Brain & Nervous System Alzheimer's Dementia & Related Cognitive Disorders The Stages and Progression of Vascular Dementia By Esther Heerema, MSW Esther Heerema, MSW Facebook LinkedIn Twitter Esther Heerema, MSW, shares practical tips gained from working with hundreds of people whose lives are touched by Alzheimer's disease and other kinds of dementia. Learn about our editorial process Updated on September 19, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Nicholas R. Metrus, MD Medically reviewed by Nicholas R. Metrus, MD LinkedIn Nicholas R. Metrus, MD, is a board-certified neurologist and neuro-oncologist. He currently serves at the Glasser Brain Tumor Center in Summit, New Jersey. Learn about our Medical Expert Board Print ivanastar / Getty Images Vascular dementia (also referred to as vascular cognitive impairment) is the term used for cognitive decline caused by reduced blood flow in the brain. This change can result from a sudden event, such as a stroke. It can also be related to a more gradual blocking or slowing of blood flow triggered by a series of smaller strokes or to another cause such as cholesterol that accumulates on the walls of blood vessels. An Overview of Vascular Dementia How Does Vascular Dementia Progress? Vascular dementia does not always have a typical progression that might be classified into stages, although its symptoms can generally be classified as fitting in the early stages, middle stages, or late stages of dementia. Early stages of vascular dementia often include impaired memory, difficulty with executive functioning, word-finding difficulty, and a decline in attention. Mood and personality changes may also be seen in vascular dementia, and some people experience a decline in balance and walking. Symptoms and Decline As vascular dementia progresses, symptoms increase and overall functioning further declines. What to Expect Progression of vascular dementia depends on the location and extent of the damage in the brain's blood flow. While some people with vascular dementia progress gradually—mimicking Alzheimer's—others will experience a decline in cognitive abilities, followed by a period of stability, and then there will be another step down in abilities and then stability for a time, etc. This is often referred to as a "step-like progression" or "stepwise" pattern of progression. Sometimes, the sudden step-like declines are related to clear vascular events, such as the occurrence of a stroke. In other cases, there's a less clear trigger for the decline. Progression is also affected by other brain changes. For example, some people with vascular dementia also have some evidence of Alzheimer's disease in their brains. This is called mixed dementia, and it's often not discovered until an autopsy after death. The autopsy of such a patient may show evidence of brain-related changes such as widespread tau pathology (neurofibrillary tangles), which has been strongly associated with cognitive decline. Can Treatment Slow the Stages of Vascular Dementia? While there's no guaranteed treatment for vascular dementia, researchers suggest that taking good care of your heart and your brain may reduce the chance of, or slow, further progression. This includes maintaining a healthy blood pressure, exercising regularly, not smoking, and eating a healthy diet. Was this page helpful? Thanks for your feedback! When it comes to Alzheimer's, the MIND diet has shown promise in reducing risk and promoting brain health. Sign up for our Alzheimer’s and Dementia Newsletter and get your free recipe guide today. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 4 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Institutes of Health. National Institute on Aging. Vascular contributions to cognitive impairment and dementia. Bahar-Fuchs A, Clare L, Woods B. Cognitive training and cognitive rehabilitation for mild to moderate Alzheimer's disease and vascular dementia. Cochrane Database Syst Rev. 2013;(6):CD003260. doi:10.1002/14651858.CD003260.pub2 Alzheimer's Association. Vascular dementia. Mather M, Harley CW. The Locus coeruleus: essential for maintaining cognitive function and the aging brain. Trends Cogn Sci (Regul Ed). 2016;20(3):214-226. doi:10.1016/j.tics.2016.01.001