血管痴呆如何与阿尔茨海默氏症不同？
血管痴呆（VAD）是第二种最常见的痴呆症老年痴呆症并负责最多25％的痴呆症。Vad，以前称为multi infarct dementia,如阿尔茨海默氏症,是由大脑损伤引起的。的crucial difference is that in VaD the damage is due to strokes. Between 500,000 and 700,000 Americans have a stroke each year. Scientists believe that after
three months approximately 25% to 30% (125,000 people) will develop dementia.
Strokes can affect the cortical and sub-cortical areas of brain tissue, so symptoms tend to vary depending on the stroke location. However, because the brain and its nerve pathways are so complex, this is not always so. This also means that some mental abilities may not be as reduced as in Alzheimer's disease.
血管痴呆症的危险因素
Risk factors for VaD include people who are more susceptible to cardiovascular disease. For example, people withdiabetes，动脉硬化的历史（动脉硬化），high blood pressure, smokers, and people who have cardiac arrhythmias (abnormal electrical activity in the heart).
Age of Onset of Vascular Dementia
的age range for getting Alzheimer's is similar to VaD. Cardiovascular disease is tied to stroke. As a result, the rate of vascular dementia increases 200 fold from the age of 60 to 90 years of age. Because VaD does not exclude you getting Alzheimer's disease, there is a certain amount of overlap in these statistics.
Symptoms & Diagnosis of Vascular Dementia
Onset of VaD can be gradual or sudden depending on the cause. A number of mini strokes will lead to gradual symptoms, but a stroke will produce sudden symptoms immediately. Early signs and symptoms of vascular dementia are similar to those of Alzheimer's disease.
Although symptoms can be similar to Alzheimer's there
are often associated neurological problems where one-half of a patient's body is paralyzed or weakened (hemiplegia or paresis), Parkinson's type symptoms.
Doctors can often tell where the damage from the stroke/strokes occurred by symptoms and by neuroimaging tests (MRI or CT scans etc). Diagnosis will also be helped by evidence of cardiovascular disease.
血管痴呆的治疗
Treatment for VaD is to reduce the possibility of stroke so that no further brain damage can occur. This is done by :
First，减少生活方式变化的风险因素，如ahealthy diet, regular exercise, reducing obesity&
避免烟草。第二,
prescribing anticoagulants such as华法林（香豆素）。血管疾病严重病例的手术。
Prescribing antiplatlet agents such as asprin, ticlopidine (Ticlid),clopidogrel (Plavix),cilostazol (Pletal).
Prescribing medications that decrease viscosity (blood thickness) such as pentoxifylline (Trental).
Third,possible use of neuroprotective
agents.第四, as with Alzheimer's disease, using acetylcholinesterase
inhibitors such asdonepezil (Aricept),
rivastigmine (Exelon)
,galantamine (Reminyl)to improve cognition, function and behavior.
预后
用于血管痴呆
Preventative health measures and improved treatments for cardiovascular disease and strokes mean that, unlike Alzheimer's disease, the rates of vascular dementia are actually decreasing.
寻求卒中的紧急治疗是重要的，以防止脑损伤和痴呆症。
其他主要形式的如此称为皮质标准类型的VAD是;
*Binswanger disease
，慢性血管痴呆血管痴呆症，与慢性高血压相关。
*脑常染色体显性动脉瘤与皮质梗塞和白细胞病（Cadasil）影响染色体19的遗传疾病，是一种缓慢的痴呆，影响其中间40s的成年人。
*Cerebral amyloid angiopathy (CAA).
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