Controlling underlying conditions and risk factors

Controlling conditions that affect the underlying health of your heart and blood vessels can sometimes slow the rate at which vascular dementia gets worse, and may also sometimes prevent further decline. Depending on your individual situation, your doctor may prescribe medications to:

• Lower your blood pressure
• Reduce your cholesterol level
• Prevent your blood from clotting and keep your arteries clear
• Help control your blood sugar if you have diabetes

Alzheimer's medications

The Food and Drug Administration (FDA) has not approved any drugs specifically to treat changes in judgment, planning, memory and other thought processes caused by vascular dementia. However, certain medications approved by the FDA to treat these symptoms in Alzheimer's disease may also help people with vascular dementia to the same modest extent they help those with Alzheimer's.

Doctors may prescribe one or both types of the following Alzheimer's drugs:

• Cholinesterase inhibitors — including donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon) — work by boosting levels of a brain cell chemical messenger involved in memory and judgment. Side effects can include nausea, vomiting, muscle cramps and diarrhea.
• Memantine (Namenda) regulates another brain cell chemical messenger important for information processing, storage and retrieval. Side effects can include headache, constipation, confusion and dizziness.

What to expect from your doctor

Your doctor is also likely to have questions for you. Being ready to respond may free up time to focus on any points you want to talk about in-depth. Your doctor may ask:

What kinds of thinking problems and mental lapses are you having? When did you first notice them?
Are they steadily getting worse, or are they sometimes better and sometimes worse? Have they suddenly gotten worse?
Has anyone close to you expressed concern about your thinking and reasoning?
Have you started having problems with any long-standing activities or hobbies?
Do you feel any sadder or more anxious than usual?
Have you gotten lost lately on a driving route or in a situation that's usually familiar to you?
Have you noticed any changes in the way you react to people or events?
Do you have any change in your energy level?
Are you currently being treated for high blood pressure, high cholesterol, diabetes, heart disease or stroke? Have you been treated for any of these in the past?
What medications are you taking?
Are you taking any vitamins or supplements?
Do you drink alcohol? How much?
Do you smoke?
Have you noticed any trembling or trouble walking?
Are you having any trouble remembering your medical appointments or when to take your medication?
Have you had your hearing and vision tested recently?
Did anyone else in your family ever have trouble with thinking or remembering things as they got older? Was anyone ever diagnosed with Alzheimer's disease or dementia?