How Vascular Dementia and Stroke are Connected

February 26, 2024

While strokes are typically seen as affecting immediate health, they also raise substantial risks for future cognitive decline.  More specifically, strokes share a connection with vascular dementia, the 2nd most common form of dementia after Alzheimer’s disease.  To conclude Heart Awareness Month, let's explore a pivotal yet often overlooked aspect: the interplay between stroke and vascular dementia. 

What is Vascular Dementia? 

Although you may be familiar with Alzheimer’s disease, have you ever heard of vascular dementia?  Often undiagnosed (or misdiagnosed), vascular dementia is characterized by brain damage caused by impaired blood flow to the brain, often associated with conditions like stroke.1 

Vascular dementia is similar to other types of dementia in that people with vascular dementia have significant decline in their memory and thinking ability, which impacts their daily functioning.  However, vascular dementia is unique in that the cognitive impairment that occurs is attributed to blood flow- related changes in the brain.  When blood flow is reduced to certain parts of the brain, your brain cells don’t get the oxygen and nutrients that they need to function, leading to brain damage.  This damage causes changes in cognitive function, which can lead to dementia.  Vascular dementia differs from Alzheimer’s disease in that Alzheimer’s is associated with the buildup of amyloid plaques and neurofibrillary tangles in the brain, while vascular dementia is directly related to the aforementioned changes in blood flow.2

While vascular dementia symptoms are often similar to those of Alzheimer’s disease, symptoms can vary greatly, depending on which part of the brain is impacted.  Some early symptoms specifically seen with vascular dementia include reduction in thinking speed and problem solving.2  For example, someone with vascular dementia may have more difficulty following a set of instructions, such as when preparing a meal.  

Given that vascular dementia is caused by changes in blood flow, it may not be surprising to hear that it shares a relationship with heart health and stroke.  Cardiovascular disease increases the risk for both stroke and vascular dementia, and stroke itself can be a contributing factor to vascular dementia.1,3 

What is a Stroke? 

A stroke is an acute condition in which blood flow to part of the brain is blocked or a blood vessel in the brain ruptures, leading to brain damage.   Stroke symptoms often come on suddenly and include confusion, numbness on one side of the body, difficulty speaking, blurred vision, and dizziness. 

Visit this article here to learn how to spot stroke in someone else using the FAST method.  

There are different types of strokes: 

  • Ischemic strokes are the most common form and occur when blood flow is blocked by either a blood clot or built-up plaque clogging an artery.  
  • A hemorrhagic stroke occurs when a blood vessel bursts and blood leaks into the brain, causing brain damage due to high pressure build up.  
  • Transient ischemic attacks (TIAs) are often referred to as a “mini strokes” and are a temporary blockage of blood flow in a part of the brain.  A TIA can signal risk of a future stroke and can be accompanied by temporary symptoms similar to that of a stroke.4  

What’s the difference between a stroke and vascular dementia, then?  Strokes differ from vascular dementia in that they occur acutely (in the short-term), while vascular dementia develops gradually over time.  In fact, stroke and TIA’s are themselves major risk factors for vascular dementia!5 

The Connection:  Shared Risk Factors of Stroke and Dementia Risk  

Because vascular dementia is so closely related to cardiovascular health, the factors that increase your risk of heart disease and stroke also raise your vascular dementia risk.  These risk factors include: 

  • Diabetes,  
  • High blood pressure,  
    High cholesterol,  
  • Smoking,  
  • Obesity, and  
  • Aging.2  

For example, one study found up to a 5.6-fold increased risk of vascular dementia in those with high blood pressure!6  And as a reminder, stroke and TIA themselves are a risk factor for vascular dementia.5 

Many of these risk factors, such as high blood pressure, high cholesterol, and obesity may remind you of metabolic syndrome, which we highlighted in a previous article (click here).  In fact, some research links metabolic syndrome with vascular dementia.  In fact, studies have found metabolic syndrome elevates the risk of vascular dementia specifically.7,8

download e-guide

How Your Risk for Vascular Dementia Increases Post-Stroke 

Vascular cognitive impairment or vascular dementia typically occurs following a stroke due to brain damage.  During a stroke, blood flow to the brain is cut off, resulting in lesions (damaged areas of the brain) in the part of the brain lacking blood flow.  As mentioned, neurons die when they are unable to receive the oxygen and nutrients they need from the blood to survive, leading to cognitive impairment.2

For some people, the damage after a stroke continues to evolve into vascular dementia.  In fact, dementia has been observed in up to 40% of people one year after a stroke.9  Dementia can develop following a stroke immediately if it is a major stroke, or over a longer period of time following several small strokes or TIAs.10  Eventually, the damage from numerous TIAs in different parts of the brain can accumulate, leading to significant cognitive changes.  Think of it as a twig flowing down a stream.  If there’s just one or two rocks blocking the path, it can still flow by, but if lots of sticks and rocks build up and create a dam, the twig gets stuck. 

Nutrition for Reducing Stroke Risk and Vascular Dementia 

Diet can make a significant difference in reducing your risk of stroke and vascular dementia.  In particular, the Mediterranean and DASH diets are especially great for risk reduction, as they are part of an overall strategy to increase antioxidant, vegetable, fruit, and fiber intake.11  In fact, higher adherence to the Mediterranean diet has been associated with over a 30% risk reduction in stroke.12 

download e-guide

Here are some key nutrients to support vascular health and reduce risk of stroke: 

  • L-Theanine: Green tea is a great source of l-theanine, and consumption of three or more cups of tea per day was associated with a 21% lower risk of stroke compared to consuming less than one cup of tea.13  
  • Vitamin B12: Higher intake of vitamin B12, from foods like poultry, is associated with a significantly reduced risk of ischemic stroke, with up to a 27% reduced risk reported.14 
  • Vitamin E: An 8% reduced risk of ischemic stroke has been associated with vitamin E supplementation in an analysis of 18 different studies.15 
  • Magnesium: An analysis of several studies found that increasing magnesium intake by 100 mg per day was associated with an 8% reduction in the risk of stroke, specifically in reducing ischemic stroke.16 
  • Vitamin D: Low vitamin D levels have been associated with an increased risk of stroke in several studies, as well as poor prognosis following stroke.17 
  • Chocolate Can Also Reduce Your Risk: Consumption of chocolate is associated with a 19% reduced risk of stroke!11  Chocolate contains high amounts of flavonoid antioxidants, which are associated with improving endothelial function (blood flow), reducing blood pressure, and improving insulin resistance.18  See below to learn how you can get high quality dark chocolate this month! 

Learn about some other key nutrients to help manage overall heart health by visiting here.  

Our nutritional supplement RELEVATE makes it easy to get many of the nutrients mentioned above, plus others from the neuroprotective Mediterranean-MIND diets that are good for your heart and especially brain health.  Certain nutrients in RELEVATE are particularly associated with stroke reduction, including vitamin D3, B vitamins, green tea catechins, and magnesium.19-22  

Don’t miss-out on our February 2024 promotion:  This month, all orders using code HEARTMONTH receive a premier dark chocolate bar and reusable errand bag to give extra love to your health.  Order now by visiting here. 

While stroke is most commonly known for its cardiovascular and brain health aspects, vascular dementia is the silent, lesser known, but highly common form of dementia that shares many of the same risk factors with stroke.  So take action this month to show some love to your heart and brain – and to reduce your likelihood of stroke and vascular dementia too!  

References

    1. Bir SC, Khan MW, Javalkar V, Toledo EG, Kelley RE. Emerging Concepts in Vascular Dementia: A Review. J Stroke Cerebrovasc Dis. 2021;30(8):105864. doi:10.1016/j.jstrokecerebrovasdis.2021.105864
    2. Vascular Dementia. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/vascular-dementia/symptoms-causes/syc-20378793. Published 2021.
    3. Brain J, Greene L, Tang EYH, et al. Cardiovascular disease, associated risk factors, and risk of dementia: An umbrella review of meta-analyses. Front Epidemiol. 2023;3(February):1-14. doi:10.3389/fepid.2023.1095236
    4. Stroke. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/stroke/symptoms. Published 2023.
    5. Skoog I. Status of Risk Factors for Vascular Dementia. Neuroepidemiology. 1998;17(1):2-9. doi:10.1159/000026147
    6. Ninomiya T, Ohara T, Hirakawa Y, et al. Midlife and late-life blood pressure and dementia in japanese elderly: The hisayama study. Hypertension. 2011;58(1):22-28. doi:10.1161/HYPERTENSIONAHA.110.163055
    7. Raffaitin C, Gin H, Empana JP, et al. Metabolic syndrome and risk for incident alzheimer’s disease or vascular dementia. Diabetes Care. 2009;32(1):169-174. doi:10.2337/dc08-0272
    8. Solfrizzi V, Scafato E, Capurso C, et al. Metabolic syndrome and the risk of vascular dementia: the Italian Longitudinal Study on Ageing. J Neurol Neurosurg & Psychiatry. 2010;81(4):433 LP - 440. doi:10.1136/jnnp.2009.181743
    9. Filler J, Georgakis MK, Dichgans M. Risk factors for cognitive impairment and dementia after stroke: a systematic review and meta-analysis. Lancet Heal Longev. 2023;5(1):e31-e44. doi:10.1016/S2666-7568(23)00217-9
    10. Kalaria RN, Akinyemi R, Ihara M. Stroke injury, cognitive impairment and vascular dementia. Biochim Biophys Acta - Mol Basis Dis. 2016;1862(5):915-925. doi:10.1016/j.bbadis.2016.01.015
    11. Larsson SC. Dietary approaches for stroke prevention. Stroke. 2017;48(10):2905-2911. doi:10.1161/STROKEAHA.117.017383
    12. Kontogianni MD, Panagiotakos DB. Dietary patterns and stroke: A systematic review and re-meta-analysis. Maturitas. 2014;79(1):41-47. doi:10.1016/j.maturitas.2014.06.014
    13. Arab L, Liu W, Elashoff D. Green and black tea consumption and risk of stroke: A meta-analysis. Stroke. 2009;40(5):1786-1792. doi:10.1161/STROKEAHA.108.538470
    14. Yahn G, Abato J, Jadavji N. Role of vitamin B12 deficiency in ischemic stroke risk and outcome. Neural Regen Res. 2021;16(3):470-474. doi:10.4103/1673-5374.291381
    15. Loh HC, Lim R, Lee KW, et al. Effects of vitamin e on stroke: A systematic review with meta-analysis and trial sequential analysis. Stroke Vasc Neurol. 2021;6(1):109-120. doi:10.1136/svn-2020-000519
    16. Larsson SC, Orsini N, Wolk A. Dietary magnesium intake and risk of stroke: A meta-analysis of prospective studies. Am J Clin Nutr. 2012;95(2):362-366. doi:10.3945/ajcn.111.022376
    17. Fu J, Sun J, Zhang C. Vitamin D supplementation and risk of stroke: A meta-analysis of randomized controlled trials. Front Neurol. 2022;13. doi:10.3389/fneur.2022.970111
    18. Larsson SC. Coffee, tea, and cocoa and risk of stroke. Stroke. 2014;45(1):309-314. doi:10.1161/STROKEAHA.113.003131
    19. Hankey GJ. B vitamins for stroke prevention. Stroke Vasc Neurol. 2018;3(2):51-58. doi:10.1136/svn-2018-000156
    20. Marek K, Cichoń N, Saluk-Bijak J, Bijak M, Miller E. The Role of Vitamin D in Stroke Prevention and the Effects of Its Supplementation for Post-Stroke Rehabilitation: A Narrative Review. Nutrients. 2022;14(13). doi:10.3390/nu14132761
    21. Zhao B, Hu L, Dong Y, et al. The effect of magnesium intake on stroke incidence: A systematic review and meta-analysis with trial sequential analysis. Front Neurol. 2019;10(JUL). doi:10.3389/fneur.2019.00852
    22. Lee J, Kim Y. Association between green tea consumption and risk of stroke in middle-aged and older Korean men: The health Examinees (HEXA) study. Prev Nutr Food Sci. 2019;24(1):24-31. doi:10.3746/pnf.2019.24.1.24
    Back to Blog