Former Husker and NFL Hall-of-Famer Roger Craig’s recent announcement that he has been diagnosed with vascular dementia is bringing new attention to a condition that affects millions of people. Craig, who played for the San Francisco 49ers, has said he believes his diagnosis may be partly connected to concussions he suffered during his football career.
Dr. Matthew Purbaugh with Bryan Neurology says vascular dementia occurs when blood vessel damage affects the brain. “Vascular dementia is the second most common type of dementia in North America,” Purbaugh tells KLIN News. “It’s all caused by vascular injury to the brain.”
That injury can come from major strokes or from smaller “mini” strokes that happen over time without being immediately recognized. Purbaugh says Craig’s comments about his football career raise the possibility of what doctors call mixed dementia.
“Vascular dementia can exist by itself or it can exist with other types of dementia like CTE, which is typically what we think of as occurring in football players with repetitive head injury,” Purbaugh says. He adds that repetitive head injuries can also cause damage to the brain’s small blood vessels and may accelerate changes associated with vascular dementia.
So what actually happens in the brain? Purbaugh compares the brain to a network of computers. Even if individual parts of the brain are functioning properly, damage to the connections between them can interfere with how the brain works. “What vascular dementia does is it causes the disruption of the networks inside of the brain,” Purbaugh says.
That can lead to problems with executive thinking, decision-making, processing speed and spatial awareness. Early warning signs can include slowed thinking, difficulty making decisions and personality or psychiatric changes that appear unexpectedly.
Purbaugh says many of the biggest risk factors for vascular dementia are also familiar cardiovascular health risks, including tobacco use, high cholesterol, high blood sugar and a lack of physical inactivity.
And he says prevention is key. “The best treatment for vascular dementia is prevention,” Purbaugh says. That means controlling blood sugar, cholesterol and blood pressure, avoiding tobacco and staying physically active.
While medications can sometimes provide modest cognitive benefits, Purbaugh says they do not slow the progression of vascular dementia and are not FDA-approved specifically for treating the condition. Craig’s diagnosis is putting a personal face on vascular dementia, and highlighting the connection between long-term cardiovascular health, brain health and, potentially, repeated head injuries.