Treatment - Vascular dementia

Treatment can help prevent further damage to the brain in people with vascular dementia and may slow down its progression.

But there's currently no cure for the condition or a way to reverse the damage that's already happened.

Care plans

Before treatment starts, your current and future health and social care needs will be assessed and a care plan will be created. This is to make sure you receive the right treatment for your needs.

A care plan identifies areas where you may need help, such as:

• support for you or your carer so you can remain as independent as possible, including whether you might need care at home or in a nursing home
• changes that might need to be made to your home so it's easier to live in
• financial assistance

Read more about care plans.

Lifestyle changes

The main aim of treatment for vascular dementia is to treat the underlying cause to help stop the condition getting worse.

This will usually involve making healthy lifestyle changes, such as:

• eating a healthy, balanced diet. For example, you may be advised to follow a low-salt diet to manage high blood pressure
• losing weight if you're overweight
• stopping smoking
• getting fit
• cutting down on alcohol

Medicines

Medicines may also be offered to treat the underlying cause of vascular dementia and help stop it getting worse.

These include:

• medicines to treat high blood pressure
• medicines to treat high cholesterol, such as statins
• medicines such as low-dose aspirin or clopidogrel to reduce the risk of blood clots and further strokes
• anticoagulant medicines, such as warfarin, which can also reduce the risk of blood clots and further strokes
• medicines to treat diabetes

An antipsychotic medicine, such as haloperidol or risperidone, may sometimes be given to people showing persistent aggression or extreme distress where there's a risk of harm to themselves or others. A consultant psychiatrist should be involved in deciding whether to prescribe this medicine.

Alzheimer's disease medicines, such as donepezil (Aricept), galantamine (Reminyl), rivastigmine (Exelon) or memantine are not used to treat vascular dementia, but may be used in people who have a combination of vascular dementia and Alzheimer's disease.

Support and other therapies

There are also several therapies and practical measures that can help make everyday living easier for someone with dementia.

These include:

• occupational therapy to identify problems in everyday life, such as getting dressed, and find practical solutions
• speech and language therapy to help improve communication problems
• physiotherapy to help with movement difficulties
• psychological therapies, such as cognitive stimulation (activities and exercises to improve memory, problem-solving and language)
• relaxation techniques, such as massage, music or dance therapy
• social interaction, leisure activities and other dementia activities, such as memory cafes (drop-in sessions for people with memory problems and their carers to get support and advice)
• making changes to your home, such as removing loose carpet and potential trip hazards, making sure the home is well lit, and adding grab bars and handrails

It can also be helpful to get in touch with a support group, such as the Alzheimer's Society or Dementia UK.

Read more about other treatments for dementia and living well with dementia.

End of life and legal issues

If you have been diagnosed with dementia, you might want to make arrangements for your care that take into account the decline in your mental abilities.

This may include making sure that your wishes are upheld if you're not able to make decisions for yourself.

You may want to consider:

• creating an advance decision to refuse treatment (living will), which makes your treatment preferences known in case you're unable to do this in the future
• having a "preferred place of care" plan, which outlines where you would like to receive treatment
• giving a relative lasting power of attorney, enabling them to make decisions about you if you're unable to

Read more about managing legal affairs for someone with dementia and end of life planning.

Help and advice for carers

If you care for someone with dementia, you may find it helpful to read more about:

• Looking after someone with dementia
• Carer's breaks and respite care – this can allow you to take breaks from caring
• Benefits for carers – such as allowances and tax credits that may be available