Vascular dementia results from conditions that damage blood vessels and block blood flow to your brain. Many of these conditions, like heart disease, diabetes, high blood pressure and high cholesterol, are manageable or even preventable. There’s no direct treatment or cure for vascular dementia, so managing these risk factors is crucial to prevent it from becoming more severe.
Vascular dementia is a common type of dementia that happens when there’s decreased blood flow to areas of your brain. The resulting lack of oxygen and nutrients damages brain tissue. This leads to a decline in mental (cognitive) functions that’s severe enough to interfere with daily living. Several conditions can contribute to a lack of blood flow, including stroke.
Vascular dementia is among the most common causes of dementia in people over 65 in North America and Europe. Researchers estimate that 5% to 10% of people with dementia have just vascular dementia. But vascular dementia is more commonly present with Alzheimer’s disease. Providers call this mixed dementia (when you have more than one cause of dementia).
Healthcare providers may use the term “vascular cognitive impairment” (VCI) instead of “vascular dementia.” This is because it represents the wide range of severity in thinking changes that can result from vascular damage — from mild cognitive impairment (MCI) to dementia.
Receiving a dementia diagnosis can turn your life upside down. You and your loved ones may worry about what lies ahead. Vascular dementia affects each person differently, so lean on your healthcare team to guide you through the journey and what to expect.
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Symptoms of vascular dementia can vary widely. They depend on the area(s) of your brain that are affected and the extent of the damage. Symptoms may include:
It’s important to see your healthcare provider if you or a loved one develop these symptoms.
There are no definitive stages of vascular dementia — it affects each person differently and progresses in a variety of ways depending on which areas of your brain are affected and the severity.
Most commonly, the symptoms appear in steps over the course of years. But they may be most obvious and sudden after a major stroke. There may even be short periods when symptoms improve. But if more strokes happen, they can cause further decline.
Vascular dementia can also happen alongside another form of dementia, like Alzheimer’s disease, which can impact how the symptoms progress.
Conditions that damage blood vessels in your brain or partially or fully block blood flow cause vascular dementia. Decreased blood flow results in a lack of oxygen and nutrients to parts of your brain. Without these, brain cells begin to die.
Common causes of vascular dementia include:
Certain factors increase your risk of experiencing these blood vessel issues and vascular dementia, including:
Healthcare providers use different terms for vascular dementia that reflect the number and type of blood vessels involved and the way the symptoms progress. They include:
Vascular dementia itself isn’t hereditary (genetic). But the conditions that contribute to it can run in biological families, like high blood pressure and heart disease.
Two rare forms of vascular dementia result from multiple strokes happening in the context of mutations (changes) in certain genes. Both mainly affect the small blood vessels in the white matter of your brain. They are:
Symptoms unique to CADASIL are migraine headaches and repeated strokes. Common symptoms of CARASIL are stiffness in your legs and difficulty walking.
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Confirming a diagnosis of vascular dementia needs evaluation by a specialist. There are many forms of dementia, and several of its symptoms overlap with other conditions.
Your healthcare provider will:
They’ll then likely recommend a variety of tests, including laboratory, imaging and neurocognitive tests. You may need to see dementia specialists, like neurologists and geriatricians to get a diagnosis.
Laboratory tests rule out other conditions as the cause of dementia symptoms, like infection, inflammation, hypothyroidism and vitamin deficiency (especially vitamin B12).
Sometimes, providers order cerebrospinal fluid (CSF) tests (via a spinal tap) to check for autoimmune conditions and neurodegenerative diseases.
Your provider may order the following imaging tests of your brain:
During neuropsychological testing, your provider uses written and computerized tests to evaluate your mental abilities, including:
Specially trained psychologists — neuropsychologists — then look at the results to better understand the relationship between your brain health and thinking (cognition).
Healthcare providers use the following criteria to diagnose vascular dementia:
These criteria suggest the greatest likelihood that mild cognitive impairment (MCI) or dementia is due to vascular damage and not another cause.
Vascular dementia isn’t reversible, unfortunately — once your brain is damaged, it can’t be repaired completely. Instead, the main goal of vascular dementia treatment is to prevent or slow down further damage by managing risk factors. Treatment also involves helping you find new ways of doing things to compensate for the damage in your brain.
Unlike for Alzheimer’s disease, there aren’t any medications that have U.S. Food and Drug Administration (FDA) approval for this condition specifically. But providers may prescribe cholinesterase inhibitors for vascular dementia. Studies show that they may result in modest cognitive improvements by helping to increase blood flow in your brain.
Memantine is another medication that’s approved for Alzheimer’s disease and may help with vascular dementia.
Your provider may prescribe other medications to help manage risk factors for stroke. These include medications for high blood pressure, high cholesterol and diabetes.
You may work with specialists to help manage symptoms of vascular dementia. For example, physical and occupational therapists can help you improve your physical abilities and find new ways of doing everyday tasks. A speech-language pathologist can help with speaking, swallowing and learning other ways to communicate.
Other specialists you may work with include:
These specialists will work with you and your loved ones to make sure you have ongoing care that matches your needs and goals. They’ll advise you and your loved ones on advance care planning for financial and healthcare decisions. They’ll also make referrals for palliative care or hospice when vascular dementia has progressed to its later or end stages.
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You can’t change some of the risk factors for the condition, like your age or genetics. But you can manage many other risk factors for the condition to try to prevent it — mainly those that damage your blood vessels. Steps you can take include:
Vascular dementia is unique from many other forms of dementia in that it’s partly preventable. If you have any of these risk factors, talk to your provider about what you can do to manage them.
Vascular dementia may get worse over time. The changes can happen in sudden steps or gradually. Each person has their own unique journey. Treatments may help slow the progress of the disease. You and your healthcare provider will work together to develop a treatment plan best suited for managing your symptoms and the stage of the disease.
Lean on loved ones for support during this time. Together, you can make a plan to ensure your quality of life and wishes are respected as dementia progresses.
A person with vascular dementia will need help with at least some aspects of daily function, like managing medications, paying bills or preparing food. Your loved one with this condition may be able to do many things for themselves. But it may not be safe for them to live alone, depending on what abilities are affected. For some people with vascular dementia, more specialized care may be required from facilities that care specifically for people with dementia.
The life expectancy for someone with this condition depends on the severity of the disease. Vascular dementia has wide-ranging severity and affects each person differently.
This life expectancy is lower than it is for people with Alzheimer’s disease because someone with vascular dementia is more likely to die from a stroke or heart attack than from dementia itself.
It’s difficult to pinpoint the exact end-of-life symptoms of vascular dementia. It may be more helpful to think of how dementia has affected your loved one holistically. By the later stage of dementia, it’ll have a severe impact on most aspects of your loved one’s life. They’ll need full-time care and support.
Late-stage or end-of-life symptoms may include:
Your loved one’s healthcare team, hospice nurse or palliative care provider are the best people to ask about timelines. They can tell what signs to watch for, so you have a general idea of what to expect.
You or your caregiver should call your healthcare provider if you notice any worsening of your symptoms or when new symptoms appear. Your provider or healthcare team will want to assess any changes and make adjustments to your treatment plan if needed.
If you or a loved one has vascular dementia, know that you’re not alone. Almost everyone has been touched by dementia in one or more of its many forms. Knowing the diagnosis gives you and your family time to prepare and plan for your future. You can learn about the type of care you may need and where you wish to receive it. Your entire healthcare team is ready to help you.
Last reviewed on 07/22/2024.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy