What Is Vascular Dementia?

Table of Contents
View All
Table of Contents

Vascular dementia results from impaired blood flow to the brain. After Alzheimer's disease, it's one of the most common types of dementia, along with Lewy body dementia. Learning about vascular dementia can help you know how to reduce your risk as well as know what to expect if you've been diagnosed.

Vascular dementia was formerly called "multi-infarct dementia" because it was thought to only be caused by small strokes. However, the name was changed to "vascular dementia" to reflect the array of conditions that can impair the blood's ability to circulate to the brain. More recently, some physicians use the term "vascular cognitive impairment," perhaps because it seems to capture the wide range of cognitive decline (from mild to severe) that vascular dementia can cause. Vascular dementia often occurs alongside Alzheimer's disease, resulting in mixed dementia.

Between 5% and 10% of people over the age of 65 in developed countries have vascular dementia. The risk of developing it increases dramatically with age. Vascular dementia is estimated to account for between 20% to 40% of all dementia cases.

Cognitive and neurological symptoms of vascular dementia

Verywell / Emily Roberts

Vascular Dementia Symptoms

People with vascular dementia often display multiple cognitive problems including:

In most cases, symptoms make it difficult to hold a job, carry out household responsibilities, or maintain social relationships. People with vascular dementia also experience neurological symptoms including:

  • Exaggerated reflexes
  • Problems with walking and balance
  • Weakness in the limbs, hands, and feet

Depending on the individual and on the cause of dementia, delusions, confusion, agitation, urinary problems, and/or depression can also accompany vascular dementia. Interestingly, memory loss usually occurs later in vascular dementia compared to Alzheimer's disease.

In vascular dementia, the first symptoms are often the neurological ones, such as problems with reflexes, walking, and muscle weakness. On the other hand, memory problems and behavioral symptoms are commonly the first issues noticed in Alzheimer's.

Additionally, vascular dementia often progresses in a step-wise fashion. For example, the person will seem stable for a period of time, then suddenly get much worse, then continue to alternate between stable periods and sudden drops in functioning. Alzheimer's disease typically progresses in a more gradual, downward fashion.


Vascular dementia can occur either by a narrowing or a complete blockage of blood vessels in the brain, which deprives brain cells of nutrients and oxygen they need to function properly.

In addition, vascular dementia often results from several small strokes that occur over time. It can also occur after a single major stroke, which is sometimes referred to as "post-stroke dementia."

Not all strokes lead to dementia, but up to one-third of those who have a stroke will develop dementia within six months.

Conditions like high blood pressure and diabetes that don't block blood vessels, but simply narrow them, can also lead to vascular dementia.

Risk Factors

People who develop vascular dementia often have a history of certain conditions:

In particular, if an individual has a history of multiple strokes, the risk of developing vascular dementia increases with the number of strokes experienced over time.

Other factors that may increase your risk include if you are a smoker, a male, of African American descent, if you have had atrial fibrillation, or have a family history of vascular dementia.


As with Alzheimer's disease, a complete diagnostic workup should be performed in order to rule out other possible causes of the person's symptoms. Vascular dementia is usually identified through imaging procedures, which can reveal strokes and narrowed or blocked arteries. Neuropsychological tests might also be conducted to determine the nature and extent of cognitive impairment.


Doctors often prescribe patients with vascular dementia the same medications that are used to treat Alzheimer's. This may include both a cholinesterase inhibitor (Aricept, Exelon, or Razadyne) and Namenda.

No drugs have been approved by the FDA specifically to treat vascular dementia, but medications approved to treat Alzheimer's sometimes help.

Managing cardiovascular problems through medication and/or lifestyle changes may also help slow the worsening of vascular dementia symptoms. It's critical to monitor blood pressure, pulse, cholesterol, blood sugar, and weight, all of which impact brain health and the ease of blood flow to the brain.

Behavior management strategies are also useful for handling the challenging behaviors that sometimes accompany vascular dementia.


Currently, there is no cure for vascular dementia. If the dementia was caused by multiple strokes, the person may get worse in a step-wise progression, where stable periods are interrupted by sudden downward episodes.

Life expectancy for someone with vascular dementia is highly individual and depends on the nature of the cardiovascular problems that are causing dementia, along with the person's age and other medical conditions.

A Word From Verywell

Vascular dementia results from impaired blood flow to the brain and is the second most common type of dementia after Alzheimer's disease. A host of cognitive and neurological impairments accompany vascular dementia, including memory impairment and trouble with coordination such as walking and balancing. It is best to consult a doctor or healthcare professional (or accompany a loved one to the doctor if you suspect they are at risk) to rule out other similar conditions. Though there is no cure, there are treatment options and ways to manage.

Was this page helpful?
12 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.
  1. Román GC. Vascular dementia may be the most common form of dementia in the elderly. J Neurol Sci. 2002;203-204:7-10. doi:10.1016/s0022-510x(02)00252-6

  2. McKay E, Counts SE. Multi-infarct dementia: a historical perspectiveDement Geriatr Cogn Dis Extra. 2017;7(1):160-71. doi:10.1159/000470836

  3. Ramos AR, Dib SI, Wright CB. Vascular dementiaCurr Transl Geriatr Exp Gerontol Rep. 2013;2(3):188-95.

  4. Lee AY. Vascular dementiaChonnam Med J. 2011;47(2):66-71. doi:10.4068/cmj.2011.47.2.66

  5. Karantzoulis S, Galvin JE. Distinguishing Alzheimer's disease from other major forms of dementiaExpert Rev Neurother. 2011;11(11):1579-91. doi:10.1586/ern.11.155

  6. National Institute on Aging. What is dementia? Symptoms, types, and diagnosis.

  7. Mijajlović MD, Pavlović A, Brainin M, et al. Post-stroke dementia - a comprehensive reviewBMC Med. 2017;15(1):11. doi:10.1186/s12916-017-0779-7

  8. Song J, Lee WT, Park KA, Lee JE. Association between risk factors for vascular dementia and adiponectinBiomed Res Int. 2014;2014:261672. doi:10.1155/2014/261672

  9. Kalaria RN, Akinyemi R, Ihara M. Stroke injury, cognitive impairment and vascular dementiaBiochim Biophys Acta. 2016;1862(5):915-25. doi:10.1016/j.bbadis.2016.01.015

  10. Rusanen M, Kivipelto M, Quesenberry CP, Zhou J, Whitmer RA. Heavy smoking in midlife and long-term risk of Alzheimer disease and vascular dementia. Arch Intern Med. 2011;171(4):333-9. doi:10.1001/archinternmed.2010.393

  11. Vijayan M, Reddy PH. Stroke, vascular dementia, and Alzheimer's disease: molecular linksJ Alzheimers Dis. 2016;54(2):427-43. doi:10.3233/JAD-160527

  12. Igoumenou A, Ebmeier KP. Diagnosing and managing vascular dementia. Practitioner. 2012;256(1747):13-6, 2.

Additional Reading
  • Alzheimer's Association. Vascular Dementia. 

  • American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (DSM-5). Washington, DC: .
  • Plassman, B. L., Langa, K. M., Fisher, G. G., Heeringa, S. G., Weir, D. R., Ofstedal, M. B., et al. (2007). Prevalence of dementia in the United States: The aging, demographics, and memory study. Neuroepidemiology, 29, 125-132.
  • UC Memory Disorders Center. Vascular Cognitive Impairment.