Medically reviewed by Nancy Hammond, MD
Written by Jon Johnson
Vascular dementia is damage in the brain that occurs due to reduced blood flow. People most often develop vascular dementia following a stroke, but there are several other potential causes and risk factors.
Vascular dementia is the second most common form of dementia after Alzheimer’s disease. It often affects memory, reasoning, and other thought processes.
Treatment may help slow or sometimes prevent the progression of the condition.
This article discusses the causes, symptoms, and methods of diagnosis of vascular dementia, as well as some treatment options.
What is vascular dementia?
Vascular dementia occurs when restricted blood flow to the brain damages brain cells. Without enough fresh blood flowing into the brain, cells can become damaged or die. The repair process in these cells is slow, and the body cannot always replace them.
The symptoms may occur suddenly, such as after a stroke or ischemic event. In other cases, cell damage can build up over time. If this is the case, the symptoms will gradually become worse.
The effects of vascular dementia may range from mild to severe. The symptoms can greatly impact a person’s quality of life and affect their ability to live independently.
Causes and risk factors
The cause of vascular dementia is a lack of blood flow in the brain. There are several different conditions that may cause this restriction, either gradually or straight away:
A stroke occurs when a blood vessel leading to the brain bursts or becomes blocked by a clot. Stroke can have many effects on the body, one of which is the development of vascular dementia.
Damaged or narrowed blood vessels
Damaged or narrowed blood vessels leading to the brain may also cause vascular dementia. Because of this, conditions that damage the blood vessels over time or cause them to narrow may also increase the risk of vascular dementia.
Other risk factors
The risk of vascular dementia tends to increase as a person gets older. In fact, the National Heart, Lung, and Blood Institute state that the condition affects almost one-third of people over the age of 70.
Also, a number of other factors and conditions may increase the risk of damaged blood vessels and vascular dementia, including:
- abnormal heart rhythms
- high cholesterol
- high blood pressure
- a history of heart attack or stroke
The effects of vascular dementia vary from person to person depending on where the blood flow in the brain is most limited. Some possible symptoms of vascular dementia include:
- trouble concentrating
- general confusion
- a sudden headache or numbness or paralysis on one side of the face or body, which mirror the symptoms of stroke
- difficulty paying attention
- difficulty analyzing problems or situations
- difficulty making decisions
- depression or mood changes
- personality changes
In some cases, such as when the symptoms appear following a stroke, the cause may be easy to pinpoint. In these cases, a doctor may refer to the symptoms as “post-stroke dementia.”
In other cases, however, the symptoms come on slowly over time, and they may not be immediately obvious to the person.
There is no single test to determine whether or not someone has vascular dementia. A doctor will perform a physical exam and ask about the person’s medical history and symptoms.
They may also perform tests to rule out other potential causes of the symptoms, including:
A doctor will likely recommend neurocognitive tests to examine the person’s mental abilities, including their:
- problem solving
These tests help doctors differentiate between types of dementia. For instance, the National Institute on Aging note that memory loss is more prominent in Alzheimer’s disease, whereas issues with organization, problem solving, and attention may be tied to vascular dementia.
Doctors may need to order laboratory tests to check for health indicators that are not apparent in a person’s recent medical history. This may include tests to check their cholesterol or blood sugar levels.
They may also order additional tests to help rule out other issues that may cause similar symptoms, such as vitamin deficiencies, anemia, and thyroid disorders.
Imaging tests of the brain can help doctors locate any visible damage or changes in the brain itself, such as the impact of trauma from a stroke.
The sections below describe some imaging tests a doctor may use to diagnose vascular dementia.
MRI scans use radio waves and a magnetic field to produce highly detailed images of the brain. This can help doctors accurately document changes in the brain due to strokes, transient ischemic attacks, or other issues in the blood vessels.
A doctor may also recommend a CT scan to show visible changes in the brain or blood vessels. A CT scan takes X-ray images from many angles and compiles them to make a 3D image.
A doctor may also recommend an ultrasound scan to check the carotid arteries, which are the main arteries leading to the brain. Ultrasound scans use high frequencies to take images of soft tissues in the body, such as the arteries.
Doctors will also likely check for signs of neurological damage by testing factors such as a person’s:
- balance and coordination
- sense of touch
- muscle tone and strength, including comparing one side of the body with the other to determine any changes
There is currently no cure for vascular dementia, as there is no way to reverse damage to the brain. However, it may be possible to slow or sometimes stop the progression of the condition by controlling certain risk factors.
A typical treatment plan for vascular dementia involves taking steps to manage the condition and control any other risk factors.
Doctors will work with the person and their family to make an individualized treatment plan.
Treatment will generally include medication or therapies to treat any underlying cardiovascular diseases, which may help reduce the risk of stroke or other ischemic events. Medications can help manage some of the symptoms, including memory problems.
Doctors will often recommend that the person takes steps to care for their health and reduce their risk factors for vascular dementia.
Home care and preventive measures are still helpful, even if a person already has vascular dementia.
Some tips for managing vascular dementia include:
- getting regular exercise
- maintaining a healthy weight
- eating a healthful diet
- maintaining a healthy blood pressure
- reducing cholesterol
- avoiding or quitting smoking
- limiting alcohol consumption
- controlling or preventing diabetes
- reducing stress levels
The prognosis will vary based on a number of factors, including how well the person can stick to their treatment plan and any home care tips the doctor provides.
Dementia in general and vascular dementia following a stroke can shorten a person’s expected life span. This is different for each person. People can ask their doctor about the outlook for their individual circumstances.
Treatment and prevention efforts can increase a person’s life span and quality of life.
Vascular dementia refers to damage in the brain from restricted blood flow. It may occur after a stroke or build up over time.
Although there is no outright cure for vascular dementia, it may be possible to slow or halt the progression of the condition.
Proper treatment will include controlling a person’s individual risk factors through medical therapies and making lifestyle changes. Doing so may significantly improve their quality of life and life expectancy.