Differences between Alzheimer's dementia and vascular dementia

Dementia is an umbrella term for a syndrome marked by deterioration in memory, other cognitive abilities and the ability to perform everyday activities. Although dementia mainly affects older people, it is not a normal part of aging. It is one of the major causes of disability and dependency among older people worldwide (WHO). There are several types of dementia. The most common is Alzheimer’s disease. Vascular dementia is another type of dementia.

While Alzheimer’s disease and vascular dementia are both types of dementia, their causes, symptoms and prognosis differ.

·         Vascular dementia is caused by an acute event such as stroke or transient ischemic attack (TIA), while the cause of Alzheimer’s disease still remains unknown.

·         Diabetes, hypertension, coronary artery disease, high cholesterol levels are risk factors for vascular dementia. Alzheimer’s disease is an irreversible, degenerative disease of the brain. Age is the best known risk factor for Alzheimer’s disease. Genetics may also have a role.

·         In vascular dementia, cognitive impairment occurs more suddenly and then remains stable for some time (step-like decline) and is related to an acute event like stroke or TIA. Whereas, in Alzheimer’s disease, memory problems are characteristically one of the first warning signs of cognitive loss and memory gradually declines over time.

·         Physical disability occurs at the same time as cognitive impairment in vascular dementia. In Alzheimer’s, cognitive impairment occurs first followed by physical disability.

·         A CT scan or MRI can detect an area of brain affected by stroke or TIA (infarcts). Alzheimer’s disease, on the other hand, is a diagnosis of exclusion. All other causes of dementia such as B12 deficiency (reversible) need to be ruled out before diagnosing a person with Alzheimer’s disease.

·         Prognosis of vascular dementia depends on the extent of damage in brain. Alzheimer’s disease progresses over the years. Survival after a diagnosis of Alzheimer’s disease is usually 8.4 years.

Dr KK Aggarwal

Padma Shri Awardee

Vice President CMAAO

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA