Who gets vascular dementia?

Ageing

The biggest risk factor for vascular dementia is ageing. Once a person gets to 65, their risk of developing the condition roughly doubles every five years.

Vascular dementia under the age of 65 is uncommon and affects fewer than 8,000 people in the UK. Men are at slightly higher risk of developing vascular dementia than women.

Health conditions

There are lots of health problems that increase a person’s risk of developing vascular dementia. It’s important to keep these under control and get support from health professionals as early as possible. These include:

• cardiovascular conditions – people who have problems with their heart and blood circulation, such as high blood pressure or heart disease, have a higher risk of developing vascular dementia. This is because these conditions increase the chances of a clot or bleed happening in the blood vessels in the brain. A person who has had a stroke, or who has diabetes or heart disease, is around twice as likely to develop vascular dementia as someone who has not had these conditions
• cerebral amyloid angiopathy (CAA) – this is a type of vascular disease that damages the small arteries of the outer regions of the brain. This causes the blood vessels in that part of the brain to become leaky and prone to bleeding. Some people with CAA do not show any symptoms and others may only have mild problems with memory and thinking. However, many people with CAA develop vascular dementia, either from having a stroke or from more gradual disease
• sleep apnoea – this is a common health problem where a person stops breathing for a few seconds or minutes during sleep. This can cause small blood clots to form in the brain that go unnoticed. These greatly increase the risk of high blood pressure, stroke, heart attacks and vascular dementia. Because of this, sleep apnoea is a serious condition and anyone who may have it should contact their GP for advice.

Lifestyle factors

Vascular dementia is mostly caused by cardiovascular diseases (such as high blood pressure, stroke or heart problems). There is a lot of evidence that our lifestyle choices can affect our risk of developing cardiovascular diseases. Therefore, lifestyle choices that increase the risk of cardiovascular diseases also increase the risk of developing vascular dementia.

This section explains how lifestyle factors can increase a person’s risk of cardiovascular diseases.

• Physical inactivity – Physical inactivity can worsen the health of a person’s heart, lungs and blood circulation, and make it harder for them to control their blood sugar. It is closely linked to a higher risk of heart disease, stroke and type 2 diabetes.
• Smoking – Smoking damages a person’s heart, lungs and blood circulation, particularly the blood vessels in the brain. It causes harmful substances to build up in the brain that cause inflammation and prevent enough oxygen getting to nerve cells. The substances also increase a person’s risk of having a stroke.
• Unhealthy diet – An unhealthy diet can lead to high cholesterol, high blood pressure and weight gain. Ideally a person should eat lots of fruits and vegetables, wholegrain cereals, fish, low-fat dairy, beans and pulses, and not too much red or processed meats, like sausages, ham or bacon. Too much sugar and salt is linked with higher risk of cardiovascular diseases.
• Too much alcohol – Regularly drinking above the recommended amounts of alcohol can increase cholesterol and blood pressure and lead to weight gain. The recommended limit of alcohol per week is 14 units, ideally spread over at least three days rather than all at once.

The NHS Health Check is a mid-life check-up for those aged 40–74. At the check, a person’s blood pressure, cholesterol, and body mass index will be measured and results given, along with advice and support. This could reduce the risk of diabetes, heart or kidney disease, stroke and dementia.

Genes

Some people with a relative who has or had vascular dementia are concerned that they, or their family, are at greater risk. Most families affected by vascular dementia do not have single genes that pass on the disease. This means that, in general, there is a fairly low risk of inheriting vascular dementia.

However, there are some rarer types of vascular dementia that get passed down through families. One of these is CADASIL. This is a condition caused by a gene mutation which causes a person to have multiple smaller strokes from middle age onwards, eventually leading to vascular dementia.

Ethnicity

People from Black African, Black Caribbean or South Asian ethnic groups in the UK have a higher risk of diabetes and cardiovascular diseases than people from White ethnic groups, especially if they are overweight. This means they may also have a higher risk of vascular dementia.