Neurologist links heart health to dementia

People who are at increased risk of stroke, high blood pressure, and diabetes may also have a higher risk of developing dementia.  Dr. Stephen English, a vascular neurologist at the Mayo Clinic, believes vascular issues that affect the heart are a common but often overlooked cause of cognitive decline.

According to English, vascular dementia arises when the brain’s blood supply is disrupted, causing areas of the brain to receive insufficient oxygen and nutrients. 

“Vascular changes in the brain most often damage the axons — or cables — that connect different parts of the brain,” English explains. “Therefore, signals take longer to travel, so our brains are not working at full speed.”

Recognizing the signs

Vascular dementia, which accounts for roughly 25% of all dementia diagnoses, often manifests in subtle but progressive ways. Early symptoms may include difficulties with reasoning, planning, judgment, memory, and other cognitive functions. 

Unlike Alzheimer’s disease, which is primarily characterized by memory loss, vascular dementia typically results from cumulative damage to the brain’s blood vessels over time.

The same health conditions that increase the risk of heart disease and stroke — high blood pressure, high cholesterol, diabetes, smoking, obesity, and sleep apnea — are also implicated in the development of vascular dementia. 

“These are the modifiable risk factors that, if untreated, can cause wear and tear on the small blood vessels in the brain over time,” English said.

Events like strokes, brain hemorrhages, and chronic narrowing of blood vessels can all trigger or worsen vascular dementia. But English said that this trajectory isn’t inevitable.

Prevention and treatment

Many of the risk factors for vascular dementia are treatable. English said medications and lifestyle changes can lower blood pressure and cholesterol.

“We can treat sleep apnea with certain devices or surgeries, and we can help you stop smoking,” he said.

Treatment strategies focus on managing underlying health conditions and preventing further vascular damage. This might include prescriptions for blood pressure and cholesterol control, medications to prevent clotting, and interventions to regulate blood sugar in diabetics. When successful, these treatments can slow the progression of vascular dementia and help preserve quality of life.