What Is Vascular Dementia?

What are the symptoms of vascular dementia?

When people think about dementia, they tend to think about memory loss. That’s because memory loss is the major symptom of Alzheimer’s, which makes up 60 to 80 percent of all dementia diagnoses, according to the Alzheimer’s Association.

Vascular dementia presents itself a little differently. People with vascular dementia often have fewer memory problems but struggle with the skills they use to manage everyday tasks. Common symptoms include:

• Difficulty planning and organizing
• Slowed thinking
• Mobility issues, such as trouble walking 

Memory does become an issue in more advanced stages of the disease. But early symptoms have less to do with memory loss and look more like struggling to follow a recipe or use digital banking, says Jeff Williamson, M.D., chief of geriatric medicine and gerontology at Wake Forest School of Medicine in Winston-Salem, North Carolina.

For instance, “maybe you know where you’re going in the car, but you’re having trouble remembering two or three turns in between,” he says. 

Another difference can be spotted in a common test used to diagnose dementia. Doctors will sometimes ask people to list categories, like naming animals. People with Alzheimer’s may struggle to remember animal names. People with vascular dementia, on the other hand, can often complete the category task but will take longer to finish it than in the past, Williamson says.

However, “there’s quite a lot of variability [in symptoms], depending on what parts of the brain have been affected,” Levinson says. Vascular dementia and Alzheimer’s disease often occur together, so people with both might experience memory loss along with the other symptoms mentioned above in earlier stages of their disorders. Only about 5 to 10 percent of people with dementia have vascular dementia alone.

How is vascular dementia diagnosed?

Vascular dementia is diagnosed through an MRI of the brain. Usually, a patient or someone close to them will notice that they’re struggling with tasks they used to do easily. For instance, people might find that they have difficulty making sense of a menu. Doctors will use a cognitive exam, such as the clock-drawing test, to see if their patient is showing signs of dementia. If they are, then the physician will run several types of tests to determine what type of dementia the patient has. Blood tests are used to look for amyloid and tau, the proteins that build up and indicate Alzheimer’s. Doctors will also look at a patient’s medical history to see whether they have any risk factors for vascular dementia, like high blood pressure or a previous stroke. MRI is then used to look for abnormalities in brain tissues and blood vessels.

What are the stages of vascular dementia?

Vascular dementia is inherently a disabling disease. Anyone can develop vascular dementia, but it is most common in people age 65 and over, according to Dementia UK. The risk of developing vascular dementia doubles every five years starting at age 65. On average, people live four to nine years after their diagnosis, Williamson says. About half that time can be spent in a highly disabled state.

People in the earliest stages of vascular dementia will experience a decline in their thinking skills. This can impact their ability to do certain tasks. They might need support with some aspects of life, like paying bills and getting groceries.

Later stages are far more disruptive. People with moderate to advanced vascular dementia might struggle to perform basic tasks, like feeding and cleaning themselves. At this stage, memory loss becomes “indistinguishable” from Alzheimer’s, Williamson says. Mobility also becomes a major issue, and patients often have difficulty walking and need a cane or walker to get around.

Advanced vascular dementia can also have psychological aspects that “can be pretty distressing for families as well as the patients,” Levinson says. People with vascular dementia have higher rates of depression and apathy, and may even experience hallucinations.

How is vascular dementia treated?

There is no cure for vascular dementia. But treating the underlying causes, such as managing blood pressure or quitting smoking, may help slow the progression of the disease for some people.

Diagnosing vascular dementia while it’s still in its early stages is crucial for interventions to work, says Yasuteru Inoue, M.D., a neurology and research fellow at the Mayo Clinic in Jacksonville, Florida. “My experience is that many patients do not come to the hospital until their symptoms are very, very evident,” he says.

There are no medications approved to directly treat vascular dementia. Aside from treatments for underlying causes, such as blood pressure medications or insulin for diabetes, the physicians who spoke with AARP recommended a brain-healthy lifestyle. That means staying socially active and mentally engaged after the diagnosis, eating a healthy diet and exercising. 

Preventing dementia in the first place is also a goal. People who’ve had strokes may receive anticoagulant medications to lower their chances of developing vascular dementia. Studies suggest that keeping blood pressure below 120 systolic (the top number) can reduce the chance of people developing dementia.

For people who have been diagnosed, vascular dementia “is going to interfere with aspects of their independence,” says Levinson. “That said, people can live with vascular dementia and live well.”