Small Vessel Disease and Dementia
For me, dementia is the aspect of aging that I fear the most. My mind is what makes me who I am. As our population ages, this is a more pressing problem that has huge effects on individuals, families, and medical costs. Alzheimer’s disease is the most common form of dementia and the cause is still unclear. It causes about 2/3 of the cases. Vascular dementia may occur in another 20%. Vascular dementia is caused by small vessel disease. We discussed the treatment of small vessel disease in a previous post.
New scientific evidence shows that small vessel disease often coexists with Alzheimer’s disease. There are characteristics of small vessel disease that show up on an MRI of the brain. That means we can easily see the changes of small vessel disease on a test that is widely available. The more evidence of small vessel disease that was present, the more rapidly mental function declined and the brain got smaller. Several vascular risk factors have also emerged as risk factors for dementia and for Alzheimer’s disease. These include smoking, hypertension, diabetes, heart artery disease, obesity, lack of exercise and atrial fibrillation.
The Journal of the Alzheimer’s Association says it like this:
“The public should know what the science concludes: certain healthy behaviors known to be effective for diabetes, cardiovascular disease, and cancer are also good for brain health and for reducing the risk of cognitive decline…there is sufficiently strong evidence, from a population-based perspective, to conclude: (1) regular physical activity and management of cardiovascular risk factors (diabetes, obesity, smoking, and hypertension) have been shown to reduce the risk of cognitive decline and may reduce the risk of dementia; and (2) a healthy diet and lifelong learning/cognitive training may also reduce the risk of cognitive decline.”
Small vessel disease plays a prominent part in causing dementia. Small vessel disease and dementia share common risk factors. There is every reason to think that optimal medical therapy for cardiovascular disease and diabetes will help here too.