Neurology and dementia
This page is reference information compiled from the cited sources. It is not medical advice. For any decision about health, diagnosis or care, consult a qualified professional.
What it is
Vascular dementia is dementia caused by a series of strokes. It is listed as dementia due to cerebrovascular disease in the ICD-11 and as either major or mild vascular neurocognitive disorder in the DSM-5. Restricted blood flow due to strokes reduces oxygen and glucose delivery to the brain, causing cell injury and neurological deficits in the affected region. Subtypes of vascular dementia include subcortical vascular dementia, multi-infarct dementia, stroke-related dementia, and mixed dementia. Subcortical vascular dementia occurs from damage to small blood vessels in the brain, while multi-infarct dementia results from a series of small strokes affecting several brain regions. Stroke-related dementia involving successive small strokes causes a more gradual decline in cognition. Dementia may occur when neurodegenerative and cerebrovascular pathologies are mixed, as in susceptible elderly people.
Key facts
Vascular dementia is described as both a mental and behavioral disorder within the ICD-11. Signs and symptoms are cognitive, motor, behavioral, and for a significant proportion of people, also affective, typically occurring over a period of 5–10 years. These signs mainly include cognitive decline and memory impairment of sufficient severity to interfere with activities of daily living. The disease often presents in step-wise declines following multiple strokes, and cognitive decline can be traced back to occurrence of successive strokes. People tend to have better free recall and fewer memory errors than those with Alzheimer's disease but perform worse on frontal lobe-heavy tasks like verbal fluency. Localizing neurological signs can include hemiparesis, bradykinesia, hyperreflexia, ataxia, pseudobulbar palsy, and gait difficulties. Apathy early in the disease is more suggestive of vascular dementia, and people may exhibit frontal lobe problems such as abulia, attention difficulties, and urinary incontinence. Risk factors include increasing age, hypertension, smoking, diabetes mellitus, cardiovascular disease, and the APOE-ε4 genotype. A history of stroke increases the risk of developing dementia by around 70%.
When to seek professional help
Recommended investigations for cognitive impairment include blood tests, chest X-ray, ECG, and neuroimaging such as CT scans or magnetic resonance imaging. When available, single photon emission computed tomography and positron emission tomography neuroimaging may be used to confirm a diagnosis in conjunction with mental status examinations. Screening blood tests typically include full blood count, thyroid function tests, lipid profile, and vitamin B-12 levels. A diagnosis is made using specific diagnostic criteria such as those from the DSM or ICD, or the NINDS-AIREN criteria. Professional help is also involved in differentiating dementia syndromes, which can be challenging due to overlapping clinical features, and in diagnosing mixed dementia when there is evidence of both Alzheimer's disease and cerebrovascular disease.
Source: Vascular dementia (CC BY-SA 4.0 (Wikipedia)), retrieved 2026-08-27.