About Vascular Dementia

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

Symptoms of vascular dementia may develop gradually, or may become apparent 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 signs and 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:

  • Mixed dementia. This type occurs when symptoms of both vascular dementia and Alzheimer's exist. 
  • Multi-infarct dementia. This occurs after repeated small, often "silent," blockages affect blood flow to a certain part of the brain. The changes that occur after each blockage may not be apparent, but over time, the combined effect starts to cause symptoms of impairment. Multi-infarct dementia is also called vascular cognitive impairment.

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

Researchers think that vascular dementia will become more common in the next few decades because:

  • Vascular dementia is generally caused by conditions that occur most often in older people, such as atherosclerosis (hardening of the arteries), heart disease, and stroke.
  • The number of people older than 65 years is increasing.
  • People are living longer with chronic diseases, such as heart disease and diabetes.

Vascular dementia is a progressive disease that has no cure, but the rate at which the disease progresses can vary. Some people with vascular dementia may eventually need a high level of care due to 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.

Respite programs, adult daycare programs, and other resources can help the caregiver get some time away from the demands of caring for a loved one with vascular dementia.

Long-term care facilities that specialize in the care of people with dementias, 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.