Vascular dementia: how it differs from Alzheimer’s, and how to avoid it

The five major dietary changes you can make now

‘Dementia’ and ‘Alzheimer’s’ are terms often used interchangeably, but that’s not very accurate. Alzheimer’s is the most common form of dementia, but the second most common, vascular dementia, is increasing ‘at an epidemic rate’.

Vascular dementia (VD) accounts for approximately 17% - 30% of all cases. AD and VD are similar, but different, and it is possible to have both together.

AD is characterised by the build-up of proteins in the brain that lead to the formation of amyloid plaques and tau tangles. Cognitive decline is gradual. The first symptoms are usually memory loss and difficulties with language and decision making. There may be balance issues later.

VD is caused by impaired blood flow to the brain, usually due to stroke or mini stroke (TIA), or some other vascular defect, such as a brain haemorrhage, when a blood vessel bleeds into the brain.

Atherosclerosis is also a significant factor because the accumulation of arterial plaques narrows blood vessels, impeding the flow of oxygen and nutrients to the brain.

VD usually progresses in a step-by-step manner, often with periods of stability, though it can be unpredictable. Symptoms depend on which part of the brain has been affected, and include slow thinking, confusion, and poor concentration and decision-making. There may also be sudden or frequent need to urinate, restlessness, and depression.

The mini strokes that cause vascular dementia are often so slight that they produce no obvious symptoms, other than perhaps some temporary confusion. However, every small stroke has a cumulative effect that contributes to cognitive dysfunction.

How to reduce your risk of vascular dementia? You focus on the various causes, and make a point of avoiding them. Below are five dietary strategies.

1. Normalise blood glucose

High levels of glucose damage blood vessels throughout the body, and in the brain they increase the risk of stroke and vascular dementia. They do this by creating inflammation, oxidative stress and substances called advanced glycation end products (AGEs).

Oxidative stress arises when the level of harmful free radicals in your body is greater than your antioxidant supply. These free radicals damage the lining of the blood vessels, called the endothelium. This damage causes inflammation, which in turn can cause plaque accumulation.

Excessive circulating glucose binds to proteins and fats in the blood and forms AGEs. AGEs also promote oxidative stress, and they greatly increase inflammation, causing the vessels to narrow, reducing blood flow and increasing the risk of developing blood clots.

A diet rich in carbohydrates, especially sugars, means that your blood sugar levels are always spiking. Therefore, your first step is to eliminate sugars and greatly reduce your intake of starchy carbs, as found in virtually all sweet and savoury snack foods, soft drinks and even cereal grains (yes, those ‘healthy’ wholegrains also raise blood sugar).

2. Lower your homocysteine