Vascular Dementia: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Vascular Dementia?
A neurologist, a doctor who treats brain and nerve conditions, often helps with vascular dementia. A primary care doctor can do first checks and refer you to a memory clinic or another specialist. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is vascular dementia?
Vascular dementia is a common type of dementia caused by reduced blood flow to the brain. Dementia is a loss of brain function. It affects memory, thinking, language, judgment, or behavior. In people over age 65, it is the second most common cause of dementia after Alzheimer disease. Vascular dementia tends to get worse over time. It can occur together with Alzheimer disease.
Symptoms
Vascular dementia can start suddenly or begin slowly over time. Symptoms depend on which parts of the brain are injured. Symptoms can include:
- Trouble with tasks that used to be easy, like balancing a checkbook.
- Getting lost on routes you know well.
- Trouble finding the name of a familiar object.
- Losing interest in things you used to enjoy.
- Slow thinking.
- Changes in mood, personality, or behavior.
- Trouble walking and keeping balance.
As dementia gets worse, symptoms become more obvious. People find it harder to care for themselves. Some people feel sad or agitated, or see things that are not there. Some people improve for short periods, then decline after more silent strokes.
Causes and who gets it
Vascular dementia is caused by reduced blood flow to the brain, which damages and eventually kills brain cells. Small blood vessels in the brain can narrow or get blocked. A single stroke or many small strokes can also cause it. A stroke is brain damage from a blocked blood supply to part of the brain. When a stroke affects a small area, there may be no symptoms. These are called silent strokes. Over time, more brain areas are damaged, and symptoms of dementia appear. Risk factors include:
- Diabetes
- Hardening of the arteries (atherosclerosis)
- Heart disease
- High blood pressure
- Smoking
- A past stroke or other blood vessel disease
- Being overweight
How doctors diagnose it
There is no single test for vascular dementia. A doctor can often diagnose it with a full exam, including a nervous system exam. The doctor also asks about your health history and symptoms. Tests of memory and thinking skills are also used. A brain scan, such as an MRI or CT scan, can show changes in the brain. Other tests may look for problems that cause or worsen dementia, such as anemia, thyroid disease, or vitamin deficiency.
Treatment
There is currently no cure for vascular dementia. Doctors also cannot reverse the loss of brain cells that already happened. But treatment can sometimes slow it down by tackling the cause. This often involves:
- Eating a healthy, balanced diet and losing weight if you are overweight.
- Stopping smoking and cutting down on alcohol.
- Taking medicines to treat high blood pressure, lower cholesterol, or prevent blood clots.
Do not start or stop aspirin without talking to your provider first. Physical therapy, occupational therapy, memory cafes, and talk therapy can ease existing problems. Medicines may help with aggressive or dangerous behavior. Alzheimer medicines have not been shown to work for vascular dementia.
When to see a doctor
Contact your provider if symptoms of vascular dementia occur. Early treatment may stop it from getting worse, or at least slow it down. Go to the emergency room or call 911 if there is a sudden change in thinking, feeling in your body, or movement. These are emergency signs of a stroke.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can do a first evaluation and help manage blood pressure and other risk factors. They can also coordinate care with a memory clinic or specialist.
Common questions
Is there a cure for vascular dementia?
No, there is currently no cure for vascular dementia. Treatment can sometimes help slow it down.
What causes vascular dementia?
Vascular dementia is caused by reduced blood flow to the brain, which damages and eventually kills brain cells. Often it is linked to high blood pressure and diabetes.
Is vascular dementia the same as Alzheimer disease?
No, they are different disorders of the brain, but the symptoms can be similar. The two can also occur together.
Does vascular dementia get worse over time?
Yes, it usually gets worse over time. It can happen in sudden steps. In between, symptoms may not change much. It is hard to predict when.
Can vascular dementia be prevented?
Controlling the conditions that raise the risk of hardened arteries may help prevent it. Steps include controlling blood pressure and weight, quitting tobacco, and eating less saturated fat and salt.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
