What Is Vascular Dementia?

Discover the causes, symptoms, and treatments for vascular dementia, a condition resulting from impaired blood flow to the brain, affecting memory, mood, and movement.
Published on
May 15, 2024
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Vascular dementia, a common form of cognitive decline, happens when there is impaired blood flow to the brain, leading to cell damage. This condition, also referred to as vascular cognitive impairment (VCI), ranges from mild to severe and can significantly impact memory, mood, and movement.

What is vascular dementia?

Vascular dementia results from poor blood flow harming brain cells. Similar to strokes, it can cause sudden thinking problems or gradual decline due to more minor strokes or blood vessel issues. Some experts prefer "vascular cognitive impairment" (VCI) as it highlights the range of thinking problems, from mild to severe. Vascular changes also occur with other dementia types like Alzheimer's.

Types of vascular dementia

By understanding the distinct types of vascular dementia, caregivers and healthcare providers can better tailor their approaches to diagnosis, treatment, and support for individuals affected by this condition.

Vascular cognitive impairment (VCI)

Vascular Cognitive Impairment (VCI) is considered a milder form of cognitive decline that does not yet reach the threshold of full-blown dementia. Individuals with VCI experience memory and thinking problems that are noticeable but not severe enough to interfere significantly with daily life. VCI can be a precursor to more severe forms of vascular dementia, and early detection and management of risk factors are crucial to slow its progression.

Multi-infarct dementia

Multi-infarct dementia occurs due to multiple small strokes, known as infarcts, that cause cumulative damage to different areas of the brain. Each stroke may have minimal impact, but these combined effects lead to significant cognitive decline. Symptoms can vary depending on which parts of the brain are affected, often resulting in a mix of mental and physical impairments, including memory loss, confusion, and difficulties with movement and coordination.

Post-stroke vascular dementia

Post-stroke vascular dementia develops after a significant stroke. When a stroke damages brain regions critical for memory, thinking, and other cognitive functions, it can lead to the immediate or gradual onset of dementia. The severity and specific symptoms of post-stroke vascular dementia depend on the location and extent of the brain damage caused by the stroke. Common symptoms include:

  • Memory problems
  • Difficulties with planning and organization
  • Changes in behavior and mood

Subcortical vascular dementia

Subcortical vascular dementia affects deeper parts of the brain, such as the white matter and basal ganglia. This type of dementia is characterized by problems with body movement, cognitive functions, and mood. Individuals with subcortical vascular dementia may experience slower thinking, difficulties with walking and balance, and emotional changes such as apathy or depression. This form of dementia is often associated with conditions like small vessel disease, which affects the smaller blood vessels in the brain.


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Causes and risk factors of vascular dementia

Vascular dementia is caused when reduced blood flow damages brain cells. Several risk factors increase the likelihood of developing vascular dementia, some of which are beyond one's control.

Non-modifiable risk factors

  • Age: The risk of vascular dementia increases significantly with age. Older adults are more likely to experience conditions like high blood pressure and diabetes, which can contribute to vascular dementia.
  • Family history: Genetics can play a role in the risk of vascular dementia. Having a family history of stroke, heart disease, or dementia can increase your likelihood of developing the condition.
  • Ethnicity: Some studies suggest that certain ethnic groups, including African Americans and Hispanics, may have a higher risk of vascular dementia, partly due to higher rates of hypertension and diabetes.

Modifiable risk factors

  • Smoking: Smoking cigarettes damages blood vessels throughout the body, including those in the brain. The chemicals in tobacco smoke contribute to the narrowing and hardening of arteries (atherosclerosis), which impedes blood flow to the brain and increases the risk of stroke and vascular dementia.
  • High blood pressure (hypertension): Chronic high blood pressure strains blood vessels, weakening them over time and making them more susceptible to damage. This can lead to strokes and other issues that contribute to vascular dementia.
  • Diabetes: High blood sugar levels associated with diabetes can damage blood vessels and nerves, including the brain. Poorly managed diabetes significantly increases the risk of developing vascular dementia.
  • High cholesterol: Elevated cholesterol levels can lead to plaque buildup in the arteries, known as atherosclerosis, which reduces blood flow to the brain and can cause strokes or mini-strokes (transient ischemic attacks), contributing to the development of vascular dementia.
  • Unhealthy Diet: Diets low in fruits, vegetables, and whole grains and high in saturated fats, trans fats, and sugar can negatively impact cardiovascular health. Poor nutrition contributes to conditions like high blood pressure, high cholesterol, and obesity, which are all risk factors for vascular dementia.
  • Being overweight or obese: Excess body weight increases the strain on your heart and blood vessels, leading to hypertension and diabetes. Obesity is a significant risk factor for cardiovascular diseases, which in turn increases the risk of vascular dementia.
  • Too little physical activity: A sedentary lifestyle contributes to several risk factors for vascular dementia, including obesity, high blood pressure, and diabetes. Regular physical activity helps maintain healthy blood vessels and improves overall cardiovascular health.
  • Excessive alcohol: Drinking large amounts of alcohol can raise blood pressure and contribute to the development of vascular diseases. Limiting alcohol intake to moderate levels can help reduce this risk.

Connection between heart disease and vascular dementia

Heart disease and vascular dementia share common risk factors such as high blood pressure and diabetes. These conditions damage blood vessels, including those in the brain, reducing oxygen and nutrient supply to brain cells. This damage can lead to memory problems, difficulties with thinking, and mood swings.

Family caregivers may notice these changes in their loved ones. If you have concerns about vascular dementia, it's important to talk to a doctor. Early diagnosis and effective management of risk factors can significantly improve the overall prognosis and quality of life for individuals with vascular dementia.

Symptoms and diagnosis

Vascular dementia can be challenging to diagnose because its symptoms can vary widely and overlap with other types of dementia. Common symptoms include difficulties with planning and organizing, problems with memory, and changes in behavior and mood.

Cognitive and behavioral symptoms

Individuals with vascular dementia often have trouble with tasks that require planning, decision-making, and following multi-step instructions. Memory problems are common, such as forgetting recent events or important appointments. Additionally, changes in mood and behavior, including increased irritability, depression, or sudden anger, can occur.

Communication problems

Communication issues are frequently seen in vascular dementia. These may include difficulty finding the right words, speaking in complete sentences, or needing help understanding written text. Repeating the same questions or statements and forgetting familiar names can also be indicators.


Diagnosing vascular dementia involves a combination of medical history evaluation, physical exams, and cognitive tests. Doctors may use brain imaging techniques like MRI or CT scans to identify blood flow changes or brain tissue damage. Cognitive tests assess memory, problem-solving abilities, and other mental functions. Early and accurate diagnosis is essential for managing the condition effectively and improving the quality of life for those affected.

The importance of early detection

It is important to catch vascular dementia early. Early diagnosis allows treatment to manage symptoms and improve your loved one's quality of life. When family caregivers notice dementia symptoms, they should call the primary care doctor for a proper evaluation. 


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How to manage vascular dementia

Vascular dementia may not have a cure, but treatments will manage symptoms and better overall quality of life.


While there are no medications specifically approved to target the memory loss caused by vascular dementia, several drugs can help manage its symptoms and associated conditions. These medications can improve the overall quality of life for individuals with vascular dementia by addressing issues such as depression, anxiety, sleep disturbances, and underlying health conditions.

Medications for symptoms


  • Selective Serotonin Reuptake Inhibitors (SSRIs): Medications like sertraline (Zoloft), fluoxetine (Prozac), and citalopram (Celexa) can help manage depression and anxiety.
  • Tricyclic antidepressants (TCAs): Though less commonly used due to side effects, medications like amitriptyline can be effective in treating depression.


  • Atypical antipsychotics: Medications such as risperidone (Risperdal), quetiapine (Seroquel), and olanzapine (Zyprexa) can help manage severe agitation, hallucinations, and delusions that may occur in some individuals with vascular dementia. 


  • Benzodiazepines: Drugs like lorazepam (Ativan) and diazepam (Valium) can be used short-term to alleviate acute anxiety.

Sleep aids

  • Melatonin: A natural hormone that regulates sleep-wake cycles, melatonin supplements can help improve sleep patterns in individuals with vascular dementia.
  • Non-benzodiazepine sleep medications: Drugs such as zolpidem (Ambien) and eszopiclone (Lunesta) can be prescribed for sleep disturbances (used cautiously).

Medications for underlying health conditions


  • ACE Inhibitors and Angiotensin II Receptor Blockers (ARBs): Medications like lisinopril (Prinivil) and losartan (Cozaar) help control high blood pressure.
  • Calcium channel blockers: Drugs such as amlodipine (Norvasc) can also be used to manage hypertension and improve blood flow.

Antidiabetic medications

  • Metformin: A common medication for managing blood sugar levels in individuals with diabetes, helping to reduce vascular damage.
  • Insulin: For individuals requiring more intensive glucose control, insulin therapy can be essential in preventing complications from diabetes.

Cholesterol-lowering medications

  • Statins: Medications like atorvastatin (Lipitor) and simvastatin (Zocor) help lower cholesterol levels and reduce the risk of atherosclerosis, which can impair blood flow to the brain.

Medications for blood flow and clot prevention

Antiplatelet agents

  • Aspirin: Low-dose aspirin is often prescribed to prevent blood clots, which can reduce the risk of strokes and mini-strokes that contribute to vascular dementia.
  • Clopidogrel (Plavix): Another antiplatelet medication that helps prevent clots and maintain healthy blood flow to the brain.


  • Warfarin (Coumadin) and newer anticoagulants: These medications, such as apixaban (Eliquis) and rivaroxaban (Xarelto), help prevent blood clot formation, especially in individuals with atrial fibrillation, reducing the risk of stroke.

Lifestyle changes and diet

A healthy diet low in saturated fats and salt, regular exercise, and quitting smoking can all make a difference. Staying active goes beyond physical health - it can also improve mood, thinking, and daily activities.

Ongoing care and support

As vascular dementia progresses, your loved one may need more support with personal care, managing finances, or medication reminders. 

Speech therapy can help with communication difficulties, while occupational therapy can teach new ways to manage daily tasks.

Future directions

Researchers are actively exploring ways to combat vascular dementia. Some promising avenues include testing medications that improve blood flow to the brain. These new medicines also protect brain cells from damage. Additionally, scientists are investigating the role of healthy habits like diet and exercise in preventing or slowing down the disease. 

Vascular dementia clinical trials

Clinical trials play an important role. By involving people with vascular dementia in these studies, researchers test the effectiveness and safety of new treatments, ultimately paving the way for better ways to manage and prevent this condition.

Remember, every person with vascular dementia experiences the disease differently. Working with your loved one's primary care doctor, create a personalized care plan to manage dementia symptoms and provide the best support throughout this challenging journey.

A note from Givers

Although vascular dementia presents numerous challenges, early detection and management of risk factors can improve the quality of life for those affected. By working closely with healthcare providers and staying informed about emerging treatments and lifestyle modifications, family caregivers can help their loved ones navigate this condition more effectively.

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