Tue, Sep 02, 2014 - Page 3 News List

Dementia epidemic threatens despite treatments: doctors

By Stacy Hsu  /  Staff reporter

People who have a high risk of carotid stenosis and who have been experiencing dizziness and mild cognitive impairment should seek immediate medical attention, as they might be developing vascular dementia, the second-most common type of dementia after Alzheimer’s disease, several vascular neurologists said yesterday.

“Unlike Alzheimer’s disease, vascular dementia is triggered by a microstructural disruption of white matter integrity in the frontal-subcortical circuits, which has been associated with stenosis of the internal carotid artery,” Taipei Veterans General Hospital’s Department of Neurology attending physician Lee I-hui (李怡慧) said in Taipei.

Carotid stenosis refers to the abnormal narrowing of arteries.

Lee said carotid arteries provide the most blood to the brain and people with a carotid artery that is narrowed by more than 70 percent are more prone to potential blockages of smaller arteries.

Some of these people suffer an ischemic stroke, a main cause of vascular dementia, while others are asymptomatic, Lee said.

Lee said vascular dementia can be prevented by controlling and treating its risk factors, including hypertension, diabetes, high cholesterol, smoking or abnormal heartbeats, as early as possible.

“However, since patients with asymptomatic internal carotid artery stenosis do not suffer a stroke, they might be clueless about their narrowed carotid arteries or that they are on their way to vascular dementia, so they miss the golden period for preventive treatments,” she added.

Attending physician Lin Chun-jen (林浚仁) said a 65-year-old man surnamed Ho (何) who has a history of hypertension, diabetes and high cholesterol sought treatment after feeling dizziness and forgetfulness for the past year.

“Tests found that Ho’s right carotid artery had narrowed by 80 percent, but he had never experienced a stroke. After receiving a carotid artery stent and medication, he has shown a noticeable improvement in his dizziness and cognitive performance,” Lin said.

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