What is vascular dementia?

Vascular dementia is dementia caused by reduced blood flow to the brain, most often after strokes or from damage to small blood vessels. MedlinePlus calls it the second most common cause of dementia after Alzheimer's disease in people over 65. Early symptoms are more often slowed thinking and poor planning than memory loss, and many people have it alongside Alzheimer's.

Vascular dementia often progresses in steps rather than a steady decline, with a noticeable drop after each stroke and periods of stability in between. MedlinePlus notes that symptoms may also develop gradually, especially when small blood vessels are damaged slowly over time. The pace varies widely between people, so a doctor is the best guide to an individual's likely course.

Some of the risk can be lowered, which is not true of most other dementias. MedlinePlus lists high blood pressure, diabetes, heart disease, hardening of the arteries, smoking and stroke as risk factors, and managing them can help prevent further strokes and slow the decline. There is no guarantee of prevention, so talk with a doctor about your own risk factors and targets.

Vascular dementia is diagnosed by a doctor who reviews symptoms, medical history and risk factors such as past strokes or high blood pressure, and tests memory and thinking. MedlinePlus notes that a head CT scan or brain MRI can show evidence of earlier strokes. Other conditions that cause similar symptoms are ruled out, and a specialist such as a neurologist may be involved.

No. MedlinePlus states there is no treatment to repair brain damage caused by small strokes. Treatment instead aims to prevent further strokes, mainly by controlling blood pressure, diabetes and cholesterol and not smoking, which can slow the decline. Care and support help with daily life. Anyone with a sudden change in thinking, sensation or movement should call 911.