Brain & Nervous System Alzheimer's Dementia & Related Cognitive Disorders What Is Vascular Dementia? By Carrie Hill, PhD Carrie Hill, PhD Carrie L. Hill, PhD has over 10 years of experience working for agencies in the health, human service, and senior sectors, including The Alzheimer's Association in St. George, Utah. Learn about our editorial process Updated on July 26, 2022 Medically reviewed 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 Table of Contents View All Table of Contents Symptoms Causes Diagnosis Treatment Prognosis Vascular dementia results from impaired blood flow to the brain. After Alzheimer's disease, it's considered the second most common type of dementia. Vascular dementia also 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 15% and 30% of all dementia cases. 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. This article gives an overview of the symptoms, causes, and outlook of vascular dementia. Other Names Vascular dementia was formerly called "multi-infarct dementia" because it was thought to 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. Verywell / Emily Roberts Vascular Dementia Symptoms Symptoms of vascular dementia can appear suddenly or be subtle at first and worsen over time. People with vascular dementia often display multiple cognitive problems including: Memory impairment Aphasia (trouble with speech) Apraxia (problems with muscle movement and coordination) Agnosia (inability to recognize people or things) Problems with executive functioning In many 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 reflexesProblems with walking and balanceWeakness 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 stepwise fashion. For example, the person will seem stable for a period of time, then suddenly get much worse, and continue to alternate between stable periods and sudden drops in functioning. Alzheimer's disease typically progresses in a more gradual, downward fashion. Causes Vascular dementia can occur due to either 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 narrow blood vessels gradually over time can also lead to vascular dementia. Risk Factors People who develop vascular dementia often have a history of certain conditions: Heart attack Stroke High blood pressure Diabetes High cholesterol In particular, if an individual has a history of multiple strokes, the risk of developing vascular dementia increases with the number of strokes they've experienced. Other factors that may increase your risk include: Smoking Male sex African-American descent Atrial fibrillation Family history of vascular dementia. Diagnosis 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. If you feel you are experiencing symptoms of dementia, talk with a primary care provider first. They'll assess your symptoms, medical history, medications, and cardiovascular risk factors. They'll likely give you tests to assess your memory and thinking skills. They may also order blood tests to look for other conditions that may be responsible for your symptoms. Based on those results, they may refer you to a specialist for further evaluation. Vascular dementia is usually identified through imaging procedures, which can reveal strokes and narrowed or blocked arteries.These tests could include: CT (computed tomography) scan MRI (magnetic resonance imaging) scan PET (positron emission tomography) scan Neuropsychological tests might also be conducted to determine the nature and extent of cognitive impairment. The Diagnosis of Dementia Treatment Doctors often prescribe patients with vascular dementia the same medications that are used to treat Alzheimer's. This may include a cholinesterase inhibitor such as Aricept (donepezil), Exelon (rivastigmine), or Razadyne (galantamine), possibly along with the drug Namenda (memantine). 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 control 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. How Heart Disease Is Treated Prognosis Currently, there is no cure for vascular dementia, and damage that has already occurred in the brain can't be reversed. The goal of treatment is to prevent further damage, manage symptoms, and support function as much as possible. If the dementia was caused by multiple strokes, the person may get worse in a step-wise progression as further strokes occur, 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. Summary 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 healthcare provider early if you think you or a loved one are experiencing dementia symptoms. Though there is no cure, there are treatment options and ways to manage. The Connection Between Stroke and Dementia 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. Wolters FJ, Ikram MA. Epidemiology of vascular dementia. Arterioscler Thromb Vasc Biol. 2019;39(8):1542-1549. doi:10.1161/ATVBAHA.119.311908 Ramos AR, Dib SI, Wright CB. Vascular dementia. Curr Transl Geriatr Exp Gerontol Rep. 2013;2(3):188-95. McKay E, Counts SE. Multi-infarct dementia: a historical perspective. Dement Geriatr Cogn Dis Extra. 2017;7(1):160-71. doi:10.1159/000470836 Karantzoulis S, Galvin JE. Distinguishing Alzheimer's disease from other major forms of dementia. Expert Rev Neurother. 2011;11(11):1579-91. doi:10.1586/ern.11.155 National Institute on Aging. What is dementia? Symptoms, types, and diagnosis. Mijajlović MD, Pavlović A, Brainin M, et al. Post-stroke dementia - a comprehensive review. BMC Med. 2017;15(1):11. doi:10.1186/s12916-017-0779-7 Mijajlović MD, Pavlović A, Brainin M, et al. Post-stroke dementia - a comprehensive review. BMC Med. 2017;15(1):11. Published 2017 Jan 18. doi:10.1186/s12916-017-0779-7 Song J, Lee WT, Park KA, Lee JE. Association between risk factors for vascular dementia and adiponectin. Biomed Res Int. 2014;2014:261672. doi:10.1155/2014/261672 Kalaria RN, Akinyemi R, Ihara M. Stroke injury, cognitive impairment and vascular dementia. Biochim Biophys Acta. 2016;1862(5):915-25. doi:10.1016/j.bbadis.2016.01.015 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 Vijayan M, Reddy PH. Stroke, vascular dementia, and Alzheimer's disease: molecular links. J Alzheimers Dis. 2016;54(2):427-43. doi:10.3233/JAD-160527 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. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 2013. UC Memory Disorders Center. Vascular dementia. By Carrie Hill, PhD Carrie L. Hill, PhD has over 10 years of experience working for agencies in the health, human service, and senior sectors, including The Alzheimer's Association in St. George, Utah. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit