Vascular Dementia: Symptoms And Possible Treatments

Medically reviewed by Nikki Ciletti, M.Ed, LPC
Updated January 18, 2023by BetterHelp Editorial Team

Often considered the second most common form of dementia, vascular dementia or vascular cognitive impairment (VCI) tends to be underdiagnosed in the same manner as Alzheimer's disease. Second to Alzheimer's, they are both considered common, with vascular dementia making up roughly 10% of dementia cases. Without a cure, a diagnosis at any stage of vascular dementia can feel daunting, and a person may experience symptoms related to anxiety and depression on top of those they are already experiencing from dementia. Recognizing the symptoms of vascular dementia can help you spot it and potentially speed up the process of finding an effective treatment plan.  

Have You Received A Vascular Dementia Diagnosis?

What Is Vascular Dementia?

There are several different types of dementia, one of which is vascular dementia. This disease has its own unique symptoms, such as a general loss of cognition, impairment of memory, disorganized planning, and abstract thinking abilities. People living with vascular dementia experience these challenges as a result of a specific medical problem. The symptoms that arise in vascular dementia develop because of restricted blood flow to different parts of the brain, which can be caused by a number of medical conditions.

Some disorders that are known to contribute to or cause vascular dementia include cerebrovascular disease, central nervous system infection, brain trauma or tumors, vitamin deficiencies, metabolic and endocrine conditions, immune disorders, multiple sclerosis, Parkinson's disease, and more. All of these can lead to deterioration in intellectual functioning throughout different parts of the brain.

It is important to remember that vascular dementia may have a gradual onset or progression. Because the symptoms of vascular dementia are so similar to other types of dementia, it can be difficult to pinpoint and diagnose it.

What Are The Symptoms Of Vascular Dementia? 

Vascular dementia symptoms vary but often affect thinking, perception, and memory. These symptoms may follow a particular event that causes blood flow problems like a major stroke, or they may present more slowly over time. Depending on the part of your brain where blood flow has impinged, symptoms may differ or can even overlap if multiple areas are facing damaged blood flow. Vascular dementia signs and symptoms include:

  • Confusion or disorientation

  • Trouble speaking or understanding speech

  • Vision loss

  • Trouble paying attention or concentrating

  • Reduced ability to organize thoughts or actions

  • Declined ability to analyze situations 

  • Trouble effectively developing and communicating plans

  • Difficulty in deciding what to do next

  • Trouble remembering new or stored information

  • Feelings of restlessness and agitation

  • An unsteady gait

  • Sudden or frequent urges to urinate or an inability to control passing urine

  • Depression or apathy

How Can You Treat And Prevent Vascular Dementia?

While no drugs have been approved for vascular dementia treatment, evidence exists that some Alzheimer's drugs may be able to help people diagnosed with vascular dementia. Besides medication, certain kinds of therapy may be beneficial for people living with vascular dementia, depending on their symptoms and what stage of the disease they’re in. There are also steps that people can take to help increase blood flow in the brain and reduce damage to the brain's blood vessels. These actions will likely not treat or reverse vascular dementia but may help prevent progression into the more enervating stages of the disease.

Working with their physicians, people can develop a plan to extend their lifespan and maintain cognitive stabilization and recovery, especially after a stroke. It is important to consider the risks that can lead to strokes and other brain circulation issues. Many of these are the same as some risks to heart health like smoking, obesity, increased cholesterol, high blood pressure, and more. Many doctors recommend activities to treat vascular dementia, including:

  • Quitting smoking

  • Maintaining healthy blood pressure, cholesterol, and blood sugar levels

  • Eating according to a healthy diet

  • Exercising

  • Staying within a healthy weight range

  • Minimizing alcohol consumption

It is important to remember that these tips are also actions that can help to prevent vascular dementia. So, if you are already at risk for diabetes, obesity, high blood pressure or cholesterol, heart disease, or other vascular issues, vascular dementia could be possible, and these actions may help support your brain and cognitive health.

Causes And Risks Of Vascular Dementia

Vascular dementia results from conditions that damage your brain's blood vessels. When the blood vessels are impaired, it reduces their ability to supply your brain with the amount of nutrition and oxygen it needs to perform thought processes effectively. Common conditions that may cause vascular dementia include:

      • A stroke blocking a brain artery: These usually cause a range of symptoms that may include vascular dementia, but some don't cause any noticeable symptoms. Both silent and apparent strokes include an increased risk of vascular dementia, especially as the number of strokes increases over time.

      • Narrowed or chronically damaged brain blood vessels: Conditions that narrow or inflict long-term brain vessel damage include the wear and tear associated with aging, high blood pressure, abnormal aging of blood vessels (atherosclerosis), diabetes, and brain hemorrhage.

In general, the risk factors for vascular dementia are the same as those for heart disease and stroke. They include:

      • Increasing age (Vascular dementia rarely manifests before age 65, and the risk rises substantially by the 90s).

      • History of heart attack, strokes, or mini-strokes

      • Abnormal aging of blood vessels (atherosclerosis) occurs when deposits of cholesterol and other substances (plaques) build up in the arteries and narrow the blood vessels.

      • High cholestero

      • High blood pressure puts extra stress on blood vessels everywhere in the body, including the brain.

      • High glucose levels damage blood vessels throughout your body.

      • Smoking tobacco directly damages blood vessels, increasing the risk of atherosclerosis and other circulatory diseases. This is a common risk factor for vascular diseases in general.

      • Atrial fibrillation is an abnormal heart rhythm that causes the upper chambers of the heart to beat rapidly and irregularly, out of coordination with the lower chambers. This increases the risk of stroke by causing blood clots to form in the heart that can break off and go to the brain’s blood vessels.

What Are The Seven Stages Of Vascular Dementia?

The basic seven progressive stages of vascular dementia include the following:

      1. No Cognitive Decline: There is no true complaint of memory deficit at this point. Clinical interviews show no real memory decline.

      2. Very Mild Cognitive Decline: This is referred to as "Age-Associated Memory Impairment" where there are subjective complaints of memory deficit. These notes include forgetting where one has placed familiar objects and forgetting common names. However, the clinical interview shows no true memory decline or objective deficits in memory of regular daily events.

      3. Mild Cognitive Decline: Called "Mild Cognitive Impairment," this second stage of vascular dementia may show some more serious subjective notice of memory loss. Indicators include getting lost in travel, showing poor performance as noted at work, forgetting names more frequently, forgetting recently read content, losing valuable objects, and having difficulty concentrating. Some of these issues are clear in clinical interviews as well as in objective reviews, while the interviewee begins expression of denial or slight anxiety.

      4. Moderate Cognitive Decline: This is "Mild Dementia" where symptoms are more clearly discerned from a clinical interview. Memory loss includes the interviewee's personal history or recent events. There is also a deeper loss of ability to travel, manage finances, or recognize places, people, and time. Along with denial, the person may avoid situations where symptoms usually arise.

      5. Moderately Severe Cognitive Decline: In "Moderate Dementia" help is officially needed. During the clinical interview, the interviewee can't remember some piece of major personal details like their address or phone number, or even common details from the past like graduation date, the name of high school or college, or names of family. Some common mathematical or other tasks may be difficult, even counting backward in intervals. While people may still remember major facts about themselves and others, like their names and those closest to them, and need no assistance with physical tasks, some common daily activities like choosing clothes and making decisions may require assistance.

      6. Severe Cognitive Decline: This is "Moderately Severe Dementia" where people lose more valuable memories. They may forget their spouse’s name or lose total awareness. Things like the date and year, their surroundings, and the difference between familiar and unfamiliar faces may be unrecognizable or nonsensical. They may need help with traveling, managing incontinence, and navigating basic daily life. Their personality and mood may change, and there is a chance they may not recognize their own face in the mirror or talk at random to strangers while believing their spouse to be operating under a false identity. More symptoms set in and are often more severe. Without the ability to concentrate and think for long periods of time, people living with vascular dementia are often unable to make decisions.

      7. Very Severe Cognitive Decline: This is "Severe Dementia." It is the final stage, where a person progressively loses all verbal abilities. The interviewee may not speak at all or only mutter unintelligible phrases. They even lose basic motor abilities throughout this stage, where they are eventually unable to walk or carry out common activities. This means that the brain is unable to tell the body what to do. As time passes, the body begins to become rigid, and developmental neurological reflexes become present.

Have You Received A Vascular Dementia Diagnosis?

Online Therapy With BetterHelp

While there is currently no cure for vascular dementia, therapy can help people cope with its symptoms at different stages. Individuals living with vascular dementia are more likely to experience symptoms of depression and anxiety than people who aren’t living with vascular dementia. Online therapy can be a valuable experience for those with this disease, particularly if physical mobility is a challenge. It can also be beneficial for caregivers, who may be experiencing mental health concerns as they learn to care for their loved ones. 

By using a platform like BetterHelp, you can meet with qualified therapists at your convenience. There’s no need to drive long distances or even leave the house; rather, you can get care right from the comfort of your home. If you are struggling to verbalize your thoughts, there are numerous adaptive technology extensions that can integrate with BetterHelp’s video conferencing platform.

The Effectiveness Of Online Therapy

Vascular dementia can be a challenging diagnosis to cope with whether you have the condition yourself or are caring for someone with it. Both those with the disease and caregivers alike may experience mental health challenges like depression or anxiety. One study found that online cognitive behavioral therapy (CBT) was proven to be effective in treating participants experiencing symptoms of mental illness, including anxiety and depression. Participants experienced a reduction in their symptoms, showing the viability of an online-based intervention for mental health care.


It can be challenging to live with a condition that progressively impairs both motor and cognitive functioning. Likewise, caring for someone with this disorder can be difficult and require much patience and understanding. Support is available for people living with vascular dementia and their caregivers. Whether accessed one-on-one, with an advocate, or alongside family, online therapy can help people living with vascular dementia come to terms with their diagnosis, manage their symptoms, and find joy in their lives. Additionally, it can allow caregivers to process their feelings and learn how to care for their loved ones more effectively.

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