Understanding Vascular Dementia
Vascular dementia impacts cognitive functions like memory, reasoning, and judgment due to reduced blood supply to the brain, which damages brain tissue. This condition differs from Alzheimer’s disease, where cognitive dysfunction is caused by amyloid beta plaques blocking neuron connectivity. In vascular dementia, obstructions in blood vessels lead to brain cell damage.
A study by University of Oxford scientists, published in the journal Circulation Research, marks a significant step in the fight against dementia. Dr. Praveen Gupta, principal director of neurology at Fortis Gurgaon, told TOI that these findings could be crucial in developing treatments for dementia. However, he emphasized the need for larger studies to confirm sildenafil’s effectiveness before it could be adopted as a standard treatment.
High Prevalence in India
In India, the burden of vascular cognitive impairment and dementia is substantial, with about 5.3 million dementia patients, 40% of whom suffer from vascular dementia. The findings from the Oxford study are particularly relevant in this context, offering hope for a new treatment avenue.
Risk Factors
Dr. Manjari Tripathi, head of the neurology department at AIIMS, highlighted several risk factors for vascular dementia, including high blood pressure, smoking, diabetes, hypertension, obesity, obstructive sleep apnea, and atherosclerosis. She explained that vascular dementia could appear in different forms, such as multi-infarct dementia, which results from multiple small strokes, and strategic infarct dementia, which can occur from a single stroke in a critical brain area.
“Strokes can affect individuals of all ages. The cognitive impairments resulting from a stroke, such as diminished reasoning, logical thinking, attention, and judgment, are often more severe compared to those observed in Alzheimer’s dementia,” Tripathi told TOI. “The onset of these cognitive deficits can be sudden and profound, regardless of the patient’s age.”
Need for Further Research
Dr. Rajeev Mehta, senior psychiatrist at Sir Ganga Ram Hospital, remarked on the groundbreaking nature of the Oxford research linking sildenafil to vascular dementia improvement, noting that memory issues in vascular dementia often occur in steps. Dr. Jitendra Nagpal, chairman of the Institute of Mental Health at Moolchand Hospital, stressed the necessity of comprehensive multi-centric trials to validate these findings but welcomed any potential benefit for chronic sufferers as a step towards cognitive recovery.
