Cerebrovascular Disease (CVD) is one of the leading causes of brain death and disability and estimated to be the second most common cause of cognitive impairment after Alzheimer’s disease. CVD is a group of conditions that affect the blood supply to the brain. Blockage, haemorrhage or structural malformations (aneurysms) may lead to compromised blood supply to different parts of the brain due to which brain cells get deprived of the oxygen and glucose required for their functioning. This may cause cerebrovascular attacks in form of stroke or transient ischemic attack (TIA) causing permanent damage to brain cells which may result in permanent disability and can even be fatal.
The severity of physical and mental disability will depend on the location and extent to which the cerebral tissue is affected. It is noted that severity of symptoms tends to increase with time causing person’s physical and mental ability to deteriorate in a gradual manner.
- Generally patient may feel physically weakened and can have paralysis on one side of body characterised by limp and flaccid muscles on the affected side.
- Difficulty in swallowing and loss of gag reflex along with difficulty communicating and slurred speech.
- Mental abilities of person can also get affected. Impaired cognitive abilities include forgetfulness, confusion and difficulty in carrying out routine everyday activities that require planning, organisation and execution. Impaired balance and loss of consciousness can also occur.
- Mood swings.
- Anxiety and depression can also be observed.
Risk factors for CVD are:
Age and gender: CVD is more prevalent in age group of 65 or above and affects men more than women.
Hypertension: BP of 140/90mm Hg or higher is the most important risk factor. Simply controlling BP by means of medication and healthy lifestyle, the unwanted effects of CVD can be prevented.
High blood cholesterol: High blood cholesterol of 240mg/dl or more increases the susceptibility of the person for Atherosclerosis, which can become a threat for CVD.
Uncontrolled Diabetes: By keeping BP, Cholesterol and Diabetes under control the risk for CVD can be significantly reduced. Diabetes if left untreated not only increases the risk of stroke but also has other serious health implications.
Smoking and Alcohol (excessive) consumption: Nicotine the main toxin in cigarette smoke causes narrowing of blood vessels, resulting in hypertension thus CVD. People who smoke 20cigarettes/day are 6 times more susceptible to CVD. By quitting the habit one can get rid of a major risk factor of CVD.
Obesity and sedentary lifestyle: Obesity and physical inactivity increase the susceptibility for hypertension, high blood cholesterol, diabetes, heart disease and (hence) CVD.
Prior Stroke or Heart attack: People who have had a prior episode of stroke or heart attack are at much higher risk of having another one.
Other risk factors:
Carotid artery disease (CAD).
Moyamoya disease: Progressive disease of carotid artery and its branches and may result in irreversible blockage.
Venous Angiomas: Usually 1 in 50 people are affected.
Vein of Galen malformation: The abnormal connection between arteries and deep draining veins of the brain that occurs during embryonic development. Appropriate treatment measures should be taken for children affected with VGM.
By adopting Healthy lifestyle i.e. healthy eating, exercising regularly, no smoking, alcohol consumption in moderation and remaining stress-free can help in prevention of CVD remarkably.
Healthy diet having vegetables, fruits, low-fat or fat-free dairy products, whole grains and free from saturated and trans fats should be taken. Sodium intake should not be more than 2300 mg/day and up to 1500 mg/day for people age above 50 yrs.
Maintaining a healthy weight is also very important, as obesity can expose a person to various medical conditions, which can be achieved with controlled diet and regular exercise that will also help in keeping stress levels under control as well.
CVD in the elderly can affect their health physically, mentally and emotionally. Depending on the extent of disability, appropriate level of care should be chosen. Patients with severe disabilities should opt for nursing home care.CVD survivors with mild to moderate impairment who require regular medical attention but have reasonable mobility and cognitive abilities should choose in home senior care. Home health care is the best option for them giving them safe, familiar non-threatening environment which will have a positive impact on their health and faster recovery.