Why Does Vascular Dementia Develop?

Defining and explaining the condition

Stroke and dementia are two relatively common conditions that affect the brain. They often occur together because both have a tendency to develop in older age. It can be confusing to know the difference between a stroke and dementia, and there are some characteristic differences that distinguish the two conditions.

But sometimes a stroke and dementia occur together because certain types of strokes can cause a type of dementia called vascular dementia

What is Vascular Dementia?

Common symptoms of vascular dementia include forgetfulness, absent-mindedness, confusion and mood changes. Appetite may change, particularly manifesting as a loss of appetite. Some people tend to sleep more, while many individuals with vascular dementia lose important items or may get lost, even in familiar places. People living with vascular dementia may stop taking independent care of personal hygiene, can become disoriented and have behavioral and decision making problems.

While many families tend to 'accept' dementia as a fact of life, it is important to see a health care professional to obtain an accurate diagnosis of the cause of dementia because the treatment of vascular dementia is different than the treatment for other types of dementia.

The treatment of vascular dementia is focused on stroke prevention, while treatment of other types of dementia is focused on medications that prevent deterioration of brain cells. For example, there are medications approved for the treatment of Alzheimer’s disease that might not be the right medications for other types of dementia.

Can One Person Have Vascular Dementia and Another Kind of Dementia at the Same Time?

Other types of dementia such as Alzheimer's disease, Picks disease or Lewy body dementia can occur at the same time as vascular dementia. In such situations, the symptoms of forgetfulness and disorientation are usually more difficult to live with than they would be with one type of dementia.

Why Does Vascular Dementia Develop?

A large stroke usually results in noticeable symptoms such as weakness, vision loss or speech difficulties. But sometimes people suffer from small strokes that can go unnoticed. This is usually called a silent stroke. When many small strokes occur in different locations of the brain over time, this can result in memory changes or behavioral changes. This condition is often called vascular dementia.


Vascular dementia usually develops over time rather than suddenly. This happens because people who experience small vessel strokes often have an ability to compensate for mild deficits in memory or thinking. The brain’s ability to compensate for minor strokes may result in the patient and family members remaining unaware that strokes have occurred. However, eventually, family members may notice that profound symptoms of dementia suddenly develop.

The buildup of brain damage from many small strokes can finally result in a tipping point in which symptoms of dementia become more exacerbated or apparent. The additive effects of many silent strokes may overcome the brain’s ability to compensate for the tiny areas of brain damage. Sometimes, a mild illness or a slight infection can actually ‘bring out’ the symptoms dementia. When this occurs, some people improve once the illness subsides, while some may continue to exhibit obvious signs of dementia even after the illness resolves.

 The type of dementia caused by small strokes, vascular dementia, is also sometimes referred to as ‘small vessel disease’ or multi-infarct dementia because it is caused by small strokes (infarcts) caused by blood clots in the small blood vessels of the brain. Usually there is a characteristic appearance of vascular dementia or small vessel disease that can be detected with imaging using a brain CT scan or a brain MRI scan. Many times a trained neurologist can detect vascular dementia through a careful medical history and physical examination. 

The strokes that contribute to vascular dementia are most commonly caused by cerebrovascular disease, hypertension, diabetes, high cholesterol or smoking. 

Caring for Loved Ones who Have Vascular Dementia

Caring for patients with vascular dementia requires high-level support and care as well as medical management to prevent further strokes. Setbacks and deterioration of memory and comprehension can occur with fevers, illnesses and infections.

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