Vascular Dementia Explained for Africans: Causes, Types and Stages

By Oluwasola Samuel, Freelance health writer. Medically reviewed by A. Odutola. MBBS, PhD, FRCSEd.

 

Mature black man at risk for vascular dementia: Freepik

 

Key Points

• Vascular dementia is a growing health challenge that occurs as a result of damage to or blockage of blood vessels responsible for transporting oxygenated blood and nutrients to the brain.

• High blood pressure and diabetes are major causes of vascular dementia, especially in Sub-Saharan Africa.

• The ageing population in sub-Saharan Africa is a significant factor in the observed increase in the number of people with vascular dementia. 

• Awareness and diagnosis are low in many African countries, causing late diagnosis and poor treatment outcomes.

 

Introduction 

Vascular dementia is becoming a growing concern in Africa, yet it remains widely misunderstood by a lot of people. [1] Many families face the challenge of caring for their loved ones affected by this condition without knowing what to do or where to turn for help.

Misinformation or lack of awareness often leads to delayed action, making it harder to manage the condition effectively. 

But the truth is that having the right information can change everything. 

In this article, you will learn about vascular dementia from these viewpoints:

• What's vascular dementia?
• How common vascular dementia is in Africa
• Causes and risk factors of vascular dementia 
• Types and stages of vascular dementia

 

What is Vascular Dementia? 

Vascular dementia is a brain condition that describes problems with reasoning, planning, memory, etc., due to damage or obstruction of blood vessels that carry blood to the brain.

When blood vessels are damaged or obstructed, the brain is deprived of blood, oxygen, and other vital nutrients it needs to function optimally. As a result, some brain cells are damaged, causing a decline in brain health that can be severe enough to disrupt daily activities. 

 

How Common is Vascular Dementia in Africa?

Vascular dementia is the second most common form of dementia globally, after Alzheimer's disease. [2]

According to the Alzheimer's Disease Association, vascular dementia accounts for 17 - 30% of all dementia cases globally. [3] This shows how common this condition is and why it is a growing public health issue.

In Sub-Saharan Africa, the true burden of vascular dementia is not fully understood because there aren't enough studies that provide a clear understanding of the condition. Many cases go undiagnosed, making it difficult to capture the true and accurate statistics on how many Africans are affected.

However, some studies suggest that vascular dementia is on the rise in Africa. It's been indicated to be responsible for 30% of all dementia cases in Africa. [4] Research also suggests that the reason for the rise is because of the high number of untreated high blood pressure, diabetes, and other cardiovascular diseases in the continent. 

Many communities in Sub-Saharan Africa lack the right information and awareness about vascular dementia. This results in delayed diagnosis of symptoms and underreporting, contributing to the rise of the condition in sub-Saharan Africa. 

 

What Causes Vascular Dementia?

Vascular dementia is caused by several conditions that disrupt the flow of blood through the blood vessels to the brain.

This disruption starves the brain of oxygenated blood and vital nutrients for it to function optimally. 

Conditions that can lead to vascular dementia include:

1. Stroke

A stroke occurs when the blood supply in the blood vessels is interrupted by a blood clot (ischaemic stroke) or when the blood vessels rupture or burst (hemorrhagic stroke), thereby starving the brain of oxygenated blood. 

The longer this goes on, the more your brain cells are at risk of dying. If you have a permanent stroke, the brain cells die. This can result in memory problems, confusion, or difficulty planning and reasoning, depending on the brain region affected. 

Also, multiple silent strokes or mini-strokes can cause cognitive impairment. You might not experience symptoms immediately, but they can damage your brain over time.

2. Brain Haemorrhage

Bleeding in the brain is often caused by high blood pressure and cerebral amyloid angiopathy (a protein that weakens the wall of the blood vessels). [5]

Aneurysms (weakness in the wall of blood vessels that causes bulging and eventual rupture of the wall) and trauma (head injuries) are other conditions that can cause brain bleed.

3. Chronic blood vessel damage

Several conditions can cause the blood vessels to be damaged. These conditions weaken or block blood vessels from transporting oxygenated blood to the brain.

These conditions include: 

• Atherosclerosis: Hardening and narrowing of arteries, causing blockage of blood vessels.

• Diabetes: The rise in blood sugar levels can damage both the small and large blood vessels, which can cause brain impairment.

• Smoking: It damages the wall of blood vessels, and it also aids plaques to build up inside the vessels that transport oxygenated blood to the brain.

• High cholesterol: Excess cholesterol leads to plaque accumulation in the arteries, and it makes it difficult for oxygenated blood to flow freely to the brain tissues.

4. Vasculitis 

This condition is the inflammation of the blood vessels due to autoimmune diseases or infections. The inflammation caused can reduce the flow of blood, causing long-term brain damage.

5. Genetic disorder 

A rare genetic disorder like cerebral autosomal dominant artery disease with subcortical infarcts and leukoencephalopathy (CADASIL) can cause damage to small blood vessels in the brain. [6] This can lead to brain damage. CADASIL requires just one parent to have the condition for their child to inherit it.

 

Types of Vascular dementia

There are different types of vascular dementia, which include:

1. Multi-infarct dementia

Multi-infarct dementia is a type of vascular dementia that occurs as a result of small strokes, also known as ministrokes or transient ischaemic sattacks (TIAs). These small strokes are silent. Most times, affected persons might not know they have a stroke. 

When these small strokes happen, they often damage some areas of the brain and may gradually affect reasoning, thinking, and other cognitive functions. Small strokes only last for a short while and may improve with or without medication. 

If the stroke continues for a longer period, it could result in a permanent stroke, which can lead to significant brain damage.

2. Focal infarct dementia

This condition is determined by the area of the brain affected by stroke. If it affects or damages the part of the brain that controls memory, behaviour and thinking, then those brain functions will be compromised immediately or gradually.

3. Subcortical vascular dementia

Subcortical vascular dementia is the most common form of vascular dementia. It is caused by diseases or small tears in the small blood vessels of the deep regions of the brain. The damage that results in these parts of the brain is responsible for cognitive, emotional, and movement disorders seen in subcortical vascular dementia.

Subcortical vascular dementia is caused by underlying health conditions like high blood pressure, thickening, or stiffness of the arteries. 

Amongst all the types of vascular dementia, subcortical vascular dementia is believed to be the most common. [2]

4. Stroke-related dementia 

When the blood supply to the brain is suddenly cut off as a result of a stroke caused by clotted blood dislodged from the heart, brain damage may occur with temporary thinking and memory difficulties. However, dementia does not happen immediately as some affected people may recover with or without treatment depending on the severity of the stroke.

Stroke-related dementia occurs within 6 months after a significant clot-related stroke.

The more strokes a person has, the more the brain health continues to diminish. A person with a stroke is at greater risk of another stroke soon. This is because the underlying health condition (high blood pressure, diabetes, or heart disease) that triggered the stroke initially can still trigger it again.

5. Mixed dementia

Mixed dementia is not a specific subtype of vascular dementia. It is simply a combination of different types of dementia like Alzheimer’s dementia that may co-occur with vascular dementia. At least 1 in 10 people diagnosed with dementia have mixed dementia. [7]

 

Stages of Vascular Dementia 

Vascular dementia is typically a progressive disease that passes through stages such as early, middle and late. Different other names are also used to categorise the stages of vascular dementia.

In early-stage vascular dementia, brain health functions may be mild, like occasional forgetfulness, and difficulty with concentration and decision-making that others may not easily recognise.

In middle-stage vascular dementia, more recognisable deterioration in brain functions like thinking, planning, memory recall, decision making, etc.,  occur and these affect activities of daily living.

In late-stage vascular dementia, severe deterioration in brain functions like severe memory loss, difficulty speaking, loss of awareness of surroundings, etc.; occur to the extent that affected people become dependent on others for activities of daily living. 

 

Conclusion

Vascular dementia is a serious brain condition caused by reduced blood flow, leading to memory loss, confusion, and difficulty making decisions. It develops in stages and can be triggered by conditions like high blood pressure, stroke, and diabetes—which are common in Africa. Unfortunately, many people mistake it for normal ageing, which delays diagnosis and care.

While there is no cure, understanding and recognising early signs and causes allows for early and better care. Since vascular dementia is more common than many realise, increasing awareness in African communities is crucial. By educating ourselves and taking preventive steps, we can reduce the impact of this condition and improve the lives of those affected.

 

References:

1. George-Carey R, Adeloye D, Chan KY, Paul A, Kol?i? I, Campbell H, Rudan I. An estimate of the prevalence of dementia in Africa: A systematic analysis. J Glob Health. 2012 Dec;2(2):020401. doi: 10.7189/jogh.02.020401. Erratum in: J Glob Health. 2012;2(2):020401corr. Available from here. 

2. Alzheimer’s Society. What is vascular dementia? [Internet, n.d.]. [Cited 2025 Feb 12]. Available here.

3. Alzheimer's Disease International. Alzheimer's disease. [Internet]. 15 March, 2023. [Cited December 24, 2024]. Available from here.

4. Science Africa. The burden of dementia in Africa. [Internet]. September 16, 2024 [Cited 2024 Dec 24]. Available from here.

5. National Library of Medicine. Medlineplus medical encyclopedia Cerebral amyloid angiopathy: [Internet]. June 13, 2024. [Cited 2024 Dec 24]. Available from here.

6. National Institute of Neurological Disorders and Stroke. Cadasil [Internet]. Last reviewed Nov. 22, 2024. [Cited 2024 Dec 24]. Available from here.

7. Alzheimer’s Society. What is mixed dementia? | [Internet].14 April 2024. [Cited 2025 Feb 12]. Available here.

 

Related:

• Dementia: What Africans Need to Know

• Alzheimer's disease: What Africans need to know

• 15 Modifiable Risk Factors of Dementia African Need to Know

• 10 Things Africans Should Be Doing To Lower Dementia Risk

 

Published:  February 18, 2025

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