On this page:
What is vascular dementia?
Vascular dementia and stroke 
Small vessel disease and vascular cognitive impairment 
How vascular dementia develops 
Signs of vascular dementia 
How is vascular dementia diagnosed? 
Dementia terms you may hear 
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If you are worried about vascular dementia or know someone who is, this guide can help you understand what you need to do. It explains what vascular dementia is and how it is linked to stroke. It also explains what you can do if you or someone you know is diagnosed with vascular dementia.

It’s aimed at people who have had a stroke or who think they may have vascular dementia, but there is information for family and friends as well. If you have a question that is not answered in this guide call our Stroke Helpline.

What is vascular dementia?

Dementia can affect your memory, thinking, communication, mood and behaviour. These changes are due to damage in your brain, which can happen in different ways. Dementia often gets worse over time.

Vascular dementia happens when the blood supply to parts of your brain becomes reduced. This can be due to blood vessels being clogged, a stroke or a series of small strokes. Over time, areas of brain cells stop working, leading to symptoms of dementia.

Vascular dementia affects different people in different ways. The symptoms you develop will depend on the areas of your brain that have been damaged.

There are different types of dementia, and it's possible to have more than one.  This is called mixed dementia. Other kinds of dementia include Alzheimer's disease, dementia with Lewy bodies and frontotemporal dementia.

Up to 20% of people with dementia in the UK have vascular dementia, and about 10% have mixed dementia.

How is vascular dementia linked to stroke?

When you have a stroke, the blood supply to part of your brain is cut off, killing brain cells. The damage from a stroke can cause problems with memory and thinking. For many people, these problems improve over time. If the problems don’t improve or get worse this may be a sign of vascular dementia.

Vascular dementia can also be caused by a series of small strokes. These result in lots of small areas of damage in your brain. Often, these strokes can be so small that you don't know you are having them. These are known as silent strokes.

Sometimes symptoms of vascular dementia can be confused with the effects of stroke. Both stroke and vascular dementia can cause problems with memory, thinking and mood. Strokes happen suddenly while the symptoms of vascular dementia often get worse over time. The difference is that vascular dementia gets worse over time. If you’re unsure, go to see your GP.

Small vessel disease and vascular cognitive impairment

Vascular dementia can also be caused by small vessel disease. This is when the small blood vessels deep within your brain become narrow and clogged up. The damage stops blood from getting to parts of your brain. The damage can build up over time and may cause signs of vascular cognitive impairment. This can eventually lead to vascular dementia.

Many of the things that increase your risk of small vessel disease, such as high blood pressure and diabetes, also increase your risk of stroke. 

You can read more about how to reduce your risk of stroke and small vessel disease.

How vascular dementia develops

Symptoms of vascular dementia can appear suddenly if they are caused by a single stroke, or if they are caused by silent strokes they may appear gradually over time. Vascular dementia sometimes develops in ‘steps’, so that symptoms will stay the same for a while and then suddenly get worse. These steps are usually due to new strokes. 

You can read more about treatments to slow down the progression of dementia.

Signs of vascular dementia

If you or the people around you notice any of the signs below, you should visit your GP:

  • Not being able to understand or respond to things very quickly.
  • Not being able to remember things.
  • Finding it difficult to concentrate.
  • Not being able to find the right word when you’re speaking.
  • Struggling to plan ahead for everyday tasks.
  • Difficulty in learning new tasks
  • Seeming down or depressed.

At a later stage, signs may include:

  • Becoming confused.
  • Behaving differently, especially if you’re being aggressive or behaving inappropriately.
  • Lacking motivation.
  • Not being able to control your emotions.
  • Finding it difficult to walk and keep your balance.
  • Having problems controlling your bladder.

How is vascular dementia diagnosed?

If you’re noticing signs of vascular dementia, then you need to go and see your GP as soon as possible.

Your GP will talk to you and do a number of tests to see what may be causing your symptoms. It’s probably a good idea to take a friend or family member with you to help you answer your GP’s questions. They may have noticed symptoms that you are not aware of, or may be able to say how long you’ve had them.

To help them rule out any other causes your GP is likely to:

  • Talk to you about your symptoms.
  • Go through your medical history to see if you have any conditions that are linked to vascular dementia, like heart problems, high blood pressure or diabetes.
  • Perform a brief memory test.
  • Ask you some questions about your mood.
  • Speak to your friend or relative about any changes they may have noticed.
  • Take some blood or ask for a urine sample, so that they can check for other problems that could be causing your symptoms such as an infection, thyroid problems or low levels of vitamins or hormones.
  • Look at the medication you’re taking to see if that could be causing any of your symptoms. It is a good idea to bring a list of all the medications, vitamins and supplements you take including those prescribed by your doctor and the ones you buy yourself.

Your GP may refer you to a dementia specialist. This could be:

  • An old-age psychiatrist (a doctor who specialises in mental health conditions of older people).
  • A geriatrician (a doctor who specialises in the health of older people).
  • A neurologist (a doctor who specialises in the way the brain works).
  • A psychologist (a non-medical clinician who specialises in thinking and feelings).
  • A specialist dementia nurse.

It is possible that your assessment may happen at a memory clinic or a clinic at a hospital outpatients department.

Your specialist will carry out further tests. They will ask you questions to see how your memory and thinking may have been affected. They may ask you to perform pencil- and paperbased memory and thinking tests. These tests are designed to be challenging. Don’t worry if you find them difficult. They help the clinician work out what is wrong and you can’t pass or fail these tests. They may also arrange for you to have a brain scan, so that they can see how much damage has been caused to your brain.

Dementia terms you may hear

  • Alzheimer’s disease: the most common type of dementia, caused by clumps of proteins building up in the brain.
  • Mild cognitive impairment: this can happen after a stroke. This is when someone has memory and thinking problems but they are not severe enough to interfere with their day-today activities.
  • Other types of dementia: you may hear about dementia with Lewy bodies, frontotemporal dementia and youngonset dementia, as well as other rarer types.
  • Small vessel disease: damage to the blood vessels deep inside the brain, often caused by high blood pressure.
  • Vascular cognitive impairment: this describes all memory and thinking problems associated with stroke. It includes vascular dementia and mild cognitive impairment.
  • Vascular dementia: problems with memory and thinking due to reduced blood flow in your brain.

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