevent strokes and reduce the risk of additional brain damage. Some studies suggest that medications that are used to treat Alzheimer’s might benefit some people with an early form of vascular dementia. Treating modifiable risk factors like high blood pressure, diabetes, high cholesterol, and problems with the rhythm of the heartbeat can help prevent additional stroke. Living a healthy lifestyle is important to help reduce the risk factors of vascular dementia.

As we get ready for 2022, the Alzheimer’s Foundation of America (AFA) is encouraging individuals to make a New Year’s resolution to get a memory screening. AFA offers free, confidential memory screenings through a secure virtual format every Monday, Wednesday and Friday—appointments can be scheduled by calling AFA at 866-232-8484 or through AFA’s website. The service is available to everyone—there are no minimum age or insurance prerequisites.“Annual screenings are important, including for our brains, which is why everyone should make getting a memory screening a New Year’s resolution for 2022,” said Charles J. Fuschillo, Jr., AFA’s President & CEO. “Just as we regularly check other facets of our health, we should all get a checkup from the neck up, regardless of whether or not we are having memory problems.” 

Memory screenings are simple, quick (approximately 10-15 minutes) and noninvasive, and consist of a series of questions, administered by a qualified professional, to gauge memory, language, thinking skills and other intellectual functions. They are similar to other routine health screenings, such as those for blood pressure, cholesterol and skin checks. Results are not a diagnosis, but a memory screening can suggest if someone should see a physician for a full evaluation. 

Early detection of memory impairments is extremely important. Many different conditions can cause memory issues, including treatable or curable conditions such as vitamin deficiencies, thyroid conditions, urinary tract infections, stress, anxiety and depression. 

Even in the case of a dementia-related illness such as Alzheimer’s, early detection can provide greater opportunity to begin treatments that can help slow the symptoms of the disease, as well as taking part in a clinical trial. In addition, it affords the person the chance to take advantage of community services, such as support groups and therapeutic programming, as well as have a greater say in making legal, financial and health care decisions. 

Memory screening appointments can be scheduled by calling AFA at 866-232-8484 or through AFA’s website here. Screenings are conducted through secure videoconference technology (i.e., Facetime, Zoom, Skype)—all that’s needed is a device with a webcam and Internet capability, such as a smartphone, laptop, or tablet. 

The Alzheimer’s Foundation of America is a non-profit organization whose mission is to provide support, services and education to individuals, families and caregivers affected by Alzheimer’s disease and related dementias nationwide and to fund research for better treatment and a cure. Its services include a National Toll-Free Helpline (866-232-8484) staffed by licensed social workers, the National Memory Screening Program, educational conferences and materials, and “AFA Partners in Care” dementia care training for healthcare professionals. For more information about AFA, call 866-232-8484, visit www.alzfdn.org, follow us on Twitter or connect with us on Facebook, Instagram or LinkedIn. AFA has earned Charity Navigator’s top 4-star rating for seven consecutive years.

An area of the brain called the locus coeruleus, sometimes called “the blue spot,” might show signs of Alzheimer’s disease before any other brain area does, according to a recent NIA-supported study. Published in Science Translational Medicine, the findings suggest a potentially promising new early indicator for Alzheimer’s disease.

In Alzheimer’s disease, tau protein accumulates in cells throughout the brain and forms tangles. Tau tangles, along with the accumulation of amyloid, another type of protein that forms plaques, are two hallmarks of Alzheimer’s disease. Treating Alzheimer’s disease is a challenge, in part because it is usually diagnosed after the onset of symptoms when significant damage in the brain has already occurred. However, by using new advancements in brain imaging, scientists from Massachusetts General Hospital may be one step closer to diagnosing Alzheimer’s, even before cognitive deficits emerge.

The locus coeruleus is a small area of the brain located in the brainstem. It gets its nickname “the blue spot” because the cells in the area produce a blue pigment that makes the whole region appear blue. Many researchers who study Alzheimer’s are interested in the locus coeruleus because it seems to accumulate tau long before any noticeable clinical signs of the disease arise. However, the size of the area, and the type of brain cells within it, make the locus coeruleus difficult to image with normal magnetic resonance imaging (MRI) and positron emission tomography (PET) scans.

In this study, the team of scientists used a new technique to look at the signal intensity of the locus coeruleus. This signal intensity gives information about the number and health of cells in the region. A lower signal indicates that neurons may be damaged, which can be a sign of tau accumulation.

To conduct the study, scientists utilized data from 174 participants from the Harvard Aging Brain Study, some of whom had cognitive impairment, while others had normal brain function. All participants underwent MRI and PET brain imaging and most received repeated long-term assessments to measure brain functions, such as memory and attention, as part of the larger aging brain study.

Using the high-resolution MRI together with PET scans that identify tau tangles and plaques in other brain areas, the scientists made an important connection. They found that a low-intensity signal from the locus coeruleus was associated with an increased presence of tau tangles and amyloid plaques in an area of the brain called the entorhinal cortex, which is involved in memory function. The scientists also found that a weaker signal from the locus coeruleus was associated with a loss of memory and a decline of other brain functions.

To confirm their results, the scientists compared the imaging findings against autopsy data from two established datasets, the Religious Orders Study and Rush Memory and Aging Project (ROSMAP) and the National Alzheimer’s Coordinating Center (NACC). These datasets contain postmortem assessments of locus coeruleus damage, brain function, and Alzheimer’s-induced cellular damage in numerous other areas. Similar to the results from the high-resolution MRI, the researchers found that participants whose autopsy results showed tau tangles in the locus coeruleus also showed Alzheimer’s-related brain damage and a decline in brain function.

Scientists do not know how, or if, tau moves from the locus coeruleus to other brain areas. However, findings from this study show that changes in the locus coeruleus could be a promising marker to indicate the brain’s tau tangle and amyloid plaque burden and have the potential to help providers evaluate an individual’s risk for cognitive decline. This research paves the way for advances in the early detection of Alzheimer’s, which may increase the chances of successful treatment.

“I we sure this counts as drinking water before, during, and after your workout session?”

Deciding to become physically active can be one of the best things you can do for your health. Exercise and physical activity are not only great for your mental and physical health, but they can help keep you independent as you age. Now, let’s talk about getting started.

According to the Physical Activity Guidelines for Americans (PDF, 14.5M) you should do at least 150 minutes (2 ½ hours) a week of moderate-intensity aerobic exercise, like brisk walking or fast dancing. Being active at least 3 days a week is best, but doing anything is better than doing nothing at all.

You should also do muscle-strengthening activities, like lifting weights or doing sit-ups, at least 2 days a week. The Physical Activity Guidelines also recommend that as part of your weekly physical activity you combine multiple components of exercises. For example, try balance training as well as aerobic and muscle-strengthening activities. If you prefer vigorous-intensity aerobic activity (like running), aim for at least 75 minutes a week.

How Older Adults Can Get Started with Exercise

Exercise and physical activity are great for your mental and physical health and help keep you independent as you age. Here are a few things you may want to keep in mind when beginning to exercise.

Start Slowly When Beginning Exercise

The key to being successful and safe when beginning a physical activity routine is to build slowly from your current fitness level. Over-exercising can cause injury, which may lead to quitting. A steady rate of progress is the best approach.

To play it safe and reduce your risk of injury:

Begin your exercise program slowly with low-intensity exercises.

Warm up before exercising and cool down afterward.

Pay attention to your surroundings when exercising outdoors.

Drink water before, during, and after your workout session, even if you don’t feel thirsty. Play catch, kickball, basketball, or soccer.

Wear appropriate fitness clothes and shoes for your activity.

If you have specific health conditions, discuss your exercise and physical activity plan with your health care provider.

Fit for function infographic

Don’t forget to test your current fitness level for all 4 types of exercise—endurance, balance, flexibility, and strength. You may be in shape for running, but if you’re not stretching, you’re not getting the maximum benefit from your exercise. Write down your results so you can track your progress as you continue to exercise.

Make notes about how these test exercises feel. If the exercises were hard, do what’s comfortable and slowly build up. If they were easy, you know your level of fitness is higher. You can be more ambitious and challenge yourself.

As you get older, your reflexes might get slower, and you might not react as quickly as you could in the past. You might find that you have a shorter attention span, making it harder to do two things at once. Stiff joints or weak muscles also can make it harder to move quickly. Loss of feeling or tingling in your fingers and feet can make it difficult to steer or use the foot pedals. Parkinson’s disease or limitations following a stroke can make it no longer safe to drive.

Safe driving tips:
Leave more space between you and the car in front of you.
Start braking early when you need to stop.
Avoid heavy traffic areas or rush-hour driving when you can.
If you must drive on a fast-moving highway, drive in the right-hand lane. Traffic moves more slowly there, giving you more time to make safe driving decisions.

Medications Can Affect Driving
Do you take any medicines that make you feel drowsy, lightheaded, or less alert than usual? Do medicines you take have a warning about driving? Many medications have side effects that can make driving unsafe. Pay attention to how these drugs may affect your driving.
Read medicine labels carefully. Look for any warnings.
Make a list of all of your medicines, and talk with your doctor or pharmacist about how they can affect your driving.
Don’t drive if you feel lightheaded or drowsy.
Be a Safe Driver
Maybe you already know that driving at night, on the highway, or in bad weather is a problem for you. Some older drivers also have problems when yielding the right of way, turning (especially making left turns), changing lanes, passing, and using expressway ramps.

Have your driving skills checked by a driving rehabilitation specialist, occupational therapist, or other trained professional.
Take a defensive driving course. Some car insurance companies may lower your bill when you pass this type of class. Organizations like AARP, American Automobile Association (AAA), or your car insurance company can help you find a class near you.
When in doubt, don’t go out. Bad weather like rain, ice, or snow can make it hard for anyone to drive. Try to wait until the weather is better, or use buses, taxis, or other transportation services.
Avoid areas where driving can be a problem. For example, choose a route that avoids highways or other high-speed roadways. Or, find a way to go that requires few or no left turns.
Ask your doctor if any of your health problems or medications might make it unsafe for you to drive. Together, you can make a plan to help you keep driving and decide when it is no longer safe to drive.

For More Information About Driving
National Highway Traffic Safety Administration
888-327-4236 (toll-free)
800-424-9153 (TTY/toll-free)
[email protected]
www.nhtsa.gov/road-safety/older-drivers