Though it’s the second most common form of the disease, vascular dementia often gets overlooked. But recent research suggests that younger individuals in particular should learn about the risks factors to avoid developing vascular dementia.

How Vascular Dementia Differs from Other Dementias

Vascular dementia is not inherently neurodegenerative, which differentiates it from other dementias, such as Alzheimer’s disease.

Often the two co-occur, but when speaking of purely vascular driven cognitive decline, we often see it occurs in a stepwise manner. This highlights the potential for intervention and cessation of further decline.

Recent Research

A recent article by Lane and colleagues1 demonstrated an increased risk of vascular changes in the brain (i.e., smaller whole brain volume and higher white matter hyperintensity volume) when vascular risk factors were present earlier in life. 

Vascular risk factors in this case were those assessed by the Framingham Heart Study’s cardiovascular risk score. Cardiovascular risk scores typically involve your age, sex, blood pressure, usage of antihypertensive medication, history of diabetes, smoking status, and BMI. 

The researchers noticed that when comparing their risk scores at age 36, 53, and 69, the scores at age 36 were most predictive of the effects on the brain later in life.

Additional Findings

An interesting additional finding in this study was the lack of association between vascular risk and beta-amyloid status. 

Beta-amyloid protein has been associated with a number of neurodegenerative diseases, including Alzheimer’s Disease. 

This study only considered the presence or absence of beta-amyloid protein. Had it been measured more closely, there may have been an association with the vascular changes that was missed.

Early Intervention to Reduce Vascular Dementia Risk

This recent research reinforces what physicians often counsel patients: modifying vascular risk factors helps their brains. 

Diet, exercise, smoking, alcohol, sleep — these are all areas anyone can improve with a few small steps. Help patients focus on one change at a time to increase the chances of successful outcomes. 

Individuals are less likely to act on information until we face real changes in our health. Physicians may face challenges to motivate healthy behavior in individuals earlier in life to benefit their cognition. However, with this evidence, we can speak more confidently about how actions at a young age will impact brain health later.

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  1. Christopher A. Lane, MD, PhD; Josephine Barnes, PhD; Jennifer M. Nicholas, PhD; et al. “Associations Between Vascular Risk Across Adulthood and Brain Pathology in Late Life.” JAMA Neurology. 2020; 77(2): 175-183. doi:10.1001/jamaneurol.2019.3774

About the author

Reza Hosseini Ghomi, MD

Reza Hosseini Ghomi is a practicing neuropsychiatrist, focusing on neurodegenerative disorders. In addition to serving as Chief Medical Officer at BrainCheck, he is a partner at Avicenna Telepsychiatry, faculty member of the University of Washington department of neurology and UW Institute for Neuroengineering, and an affiliate at the eScience Institute. Dr. Ghomi received his MD from the University of Massachusetts Medical School, has post-graduate training in in psychiatry and neurology with a focus on memory and movement disorders, and holds an MSE in biomedical and electrical engineering from Johns Hopkins University.

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