Understanding key risk factors, prevention strategies, and treatment options is vital for equipping you with the tools to make informed decisions about your future health.
Key takeaways
- People with vascular dementia often have difficulty with executive functioning (the ability to plan and undertake actions) and maintaining attention. Memory and language function may also be impacted.
- A range of genetic and lifestyle risk factors, as well as the presence of other chronic diseases, all contribute to the development of vascular dementia.
- Treatment involves lifestyle changes, medication, and a wide range of supportive therapies.
Understanding vascular dementia
Vascular dementia occurs when the blood vessels that supply oxygen and vital nutrients to the brain become damaged. These changes often occur over time (e.g., due to vessel narrowing caused by cholesterol deposits), but can also happen suddenly (for example, following a stroke). [1]
People with vascular dementia experience changes in normal brain function, which can affect attention, memory, decision-making, language, and information processing. [1]
How common is it?
Dementia affects around 50 million people worldwide. Vascular dementia is the second most common form of dementia (after Alzheimer’s disease), accounting for 15-20% of cases. [2]
The average age of onset for vascular dementia is 68 years. However, people can develop vascular dementia much younger or much older, depending on a wide range of risk factors. [2]
How is it different from other forms of dementia?
Unlike Alzheimer’s disease, vascular dementia is considered ‘nondegenerative’. This means that the decline in brain tissue function is not due to the abnormal deterioration of the cells themselves, but is driven by external factors (such as reduced blood flow, infections, or traumatic injury). [3]
People with vascular dementia may have subtle differences in symptom patterns, as well as additional risk factors for blood vessel disease, that point clinicians towards a diagnosis of vascular dementia over other forms of dementia. [1]
Symptoms
The symptoms of vascular dementia are wide-ranging and often overlap with other forms of dementia. However, the pattern and timing of symptoms can provide clues about the cause of decline in thinking and memory function.
Executive functioning
Executive functioning refers to the group of mental processes that can help an individual to plan, focus, and manage their actions and behaviors. Unlike Alzheimer’s dementia, where memory and word-finding are often more prominently affected, people with vascular dementia are more likely to struggle with these executive functions. [1]
Key components of executive function include: [4]
- Impulse control - the ability to control your behaviors and actions in the face of intense emotional desires.
- Working memory - the ability to hold information in your mind and actively use it (e.g., using information to solve a problem).
- Flexibility in thinking - being able to change perspectives or approaches to fix a problem.
- Reasoning and logic - being able to apply information rationally to make reasonable assertions (also known as critical thinking).
Attention
People with vascular dementia are more likely to struggle to maintain attention. This can include struggling to follow a conversation, being unaware of events unfolding around them, or having difficulty completing a multi-step task. Again, this is a more prominent feature of vascular dementia when compared to Alzheimer’s disease. [1]
Memory
Both short and long-term memory can be impacted in any form of dementia. This can range from forgetting where you put the car keys to being unable to recognize family members. In vascular dementia, memory issues tend to appear after difficulties with executive function and attention have already developed. [1]
Language
People with vascular dementia may struggle with understanding, processing, or communicating through language. Individuals may become frustrated with word-finding, or even be unaware that they are beginning to talk nonsensically. The intensity of language difficulties often relates to the severity of their condition, and may even point to a mixed Alzheimer’s and vascular dementia picture. [1]
Risk factors
There is no single ‘cause’ of vascular dementia. As such, it can be helpful to think about the various contributing causes as risk factors.
Non-modifiable risk factors
Non-modifiable risk factors are things outside of your control, primarily related to your individual genetic makeup. Important non-modifiable risk factors include: [1] [5]
- Older age (generally over 65\)
- Male sex
- Family history of dementia
- Family history of heart and blood vessel disease
- Specific gene variants (primarily the APOE ε4 genotype)
Modifiable risk factors
Modifiable risk factors are sometimes also referred to as lifestyle risk factors. They are changeable habits that contribute to your risk of developing vascular dementia. Key modifiable risk factors include: [1] [6]
- Smoking
- Obesity
- Lack of physical exercise
- Long-term heavy alcohol use
- High cholesterol diet
- High salt diet
- Air pollution
Other diseases and conditions
The presence of other medical conditions has a significant impact on the likelihood of developing vascular dementia. It’s essential to recognize that each condition has its own unique set of modifiable and non-modifiable risk factors. The extent to which each medical condition is adequately controlled and treated can also have an impact on the risk of developing vascular dementia. [1]
Conditions that can contribute to your risk of developing vascular dementia include: [6]
- High blood pressure (the single most impactful risk factor when not appropriately controlled)
- Diabetes
- Chronic kidney disease
- Heart and blood vessel conditions (including atrial fibrillation, heart disease, heart failure, and peripheral vascular disease)
- Stroke and mini-stroke
- Cancer
Prevention
It is impossible to prevent the development of vascular dementia entirely. However, steps can be taken to address modifiable risk factors and ensure existing conditions are well-controlled. You can:
- Quit smoking
- Cut down on alcohol use
- Engage in regular exercise
- Switch to a low-salt and low-fat diet
- Ensure that your blood pressure is well-controlled through lifestyle changes and medication
- With diabetes, make sure your sugars remain in check
Diagnosing vascular dementia
The diagnosis of vascular dementia requires a detailed and holistic assessment from your physician. They will evaluate your symptoms, risk factors, medication, mood, and current functional abilities. This assessment aims to differentiate between the various types of dementia, as well as to identify other reasons behind changes in thinking and memory function. [1]
Your provider will then want to do a physical examination, looking for evidence of peripheral vascular disease, a heart condition, or other contributing chronic diseases. [1]
Tests and assessments
The initial workup of a vascular dementia diagnosis involves a comprehensive blood test. Physicians will look for evidence of heart or blood vessel disease, as well as any other potential causes of changes in thinking and memory. [1]
Brain imaging is the cornerstone of dementia diagnosis. A non-contrast magnetic resonance imaging (MRI) scan is the gold standard for assessing changes in the brain. Radiologists will look for evidence of shrinking brain tissue, paying particular attention to the distribution and pattern to differentiate the various types of dementia. [1]
Some healthcare providers will arrange for a neuropsychological assessment. This is a specialized evaluation that examines cognitive, emotional, and behavioral patterns, providing the practitioner with insight into the impact that symptoms have on daily functioning. [1] [7]
Treatment options
Although it cannot be cured, there are a variety of options when it comes to successfully managing vascular dementia. For more information on which therapies are right for you, consult your healthcare provider.
Lifestyle modifications
Addressing risk factors is a core part of vascular dementia treatment. The control of blood pressure and cholesterol levels has been proven to lessen symptom severity and improve quality of life. [1]
Stopping smoking, reducing alcohol intake, and improving your diet can all be beneficial. Certain medications may also be needed to address chronic health risk factors, including statins (to reduce cholesterol) and antihypertensives (to control blood pressure). [1]
Medications
There are no drug therapies specifically approved for the treatment of vascular dementia. Cholinesterase inhibitors are a group of drugs used for the treatment of other types of dementia (primarily Alzheimer’s disease) that clinicians may prescribe ‘off-label’. Some people may experience improved memory and overall cognitive function when taking these medications. [1] [8]
Cholinesterase inhibitors used for the treatment of dementia include: [8]
- Donepezil
- Rivastigmine
- Galantamine
Supportive therapies
A wide range of healthcare specialists can help improve the quality of life of people with vascular dementia, including: [1]
- Nutritional specialists
- Cognitive rehabilitation practitioners
- Physical and occupational therapists
- Speech and language therapists
- Audiologists
- Psychological services
- Older persons care coordinators
Living with vascular dementia
Receiving a vascular dementia diagnosis can be scary. You may be worried about what happens as the disease progresses and its effect on your ability to care for yourself. It’s essential to understand that treatments, including lifestyle modifications, can significantly reduce the impact of symptoms and enhance overall quality of life.
A wide range of professionals can support you in continuing to live a fulfilling life. For example, occupational therapists can implement home adaptations focused on maximizing independence, and social workers can provide access to community programs and advice services.
You don’t need to go through a diagnosis of vascular dementia alone. Reach out to your physician, psychological services, friends, and family when you need that extra support.
Caring for someone with vascular dementia
Caring for someone with vascular dementia can be challenging. The disease can affect your loved one’s personality and behaviors, often in ways that can be distressing.
Patience, compassion, and clear communication are essential when caring for your loved one. Remember to utilize support services for advice and guidance, as well as access support for your own mental health and well-being.
Further resources and support
For further information, the Alzheimer’s Association is a non-profit organization that offers free advice and guidance, as well as access to support groups for individuals with all types of dementia. They also provide support to family members and carers.
Your healthcare provider can also signpost you towards relevant support services in your area.
References
1.
Vascular Dementia
Uwagbai, O., & Kalish, V. B. (2023, October 22). Vascular Dementia. PubMed; StatPearls Publishing.
Source: StatPearls Publishing
2.
Neurovascular Alterations in Vascular Dementia: Emphasis on Risk Factors
Lecordier, S., Manrique-Castano, D., El Moghrabi, Y., & ElAli, A. (2021). Neurovascular Alterations in Vascular Dementia: Emphasis on Risk Factors. Frontiers in Aging Neuroscience, 13.
Source: Frontiers in Aging Neuroscience
3.
Endocrine, metabolic, nutritional, and toxic disorders leading to dementia
Ghosh, A. (2010). Endocrine, metabolic, nutritional, and toxic disorders leading to dementia. Annals of Indian Academy of Neurology, 13(Suppl2), S63–S68.
Source: Annals of Indian Academy of Neurology
4.
Executive functions
Diamond, A. (2013). Executive functions. Annual Review of Psychology, 64(1), 135–168.
Source: Annual Review of Psychology
5.
Vascular Dementia and Underlying Sex Differences
Akhter, F., Persaud, A., Zaokari, Y., Zhao, Z., & Zhu, D. (2021). Vascular Dementia and Underlying Sex Differences. Frontiers in Aging Neuroscience, 13(13).
Source: Frontiers in Aging Neuroscience
6.
Vascular Dementia: From Pathobiology to Emerging Perspectives
Amy Elizabeth Morgan, & Tomás, M. (2024). Vascular Dementia: From Pathobiology to Emerging Perspectives. Ageing Research Reviews, 96, 102278–102278.
Source: Ageing Research Reviews
7.
Neuropsychological Assessment & Treatment
Neuropsychological Assessment & Treatment. (2012, April 5). North Bristol NHS Trust.
Source: North Bristol NHS Trust
8.
Cholinesterase Inhibitors
Singh, R., & Sadiq, N. M. (2023, July 17). Cholinesterase Inhibitors. National Library of Medicine; StatPearls Publishing.
Source: StatPearls Publishing
Author
Olly SmithWith over 7 years of experience in frontline healthcare, Olly specializes in communicating complex health topics in an accessible way. He is passionate about empowering people through knowledge and has a particular interest in mental health.
Activity History - Last updated: March 19, 2026, Published date: March 19, 2026
Reviewer
Dr. Jennifer Brown is dual board-certified in family medicine and obesity medicine. She currently works for Amwell Medical Group, providing virtual primary care services, including mental health treatment.
Activity History - Medically reviewed on April 14, 2026 and last checked on March 19, 2026
