Symptoms of vascular dementia or dementia. Treatment methods for vascular dementia

Vascular dementia- so-called lacunar (partial, dysmnestic) type of dementia. This type of vascular dementia is determined by increasing disturbances in memory and selective reproduction, disturbances in chronological dating and time orientation (with relative preservation of allo- and autopsychic orientation), progressive difficulty and slowdown of all mental processes. It is accompanied by asthenia and a decrease in mental activity, difficulties in verbal communication and finding the right words, a decrease in the level of judgment and criticism with a certain preservation of the consciousness of one’s own insolvency and basic personal attitudes (the core of personality is preserved), a feeling of illness and helplessness, a reduced tearful mood, weakness and “ incontinence of affects." This type of dementia develops mainly due to atherosclerotic processes that manifest themselves between the ages of 50 and 65 years. It is most often formed gradually by intensifying psychoorganic disorders that arose in the early stages of the disease. In some patients, lacunar dementia syndrome occurs more acutely after cerebrovascular accidents (postapoplectic dementia). In such cases, dementia is preceded by a transient amnestic (Korsakoff-like) syndrome.

After acute disorders cerebral circulation(strokes, severe hypertensive crises, subarachnoid hemorrhages), and often after acute vascular psychoses, amnestic dementia syndrome with severe memory impairments such as fixation amnesia, gross disorientation and confabulations is possible. The picture of such amnestic dementia is in some cases reversible to some extent.

Another type of dementia occurring in vascular lesions of the brain, is called "pseudo-paralytic" due to the predominance in the clinical picture of carelessness, euphoria, talkativeness, disinhibition of drives, absence of a sense of illness, a sharp decrease in criticism and level of judgment - with a relatively lesser severity of memory and orientation disorders. The pseudoparalytic type of vascular dementia is usually found in patients under 65 years of age with severe hypertensive encephalopathy or with frontal localization of softening foci.

With severe hypertensive encephalopathy, sometimes there is a rare form of vascular dementia, with workload and stunnedness of patients, adynamia and reduced motor and speech activity, pronounced difficulties in fixating, perceiving and comprehending what is happening - this form of vascular dementia is described as "pseudotumorous". It requires especially careful differentiation from a brain tumor.

Dementia syndromes observed during the manifestation of the vascular process in old age also have certain clinical features. Due to some similarities between the clinical picture of these syndromes and senile dementia, they speak of senile-like type of vascular dementia. As with senile dementia, the initial stage of this type of vascular dementia is characterized by pronounced personality changes, a gloomy or displeased or irritable mood, a distrustful and hostile attitude towards others, individual ideas of attitude and detachment. The clinical picture of dementia is determined by deeper and more diffuse memory impairments (than with dysmnestic dementia), more pronounced disorientation, and elements of “shifting the situation into the past,” and a deeper decline in all types of mental activity.

An independent clinical variant of vascular dementia is Alzheimer's-like form with focal cortical disorders caused by a special localization of the vascular process, resulting from the addition of atherosclerotic changes in blood vessels cerebral cortex to the senile-atrophic process.

Psychotic syndromes. In direct causal dependence on the vascular process (its nature, course, rate and degree of progression) are acute and subacute psychoses of the exogenous and exogenous-organic type - “arteriosclerotic states of confusion.” These psychoses are distinguished by a number of common clinical properties: 1) syndromes of altered consciousness that arise within these psychoses (exogenous types of reactions), as a rule, are atypical, rudimentary and syndromic incomplete. Manifestations of acute vascular psychoses do not always correspond to the known syndromic types of delirium, amentia, twilight states and others, which has allowed many modern psychiatrists to generally qualify them as “states of confusion”; 2) acute psychotic disorders are quite often short-term, episodic. Their duration often does not exceed several hours. They occur predominantly at night, and during the day patients can be clearly conscious and do not exhibit psychotic disorders. Confusion at night, in particular, recurs frequently; 3) the course of acute vascular psychoses differs significantly from the course of symptomatic psychoses of other etiologies. 4) with a more protracted (subacute) course of vascular psychoses, in addition to syndromes of altered consciousness, there may be observed not accompanied by stupefaction, but also reversible syndromes, which were called transitional or intermediate. In vascular psychoses, almost all types of intermediate syndromes can occur (preceding or following syndromes of altered consciousness): neurotic and affective (asthenic, depressive, anxious-depressive), hallucinatory-paranoid (schizoform) into organic circle syndromes (adynamic, apathetic-abulic , euphoric, expansive-confabulatory, amnesic-Korsakoff-like).

Acute psychotic states are sometimes observed in the prodrome of stroke. Such post-stroke psychoses with confusion, disorientation, delirious agitation, anxiety, individual hallucinatory and delusional disorders usually turn into prolonged asthenodepressive states, but can also transform into various states dementia.

Acute psychotic episodes can occur during exacerbation of the vascular process against the background of various, even stabilized, mental changes (including dementia).

Of all the so-called endoform (protracted) vascular psychoses (as well as in atrophic processes), the most clinically justified is the identification of protracted vascular paranoid psychoses. They are most often observed in men in the form of paranoid delusions of jealousy. The plot of the delusion contains many naked sexual details. Typical storylines: cheating on a wife with young people, young family members, including a son or son-in-law. Delusions of jealousy are usually combined with ideas of damage (the wife feeds rivals better, gives them the patient’s things), a tearfully depressed mood with outbursts of irritability, anger, and aggressiveness.

There is also no doubt that chronic verbal hallucinosis is classified as vascular psychosis. Chronic vascular hallucinosis is defined by polyvocal true verbal hallucinosis. It flows in waves, often at the height of development it becomes scenic (scenes of public condemnation of the patient), usually intensifies in the evening and night hours and has a predominantly threatening content.

TREATMENT, PREVENTION AND ORGANIZATION OF CARE FOR PATIENTS. The main focus should be on the treatment of the underlying vascular disease and the hemodynamic disorders caused by it. Psychotropic drugs are prescribed for general indications, with maximum caution. Preferably drugs with moderate or even relatively weak neuroleptic activity are administered (aminazine, usually no more than 50-75 mg/day, thioridazine - Melleril). Small doses of haloperidol (for hallucinosis), tizercin (for anxiety-delusional states) are used. Particular caution should be taken regarding the combined use of psychotropic drugs. Such combinations are indicated only for short-term use to reduce anxiety and agitation (for example, in the form of a combination of 25-50 mg/day amitriptyline and 20-25 mg melleril or aminazine). A combination of antidepressants or neuroleptics with weak neuroleptic activity and small doses of tranquilizers (seduxen, tazepam) is advisable. In case of pronounced anxiety agitation and vital fear, intravenous drip administration of seduxen is effective. With vascular inferiority of the brain, there is an increased risk of developing side effects of psychotropic drugs - cardiovascular disorders and the early onset of neuroleptic symptoms. Amitriptyline, which is preferable for anxiety and depression due to its sedative effect, is prescribed in doses not exceeding 50-75 mg/day. The use of pyrazidol is recommended.

In the early stages of the development of vascular mental changes, general restoratives and thoughtful regulation of the regimen are indicated. In some cases, a course of treatment with aminalon (Gammalon), piracetam (Nootropil) or Cerebrolysin is useful.

It is also necessary, if possible, to eliminate all hazards that can negatively affect the course of vascular diseases.

Vascular dementia is a disorder of the brain. Vascular dementia sometimes it begins with a stroke, damage to a blood vessel. But there is also a gradual deterioration of the condition. Different kinds dementia occurring due to impaired blood flow in the head will be discussed in the article.

Vascular (vascular) dementia: what kind of disease is it?

Vascular dementia is called incorrect operation brain: lost memories, illogical thinking, lost orientation in space and time, meaningless speech. Signs do not appear in 1 day, but within six months. But there is vascular dementia with an acute onset, when a person loses his mind instantly, immediately after a stroke.

Subcortical vascular pathology is determined by the destruction of brain cells in deep parts of the brain. The cortex does not suffer at this time. More often such problems occur against the background of persistent elevated blood pressure. The type of dementia is formed depending on what functions are controlled by the affected area of the white matter.

Subcortical syndrome often manifests itself as tremor and Parkinson's unsteady gait. The pathology lasts up to 20 years, in people aged 45-70 years.

In some cases, mixed cortical and subcortical vascular dementia occurs. Determined based on clinical picture.

There is dementia, which begins from damage to neurons in the cortical areas of the brain.

Stages of development and life expectancy

In vascular dementia, there are three degrees of pathology: initial, moderate and severe. The degree of dementia is determined by the activity of the individual and his independence. Life expectancy largely depends on patient care. Moreover, death occurs not from the disease itself, but from an associated secondary infection, sepsis, double pneumonia, or bedsores.

The mild or initial stage of dementia is characterized by a clear limitation of professional skills and social life. Intelligence is not significantly impaired. The patient does not even notice any changes and remains completely independent.

The average degree is marked by a decrease in intelligence, memory and attention. Problems arise with independent living. There is a need for control by relatives. A person can still comb his hair if he is reminded how to do it. But he may accidentally injure himself when he is left alone in the kitchen.

In severe stages of the pathology, the patient cannot eat on his own, maintain basic hygiene, or get out of bed. At this time, they are violated motor functions, intelligence. A person stops recognizing his relatives and forgets himself.

What should relatives do?

In the first stage of dementia, relatives who notice that the person has become more inhibited and has lost interest in his favorite profession should definitely take him to the doctor. You should consult yourself about caring for the patient at different stages of the disease.

At mild degree dementia, relatives simply should not be offended by a person when his mood suddenly changes dramatically or his stinginess and pedantry worsen. That is, it is enough to show a little more love, forgiveness and understanding.

Important! Not all cases of vascular dementia progress to severe disease. Many patients recover successfully when blood circulation to the head improves. But in in rare cases If a large part of the brain is affected, the forecasts for the duration and quality of life are not at all optimistic.

If your mother or elderly father has all the signs of severe dementia, independence is lost without a trace. The patient may lose control of natural bowel movements. It is necessary to provide the person with constant supervision. Diapers for adults and a hygienic diaper in bed help solve the most intimate problems.

An elderly person needs to be fed, changed, bathed, and combed. He himself is no longer capable of anything, no matter how sad it is. If all relatives work and there is no financial opportunity to hire a nurse, the patient should be placed in medical institution where he will be provided professional care, timely nutrition, supervision and hygiene.

Causes of vascular dementia

Doctors know quite a lot of reasons why vascular dementia appears:

profuse bleeding in the brain;
slight hemorrhage;
cardiovascular problems;
persistent blood clots in the capillaries;
immune pathologies, with damage to the walls of blood vessels.

Interesting! In principle, any disease of the head of vascular origin can give rise to the development of dementia.

Some factors contribute to the development of pathology. Dementia is much more common in older people over 60 and 70 years of age than in younger people.

The appearance of dementia is promoted by:

heart rhythm failure;
heart failure;
heart disease;
persistent blood pressure, above and below normal;
diabetes;
hereditary problems with blood vessels;
unhealthy lifestyle, smoking, bad dream, abuse of strong alcohol;
obesity;
sedentary type of work;
inflammatory processes;
frequent stress;
hormone cortisol.

Symptoms of vascular dementia

The first symptoms of vascular dementia are marked by an unexpected deterioration of individual character traits. A generous person suddenly becomes thrifty to the point of stinginess, turns into a real Plyushkin. Well-mannered man becomes rude, aggressive, harmful.

Over time, thinking ability slows down, forgetfulness, trembling limbs, and a slurred tongue appear.

Insanity resulting from injury different shares brain, is marked by a variety of symptoms:

cell death in part of the midbrain leads to confusion. IN further patient becomes withdrawn, indifferent to everything, his appearance, friends and family;
neuronal atrophy in temporal lobes, characterized by loss of memories, up to complete amnesia. But first, recent memories fade;
withering of cells in the frontal areas leads to apathy, idleness, and loss of desire to learn new things. Illogical actions begin, constant repetition is already famous phrase and movements;
the death of subcortical neurons is marked by dissipation of attention, inability to concentrate on one thing. It is difficult for a person to analyze, separate the important from the unnecessary, and achieve success in his endeavors;
if the pathology does not go away for a long time, cognitive degradation begins. In people with severe pathology, urination and bowel movements are not controlled;
the mood is unstable, the emotional mood ends in depression. Self-confidence and an optimistic outlook on life are lost.

Diagnosis of the disease

Early diagnosis of vascular dementia ensures good chance for restoration. IN difficult cases timely diagnosis, correct treatment stops the progression of the disease.

Today neurologists use modern methods research:

lifestyle and chronic problems with health;
a test is performed to detect cognitive degradation;
blood pressure is controlled;
the presence of sugar in the blood is determined;
The percentage of lipids and cholesterol is determined.

The latest equipment is able to determine the exact location and extent of damage to neurons:

radio examination;
CT scan;
Magnetic resonance imaging;
electroencephalogram;
ultrasound examination of the head;
Dopplerography of blood vessels to determine the quality of blood circulation;
x-ray of blood vessels;
echocardiography.

The diagnosis is clarified after familiarization with the results of examinations, reflection and comparison of all known data.

Treatment of vascular dementia

Treatment of vascular dementia involves getting rid of the vascular disease that caused the onset of the pathology. It is necessary to use medications that prevent the formation of blood clots, tablets that widen the lumens in blood vessels, and microcirculation correctors.

Are being treated concomitant diseases leading to poor circulation. Exercises are used to restore cognitive functions, taking a complex of vitamins, drugs that saturate useful elements neurons.

Certain medications cause delirium in the patient and epileptic seizures. This occurs due to excessive expansion of blood vessels. If a person is prone to seizures, nootropics are prescribed only in medium and small dosages (picamilon, pantogam). With this dementia, sensitivity to certain drugs is increased, their amount should be minimal.

Traditional methods

How to treat blood vessels and dementia that began after a violation of proper blood circulation is decided by a neurologist. About your intention to use traditional methods, you should inform your doctor.

Completely abandon traditional pills and switch to herbal infusions, it is forbidden. To live longer, you need to find the optimal combination of products traditional medicine and traditional.

During the manifestation of the first signs of dementia, mild memory loss, a few drops of alcohol tinctures are recommended:

Eleutherococcus;
ginseng root;
sprigs of Chinese lemongrass.

These tinctures are sold in all pharmacies, they strengthen memory, concentrate thoughts, restore interest in learning, but slightly increase blood pressure, this must be taken into account.

Dementia in older people can be successfully treated at home with decoctions and tinctures.

A glass of blueberry juice improves memory when dementia began after atherosclerotic neuronal damage.

Elecampane rhizome is successfully used for dementia that occurs when a person has epilepsy. In half a liter of alcohol, diluted by half, 50 grams of rhizome are kept for 30 days. Drink before meals, one tablespoon at a time, shaking first.

Nutrition, diet

To cure dementia that has developed due to diseased blood vessels and circulatory problems in the head, it is necessary to improve nutrition.

For example, if a patient has a stroke after a jump high pressure blood, you should give up strong coffee forever. It is necessary to exclude from the diet foods that contribute to persistent hypertension.

If the blood flow is impaired by cholesterol plaques, you need to switch to food from Lenten dishes. When a patient is over 60, he needs to eat more fruits and vegetables, baked, stewed, boiled and fresh.

A diet strictly observed by a person should not contain fried, fatty foods. Sweet creams, cakes, and pastries are best left in the past.

Olive oil, flaxseeds V cereal porridge, sea fish, vitamins should be chosen by people who want to overcome dementia.

Exercises

Symptoms and treatment are more successful if a person does feasible exercises. Light exercises can be done while lying in bed, then sitting. When the vessels are restored more, it is necessary to do simple and not strength exercises, already standing. After about a year, new blood vessels sprout in the body. And they become stronger if a person strives to take walks fresh air, ventilates the room.

Brain cells also need exercise to full recovery. Solving riddles, solving crosswords, studying mathematics, physics, and chemistry with children and grandchildren is good for development new network neurons.

The Internet makes it easier for a person to actively communicate. It’s easy to talk on Skype here (to train your language after a stroke), to study foreign languages, even earn money without leaving home. Mental stress normalize blood circulation and restore brain function.

Prevention

To avoid becoming a patient suffering from vascular dementia, you should take care of the health of your blood vessels. Blood vessels strengthened by contrasting douches, exercises in the fresh air.

Massage, outdoor games, football, tennis, gymnastics, swimming, are useful for of cardio-vascular system. Race walking along the paths of a pine grove, on the shores of the sea, lake, river, very well strengthens blood vessels, muscles, and immunity.

Those who do not want to waste many years recovering from a stroke should not develop bad habits. Smoking, gluttony, and drinking destroy healthy blood vessels.

Active, positive attitude, a keen interest in art, new technologies, literature, theater premieres, makes a person healthy and young even in old age. Active longevity is in fashion today! Stay fashionable and healthy, live longer!

– mental disorder, characterized by a persistent decline in intelligence and impairments social adaptation. Occurs due to brain damage due to vascular pathology: hypertension, atherosclerosis, strokes, etc. Accompanied by a violation cognitive activity, memory disorders, deterioration in thinking, decreased ability to plan and control one’s actions. The diagnosis is made on the basis of anamnesis, clinical picture and additional research data. Treatment is etiopathogenetic and symptomatic pharmacotherapy, prevention of the progression of vascular disorders.

ICD-10

F01

General information

Vascular dementia is a serious medical and social problem. Average duration life is increasing, more and more elderly patients suffering from vascular diseases brain, the prevalence of vascular dementia is increasing. Patients with such dementia need not only treatment, but also special care - and this is also a problem that relatives usually have to solve. Vascular dementia reduces the life expectancy of patients and worsens its quality. Treatment of this pathology is carried out by specialists in the field of neurology and psychiatry.

Causes of vascular dementia

The immediate cause of the development of vascular dementia is the death of brain cells due to insufficient blood circulation or complete cessation of blood flow to some part of the brain tissue. Impaired blood supply may result from an acute catastrophe or chronic dysfunction. Acute catastrophe - ischemic or hemorrhagic stroke. Ischemic stroke, which causes vascular dementia, can develop against the background of atherosclerosis, certain heart diseases and cerebral vascular abnormalities. The cause of ischemic stroke is a blockage cerebral arteries thrombus or embolus.

To identify and assess the severity of diseases that provoke the development of vascular dementia, patients are referred for consultation to a neurologist, cardiologist, psychiatrist and other specialists. Monitor blood pressure. Patients with vascular dementia are prescribed MRI of the brain, CT scan of the brain, ultrasound of cerebral vessels, REG, EEG and other studies. Differential diagnosis carried out with dementia in Alzheimer's disease. Vascular dementia is supported by the presence of neurological disorders and mild memory impairment. When making a diagnosis, the possibility of developing mixed dementia, caused by both vascular pathology, and Alzheimer's disease.

Treatment of vascular dementia

The treatment plan is drawn up individually, taking into account the nature and characteristics of the course of the underlying pathology. The goal of therapy is to maximize possible recovery and constant maintenance of adequate blood flow in the brain, as well as compensation for disorders resulting from vascular dementia. An appropriate diet is prescribed and measures are taken to stabilize blood pressure. To correct cognitive impairment, nootropics, antioxidants, vasoactive drugs, neuropeptides, MAO inhibitors, neurotrophic agents, membrane stabilizing drugs, etc.

For vascular dementia complicated depressive disorder, use serotonin reuptake inhibitors, and are prescribed for anxiety and insomnia sedatives, for psychotic disorders, antipsychotics are used. Patients with vascular dementia may experience paradoxical reactions to medicines, therefore, during the treatment process, constant monitoring of somatic and mental state the patient and promptly replace the drug if there is no effect or the patient’s condition worsens. Medicines that negatively affect cognitive function are prescribed only when necessary, in small doses and short courses.

Drug therapy for vascular dementia is supplemented non-drug methods treatment and qualified care. If possible, the patient is referred to group therapy and/or occupational therapy to support social and motor skills. A patient with vascular dementia is provided with comfortable and safe living conditions: allocate a separate room with comfortable furniture, good lighting And sufficient quantity irritants (TV, radio), if necessary, take away the keys, exclude the possibility of turning on the gas oven independently. The prognosis for vascular dementia is determined by the severity of changes in the brain and the characteristics of the course of the underlying disease.

ICD-10 code

Vascular dementia (dementia) is a disease acquired during life, which most often develops in older people after 60 years of age.

As evidenced medical statistics, this disease more often affects men. There are cases of diagnosing pathology in young people. Progressive vascular dementia is the most common of all neurological diseases after .

This is one of the types of dementia, which is distinguished by vascular origin, that is, defeat occurs individual areas in the area of cerebral vessels and.

At the same time, insufficiency of the most important cognitive (cognitive) functions of the brain, which provide the ability to cognition and study of the surrounding world, perceive it as a single whole, and apply this knowledge in the process of life, intensively develops.

Gradually, thinking abilities and the ability to accept right decisions, digestibility deteriorates new information, the decline in intelligence progresses, control over emotions and actions weakens. Accordingly, it becomes impossible to analyze one’s health status and understand the presence of a disease.

Dementia of this type leads not only to the loss of work skills, but also to the gradual loss of the ability to care for oneself.

Mechanism of occurrence and development of the disease

Acute cerebrovascular accidents (,) or chronic failure blood supply to the brain are mechanisms of the pathogenesis of vascular dementia. There have been cases of development senile dementia if both reasons are present. Signs of the disease appear faster and are more pronounced.

Both cerebral circulation disorders and insufficiency lead to the fact that in certain areas of the brain cells stop receiving the nutrients and oxygen necessary for life and die.

With a heart attack of a small number of neurons, there are no manifestations of the disease, since living brain cells compensate for their functions. When a large area of the brain is damaged, symptoms of vascular dementia appear. But in cases of even slight damage to the area responsible for cognitive functions, dementia begins to develop and progress.

Main causative factors of the disorder

Medicine calls enough a large number of Reasons why vascular dementia may develop:

acute heart failure;
chronic cerebral ischemia (blockage small vessels);
vasculitis ( autoimmune diseases, in which the walls of blood vessels are affected).

There are a number of factors contributing to the development of the disease:

old age (60 years and older);
heart disease (with atrial fibrillation, ischemic disease, heart defects);
arterial hypertension or hypotension;
diabetes;
heredity;
bad habits;
sedentary lifestyle.

The increasing prevalence of arterial hypertension has made it a leader among all risk factors for the emergence and further development of this type of dementia.

Stages of dementia development

The course and development of vascular dementia is conventionally divided into three stages, which differ in symptoms and their severity:

Easy stage senile dementia is characterized by blurred manifestations of the disease. The patient, as a rule, does not notice them. Sometimes relatives and friends pay attention to changes in his life and behavior. At the same time it becomes noticeable slight decrease intelligence, a dramatic change in mood and emotions may occur. But the patient controls them and controls his actions. He copes with everyday issues independently and does not need outside help.
Moderate Vascular dementia is more pronounced and noticeable manifestations. The patient’s life is complicated by the inability to navigate in space; a personality disorder occurs with behavioral deviations. Signs of aggression appear. Skills and abilities in handling household appliances, devices, communications equipment and the simplest objects are lost. The patient needs outside help.
Coping with severe Dementia is only possible with the constant help of loved ones. At this stage, a deep breakdown of the psyche is expressed. Difficulties arise with eating, control over the processes of urination and bowel movements is lost. The patient is unable to perform simple hygiene procedures, he does not perceive his family and friends. The patient is completely dependent on others.

However, it cannot be said that all cases of vascular dementia develop before serious condition, although most forecasts are not encouraging - life expectancy and quality of life are not encouraging.

Symptoms at each stage

The first symptoms of vascular dementia begin with a noticeable expression of conservatism in the patient’s views, judgments and actions. At the same time, some character traits are aggravated. Excessive distrust or obstinacy, frugality and other changes appear.

Mental activity and memory gradually deteriorate. This is soon accompanied by unclear speech.

In addition, vascular dementia, which appears as a result of damage to certain areas of the brain, is manifested by a variety of symptoms:

Cell death in midbrain characterized by confusion and obscurity. At further development When suffering from illness, the patient withdraws into himself, loses interest in what is happening around him, in communicating with loved ones and relatives. He doesn't care about his appearance, and he stops following him.
Cell damage hippocampus(parts of the brain in the temple area), responsible for long-term storage of information, leads to amnesia. The patient cannot remember events that happened today or recently, although he can reproduce those that happened a long time ago.
V frontal lobes brain manifests itself in indifference, apathy, laziness, loss of interest in communication. There may be illogical behavior, which is expressed in the monotonous repetition of a phrase or word that has long been known to the patient.
At in the subcortical regions There is significant absent-mindedness of the patient's attention, which makes it impossible to concentrate on one task or subject. He cannot highlight the main thing and determine the secondary in the information received, or analyze it. All his endeavors are unsuccessful.

In addition to cognitive impairment, almost all patients have problems with urination, which often becomes spontaneous.
Emotional disturbances and instability during the course of the disease often lead to depressive states, loss of optimism and self-confidence.

Methods for diagnosing pathology

Timely diagnosis of vascular dementia in the initial stages gives a chance for recovery, more difficult cases, a correctly diagnosed and selected treatment will help stop the development of the disease. For this purpose, modern neurologists use the following research:

studying the history of life and illness;
carrying out psychological tests to identify cognitive impairment;
blood pressure control;
clinical blood test;
determination of blood sugar;
determination of lipid content in the blood and the level of cholesterol concentration in it.

Modern instrumental diagnostic methods that determine the degree of damage to the blood vessels of the brain and its tissues:

radioisotope research of the brain;
(determination of blood flow);
angiography (x-ray examination of blood vessels);
echocardiography.

Studying the research results, their analysis and comparison allows us to establish an accurate diagnosis.

Principles of treatment of vascular dementia

Because causal factors Since there are many developments of vascular dementia, its treatment is prescribed in accordance with their prevalence and taking into account the mechanism of development of the disease. Therefore, treatment for each patient is selected individually and adjusted in the process.

Drug treatment is aimed primarily at reducing the risk of occurrence or re-development stroke and other cardiovascular diseases.

This is provided by antiplatelet (antiplatelet) drugs that prevent the possibility of blood clots forming in blood vessels (Aspirin, Trental, Clopidogrel, Ticlopidine). An anticoagulant is also used indirect action Warfarin.

Such drugs are prescribed and used with extreme caution, as they have a number of contraindications.

To improve cognitive functions and slow down the development of their disorders, Pentoxifylline and anticholisterase drugs are used - Donepezil (Aricept), Galantamine (Reminyl). At treatment of mild And medium degree for dementia, Memantine is used, which prevents the development of brain dysfunction.

Currently, drugs that lower blood cholesterol levels - statins (Simvastatin, Atorvastatin and others) are becoming popular in the treatment of dementia.

Do not lose their relevance (, Pramiracetam, Cerebrolysin), which have a complex effect on brain cells brain and improving its functions.

For patients with hypertension, blood pressure is monitored and medications are prescribed to reduce it. Thus, eliminating one of the serious factors in the development of the disease.

When mental problems antidepressants are prescribed and relieved. Treatment at home is considered the most favorable, especially for mild and moderate stages of the disease.

Prognosis for recovery and life expectancy

Complete recovery was recorded in approximately 15% of patients in the initial stages of the disease. The rest most often die within 4-5 years of detection and treatment of senile dementia or earlier. The life expectancy of each patient with vascular dementia is different and it is difficult to predict.

In the case of a gradual and slow course of the disease and maintaining skills Everyday life, you can live 10 - 20 years. In severe cases - no more than 10 years. But quality care and daily care from loved ones and relatives can prolong the patient’s life.

Can also lead to death accompanying illnesses, such as pneumonia, general purulent infection.

The general condition of the patient, the rate of progression of the pathology, living conditions and quality of care are decisive in their life expectancy.

Forewarned and forearmed!

Healthy and healthy people can protect older people from vascular dementia. active image life, complete abandonment of bad habits, moderate loads, optimism, development of intelligence, .

Treatment of diseases that are risk factors for vascular dementia and preventing their exacerbation is also an important preventive measure.

It is necessary to control blood pressure, blood sugar and cholesterol levels in order to prevent damage to the blood vessels of the brain and the development of senile dementia.

It is worth paying attention to nutrition. It should be varied and balanced, with a sufficient amount of vegetables and fruits, products containing essential vitamins and microelements.

You should not abuse antidepressants and sleeping pills. Lots of communication, travel and new experiences will prevent the onset of dementia.

Vascular dementia is a dementia that is acquired. The disease develops as a result of damage vascular network brain. A characteristic symptom is developing memory impairment and decreased intellectual abilities sick. Older people are most susceptible to the disease due to age-related changes in the body, in this case they speak of senile dementia.

Dementia develops due to vascular changes in the brain. The most likely causes of the disease:

suffered a stroke;
blood clot formation;
atherosclerosis;
ischemic brain disease;
heart defects;
infectious diseases, vascular neurosyphilis.

Stroke is the most likely cause of the disease in older people (after 60 years). A stroke occurs as a result of the formation of blood clots that block blood vessels, or due to atherosclerosis. Dementia in this case appears due to oxygen starvation and lack of cell nutrition, which causes the death of some groups of cells.

Cerebral ischemia provokes a decrease in the tone of small vessels, as a result of which the lumen between them narrows significantly, which causes the development of vascular dementia. Ischemia is often observed as a complication of decompensated diabetes mellitus in older age.

The risk group also includes people over 65 years of age, whose diet lacks folic acid. In this case, the likelihood of developing dementia increases significantly.

Due to heart defects and diseases of the cardiovascular system, the blood supply to certain areas of the brain is disrupted. This causes oxygen starvation, which results in a violation neural connection and death of neural tissue in the brain.

So, speaking of dementia vascular nature at an older age, a whole group of factors should be taken into account - atherosclerosis, stroke, chronic diseases and heart defects. The totality of these pathological conditions and processes in the body provokes the development of dementia.

Young people have dementia vascular type may result from infection entering the brain. The disease often occurs in patients with neurosyphilis.

At-risk groups

The disease often develops against the background of a stroke. A recurrent stroke significantly increases the risk of dementia, but this depends on the amount of tissue affected and the area of the brain affected by the stroke.

To impair intellectual abilities, damage to a small number of neurons is sufficient. Any pathology that affects the cortex and subcortical region of the brain can cause the development of vascular dementia.

If other areas of the brain are affected, mental abilities are not affected, but loss of motor coordination may develop.

Dementia can result from impaired cerebral circulation, oxygen starvation and lack of nutrition to brain cells. All this is a consequence of ischemia and the presence of diseases of the cardiovascular system.

Patients with diabetes mellitus are also at risk. At constant elevated level sugar, the walls of blood vessels become thinner. This leads to disruption of the nutrition of brain cells.

Also, vascular dementia may appear due to constantly elevated concentrations of lipids in the blood.

Senile dementia

The body ages, everything slows down metabolic processes, affecting, among other things, the brain. Age-related changes neuronal cells of the brain develop according to various reasons. Even an infectious disease can become the impetus for the development of pathology.

Senile or senile dementia is a disease of older people. Its development can be provoked the following pathologies and diseases:

obesity;
kidney dysfunction;
pathologies of the adrenal glands;
immunodeficiency;
malignant neoplasms.

The disease causes cognitive changes. This diagnosis is characterized by changes in thinking, memory impairment, problems with speech and concentration. The disease progresses very quickly, and literally after a couple of months the patient loses many skills and abilities, including professional knowledge.

Popularly, progressive age-related dementia is called senile insanity.

Symptoms of dementia

In vascular dementia, symptoms and signs largely depend on the extent of damage to neuronal cells and the location of the damage. Thus, the following symptoms are characteristic of midbrain damage:

confusion (possible hallucinations);
constant drowsiness;
speech problems.

When the limbic system of the brain is damaged, the patient's memory sharply deteriorates. Patients often cannot remember what they ate for breakfast, but they remember events from many years ago clearly and clearly.

When neuronal cells in the frontal lobes of the brain die, the patient's consciousness is impaired. This is clearly evidenced inappropriate behavior patient - the patient can constantly repeat one word or phrase, perform one action, while absolutely not reacting to external stimuli.

Subcortical vascular dementia causes intellectual impairments - loss of the ability to analyze, as well as mathematical abilities, impaired attention, inability to concentrate, loss of professional skills.

Developing dementia is characterized by neurological symptoms - gait disturbances, problems with urination (incontinence), and sudden seizures similar to epileptic ones are often observed.

The disease is accompanied by visible emotional and personality changes. TO emotional disturbances should include persistent depression and apathy, characteristic of patients with dementia. There is also emotional instability, manifested by tearfulness, sentimentality and fixation on something.

Personality changes include the sudden manifestation of traits that were not previously observed in the patient - stinginess, deterioration in behavior, indifference to the problems of others and non-acceptance of outside opinions. The development of dementia makes a person suspicious, greedy and pathologically lazy.

The human brain is distinguished by its ability to compensate for load. Thus, if certain areas of the brain are damaged, their function can be performed by neighboring areas. In dementia, this is manifested by periodic weakening of symptoms. At this time, cognitive functions are partially restored and the patient seems to be on the mend, but this condition does not last long.

Development of the disease

Depending on the location of the cell damage, dementia may have an acute onset. This form develops very rapidly, visible personal and emotional changes become noticeable very quickly. This rapid course of the disease is due to a stroke. After the first stroke, dementia develops within three months, but if the hemorrhage is repeated, mental impairment becomes noticeable a month after the stroke.

When the cerebral cortex is damaged, a multi-infarct form of dementia appears. The disease develops over four to six months and is accompanied by symptoms of ischemia.

As a rule, the disease is not limited to one area of the brain. If left untreated, dementia affects neighboring areas, resulting in mixed symptoms.

Clinical picture

Dementia develops only in the presence of a provoking factor. To develop dementia, you must have a predisposition to vascular diseases. Diseases precede ischemic lesions brain This may be asymptomatic.

The development of dementia occurs in several stages. An acute onset of pathology is often noted.

On initial stage mild cognitive impairment develops. This stage is characterized by the following symptoms:

sleep disorders;
neurosis;
attention disorder;
sudden change of mood.

With the beginning of the appearance characteristic symptoms personality changes or decreased intellectual abilities are diagnosed. This clinical stage dementia. As a rule, the patient exhibits pronounced memory impairment, aggressiveness or lack of response to stimuli. Patients are subject to sudden mood swings. Disorientation is often observed even in familiar surroundings. When communicating, the patient feels insecure. He may forget some words or lose the thread of the conversation.

The progression of dementia leads to a severe stage, at which the patient requires constant monitoring by doctors or close relatives, since self-care is difficult or no longer possible.

This stage is characterized by the following symptoms:

loss of orientation;
memory losses;
problems with movement coordination;
aggressiveness.

Patients often have difficulty moving. Many are bedridden due to the inability to stand up on their own.

The last stage of a progressive disease is death. However, dementia itself is not fatal. The death is a consequence of a stroke, which occurs due to disruption of blood supply and nutrition to parts of the brain.

Establishing diagnosis

Diagnosis of the disease is based on the manifestation clinical symptoms for a specific patient.

For precise definition Localization of brain cell damage requires examination. Magnetic resonance imaging is often prescribed for this purpose and computer examination brain

Diagnostic methods are necessary to determine the cause of brain tissue damage - heart attacks, cysts, cell damage. It is also necessary to conduct an electroencephalography of the brain.

Treatment of pathology

When talking about treating dementia, it should be understood that brain damage cannot be restored. Treatment is aimed at minimizing the manifestations of the disease and restoring intellectual abilities.

Drug therapy and treatment are necessary in order to minimize the patient’s risk of stroke. This helps stop the progression of dementia.

Treatment includes:

arterial hypertension therapy;
treatment of atherosclerosis;
getting rid of bad habits and excess weight;
treatment of concomitant diseases;
taking anticoagulants to prevent stroke;
weakening of cognitive disorders.

Normalization of blood pressure should be carried out in such a way as to prevent its decrease and deterioration of blood circulation in the brain. Normalization of brain nutrition is priority task drug treatment.

Therapy for atherosclerosis includes taking statin drugs, as well as following the necessary diet.

It is extremely important to stop smoking and drinking alcohol. These bad habits negatively affect the condition of blood vessels and blood supply to the brain and can cause rapid progression of the disease. An obese patient's weight is adjusted through diet.

Since dementia in older age can develop against the background of chronic diseases, for example, diabetes mellitus, an important part of therapy is the treatment of concomitant diseases.

To avoid the development of dementia and limiting the patient’s ability to self-care, it is necessary to carry out appropriate therapy for neurological diseases. The drug Ginkgo Biloba is often prescribed to help treat cognitive disorders. As a rule, patients are prescribed various nootropic drugs and their analogues. These medications help improve mental abilities, affecting metabolic processes nerve cells. Patients can be prescribed the drug Piracetam - the most effective drug in the treatment of dementia.

To improve the condition of blood vessels, a drug with an antioxidant effect is indicated. On early stage illness, it is important to take the drug to improve blood supply to the brain.

Forecast

For vascular dementia, treatment will not completely eliminate the disease. Brain damage due to stroke is irreversible. Drug therapy can delay the development of dementia. At timely treatment the patient takes care of himself independently and does not experience difficulties with socialization.

According to statistics, dementia leads to death five years after the stroke that triggered the development of dementia. Dementia itself is not fatal disease, death occurs due to a stroke or cerebral infarction. It is not uncommon for patients to die due to accidents. As a rule, this occurs due to the fact that the patient is not aware of his own actions and cannot react to dangers.

The progression of vascular dementia leads to the fact that the patient is unable to care for himself; care for a bedridden patient is carried out by relatives or medical personnel at the relevant institution.

Drug treatment can delay the onset of permanent dementia, but cannot cure it. Preventive measures There are no methods that would allow one to avoid dementia.