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Vascular Dementia

Vascular dementia is a type of dementia that is caused by decreased blood flow that damages brain tissue. Symptoms of vascular dementia may occur suddenly, such as after a stroke, or occur slowly over time due to conditions that restrict blood flow.

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Understanding Vascular Dementia

What is vascular dementia?

Vascular dementia is the second most common form of dementia after Alzheimer’s disease. It's caused when decreased blood flow damages brain tissue. Blood flow to brain tissue may be reduced. Or it may be completely blocked by a blood clot.

Symptoms of vascular dementia may develop slowly. Or they may develop after a stroke or major surgery, such as heart bypass surgery or abdominal surgery.

Dementia and other related diseases and conditions are hard to tell apart because they share similar symptoms. Although vascular dementia is caused by problems with blood flow to the brain, this blood flow problem can develop in different ways. Examples of vascular dementia include:



The effect of decreased or no blood flow on the brain depends on the size and location of the area affected. If a small area in a part of the brain that controls memory is affected you may be "forgetful." But this doesn't always change your ability to carry on normal activities. If a larger area is affected, you may have trouble thinking clearly or solving problems. These problems may change your ability to function normally.



  • The number of people older than 65 years is growing.


What causes vascular dementia?


  • Blood clots.

  • Bleeding because of a ruptured blood vessel (such as from a stroke).


Who is at risk for vascular dementia?

Risk factors for vascular dementia include risk factors for the conditions linked to it, heart disease, stroke, diabetes, and atherosclerosis:

  • Increasing age.

  • High blood pressure.

  • Smoking.

  • High cholesterol and triglyceride levels.

  • Diabetes.

  • Metabolic syndrome.

  • Atrial fibrillation. This is fast and irregular heart rate of the upper two heart chambers.

  • High level of homocysteine in the blood. This can cause damage to blood vessels, heart disease, and blood clots.

  • Lack of physical activity.

  • Overweight.

  • Birth control pills.

  • Conditions that cause the blood to "thicken" (clot) more easily.

  • Family history of dementia.

What are the symptoms of vascular dementia?

The symptoms of vascular dementia depend on the location and amount of brain tissue involved. They may appear suddenly after a stroke, or slowly over time. Symptoms may get worse after another stroke, a heart attack, or major surgery. These are symptoms of vascular dementia

  • Increased trouble doing normal daily activities because of problems with concentration, communication, or inability to carry out instructions.

  • Memory problems. Short-term memory may not be affected.

  • Confusion, which may get worse at night. This is known as "sundown syndrome."

  • Stroke symptoms, such as sudden weakness and trouble with speech.

  • Personality changes.

  • Mood changes, such as depression or irritability.

  • Stride changes when walking too fast or shuffling steps.

  • Problems with movement, balance. or both.

  • Urinary problems, such as urgency or incontinence.

  • Tremors.

How is vascular dementia diagnosed?

Your healthcare provider will ask about your health history and do a physical exam. He or she may also order some of these tests:

  • Blood tests to look for other conditions causing your symptoms, such as vitamin deficiencies.

  • CT scan. This imaging test uses X-rays and a computer to make images of the brain. CT scans are more detailed than general X-rays.

  • Electroencephalogram (EEG). This test measures electrical activity in the brain.




How is vascular dementia treated?


Such treatments may include:


  • Lifestyle changes, such as a healthy diet, physical activity, quitting smoking, and stopping or decreasing alcohol use.

  • Procedures to improve blood flow to the brain, such as carotid endarterectomy, angioplasty, and stenting. The carotid arteries are located in the neck and provide blood flow from the heart to the brain.


Living with vascular dementia

Vascular dementia gets worse over time and has no cure. But the rate at which the disease gets worse can vary. The disease can be stable for long periods of time. Some people with vascular dementia may eventually need a high level of care because of the loss of mental and physical abilities. Family members may be able to care for a person with vascular dementia early on. But if the disease progresses, the person may need more specialized care.


Long-term care facilities that specialize in the care of people with dementia, Alzheimer’s, and other related conditions are often available if a person affected by vascular dementia can no longer be cared for at home. Your healthcare provider can recommend caregiver resources.

When should I call my healthcare provider?

People with vascular dementia and their caregivers should talk with their healthcare providers about when to call them. They will likely advise you to call if symptoms get worse. This can be obvious changes in behavior, personality, memory, or speech. You should also call if new symptoms appear, such as sudden weakness or confusion.

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