Have you ever walked into a room and forgotten why you were there? It happens to all of us. But when memory lapses, confusion, or trouble walking begin to interfere with everyday life, they could be red flags for something more serious—vascular dementia. This type of dementia is caused by reduced blood flow to the brain and can creep in quietly. The sooner you catch the signs, the better your chances of managing the condition.
Let’s explore the early warning signs you absolutely shouldn’t ignore.
What is Vascular Dementia?
Vascular dementia is a common type of dementia that happens when there’s decreased blood flow to areas of your brain. The resulting lack of oxygen and nutrients damages brain tissue. This leads to a decline in mental (cognitive) functions that’s severe enough to interfere with daily living. Several conditions can contribute to a lack of blood flow, including stroke.
Vascular dementia is among the most common causes of dementia in people over 65 in North America and Europe. Researchers estimate that 5% to 10% of people with dementia have just vascular dementia. But vascular dementia is more commonly present with Alzheimer’s disease. Providers call this mixed dementia (when you have more than one cause of dementia).
What Causes Vascular Dementia?
Vascular dementia typically results from conditions that block or reduce blood flow to the brain—like strokes, mini-strokes (TIAs), or chronic conditions like high blood pressure and diabetes. When brain cells don’t get enough oxygen and nutrients, they start to die off, leading to cognitive decline.
Who is at Risk?
If you’re over 60, have heart disease, high cholesterol, diabetes, or a history of stroke—you’re more at risk. Smoking and obesity also raise your chances.
What are the symptoms of vascular dementia?
Symptoms of vascular dementia can vary widely. They depend on the area(s) of your brain that are affected and the extent of the damage. Symptoms may include:
- Memory loss.
- Walking and/or balance problems.
- Trouble understanding or using words (aphasia).
- Trouble concentrating, following instructions, reasoning, organizing, planning and completing tasks.
- Mood changes, like depression and irritability.
- Personality and behavior changes.
- Apathy.
- Confusion. This may get worse at night (sundown syndrome).
- Uncontrolled episodes of laughing or crying (pseudobulbar affect).
- Bowel or bladder control problems (incontinence).
- Tremors or reduced fine motor control.
- Sleeping issues.
It’s important to see your healthcare provider if you or a loved one develop these symptoms.
What are the stages of vascular dementia?
There are no definitive stages of vascular dementia — it affects each person differently and progresses in a variety of ways depending on which areas of your brain are affected and the severity.
Most commonly, the symptoms appear in steps over the course of years. But they may be most obvious and sudden after a major stroke. There may even be short periods when symptoms improve. But if more strokes happen, they can cause further decline.
Vascular dementia can also happen alongside another form of dementia, like Alzheimer’s disease, which can impact how the symptoms progress.
Types of vascular dementia
Healthcare providers use different terms for vascular dementia that reflect the number and type of blood vessels involved and the way the symptoms progress. They include:
- Post-stroke dementia: Vascular dementia can happen after only one stroke if the blockage destroys brain tissue that’s needed for more than one thinking ability. Language or memory difficulties are common, but the symptoms ultimately depend on the location of the stroke. These cognitive issues must be present either immediately after or within six months of stroke (and don’t get better) for providers to categorize the condition as post-stroke dementia.
- Multi-infarct dementia: “Infarct” is another term for stroke, so multi-infarct means many strokes affect blood flow to multiple areas of your brain. Symptoms from these strokes are often noticeable when they happen. So, cognitive changes happen in a step-wise fashion (sudden worsening over multiple periods of time).
- Binswanger disease (subcortical vascular dementia): This form of vascular dementia happens when small blood vessels located throughout white matter are blocked over time by atherosclerosis. It occurs gradually over time without sudden episodes of worsening.
- Mixed dementia: When you have more than one cause of dementia symptoms, providers call it mixed dementia. The most common combination with vascular dementia is Alzheimer’s disease, but it can also happen alongside other neurodegenerative conditions.
10 Early Warning Signs of Vascular Dementia
1. Memory Loss That Disrupts Daily Life
Occasional forgetfulness is normal. But frequent memory loss that affects work or social life may be more concerning. Forgetting names, important dates, or asking the same questions repeatedly could be a red flag.
2. Difficulty with Planning or Organizing
Struggling to follow a recipe, pay bills, or manage a calendar could point to declining executive function, a common early symptom of vascular dementia.
3. Slowed Thinking and Poor Concentration
Feel like your brain is stuck in slow motion? People with vascular dementia often report mental sluggishness, making it hard to focus or respond quickly in conversations.
4. Sudden Mood Changes or Depression
Mood swings, apathy, or unexplained depression may actually be rooted in changes to the brain. If someone suddenly becomes irritable or loses interest in things they once loved, pay attention.
5. Difficulty Walking or Balance Issues
Trouble walking, shuffling feet, or falling more often? These can be signs that parts of the brain controlling movement are being affected.
6. Trouble with Language and Communication
Can’t find the right word? Repeating yourself or losing track in conversations may be more than just old age—it could be the brain struggling to connect thoughts and speech.
7. Confusion or Disorientation
Getting lost in familiar neighborhoods or being unsure of the day or time are not normal aging signs. This kind of confusion is a hallmark of cognitive decline.
8. Poor Judgment and Decision Making
Unusual behavior, poor financial decisions, or lack of hygiene might indicate impaired judgment, especially if these behaviors are out of character.
9. Problems with Bladder Control
Yes, incontinence can be connected to vascular dementia. Damage to parts of the brain that control body functions can show up in surprising ways.
10. Sudden or Mini Strokes (TIAs)
Often, vascular dementia is triggered by a series of tiny strokes you might not even notice. Watch for brief moments of numbness, vision problems, or speech difficulty.
How Vascular Dementia is Diagnosed
Doctors use a mix of:
Cognitive tests to assess memory, thinking, and problem-solving
Brain imaging (CT or MRI scans) to look for damage
Blood tests to rule out other causes
What is the treatment for vascular dementia?
Vascular dementia isn’t reversible, unfortunately — once your brain is damaged, it can’t be repaired completely. Instead, the main goal of vascular dementia treatment is to prevent or slow down further damage by managing risk factors. Treatment also involves helping you find new ways of doing things to compensate for the damage in your brain.
Medication
Unlike for Alzheimer’s disease, there aren’t any medications that have U.S. Food and Drug Administration (FDA) approval for this condition specifically. But providers may prescribe cholinesterase inhibitors for vascular dementia. Studies show that they may result in modest cognitive improvements by helping to increase blood flow in your brain.
Memantine is another medication that’s approved for Alzheimer’s disease and may help with vascular dementia.
Your provider may prescribe other medications to help manage risk factors for stroke. These include medications for high blood pressure, high cholesterol and diabetes.
Rehabilitation and advance care planning
You may work with specialists to help manage symptoms of vascular dementia. For example, physical and occupational therapists can help you improve your physical abilities and find new ways of doing everyday tasks. A speech-language pathologist can help with speaking, swallowing and learning other ways to communicate.
Other specialists you may work with include:
- Recreational therapists.
- Registered dietitians.
- Psychologists or psychiatrists.
- Clinical social workers.
- Geriatric case managers.
These specialists will work with you and your loved ones to make sure you have ongoing care that matches your needs and goals. They’ll advise you and your loved ones on advance care planning for financial and healthcare decisions. They’ll also make referrals for palliative care or hospice when vascular dementia has progressed to its later or end stages.
Can Vascular Dementia Be Treated?
There’s no cure—yet. But that doesn’t mean it’s hopeless.
Current Treatment Options
Medications for high blood pressure, cholesterol, or blood clots
Antidepressants if depression is present
Cognitive therapy or brain training
Lifestyle Changes That Help
Exercise regularly
Eat a heart-healthy diet
Quit smoking and manage stress
These changes won’t reverse the damage, but they can slow progression.
Preventing Vascular Dementia
An ounce of prevention is worth a pound of cure. Protect your brain by:
Controlling high blood pressure and diabetes
Staying physically active
Engaging in mentally stimulating activities
Eating a Mediterranean-style diet
What can I expect if I have this condition?
Vascular dementia may get worse over time. The changes can happen in sudden steps or gradually. Each person has their own unique journey. Treatments may help slow the progress of the disease. You and your healthcare provider will work together to develop a treatment plan best suited for managing your symptoms and the stage of the disease.
Lean on loved ones for support during this time. Together, you can make a plan to ensure your quality of life and wishes are respected as dementia progresses.
How long can a person with vascular dementia care for themselves?
A person with vascular dementia will need help with at least some aspects of daily function, like managing medications, paying bills or preparing food. Your loved one with this condition may be able to do many things for themselves. But it may not be safe for them to live alone, depending on what abilities are affected. For some people with vascular dementia, more specialized care may be required from facilities that care specifically for people with dementia.
What is the life expectancy for someone with vascular dementia?
The life expectancy for someone with this condition depends on the severity of the disease. Vascular dementia has wide-ranging severity and affects each person differently.
This life expectancy is lower than it is for people with Alzheimer’s disease because someone with vascular dementia is more likely to die from a stroke or heart attack than from dementia itself.
What are the end-of-life symptoms of vascular dementia?
It’s difficult to pinpoint the exact end-of-life symptoms of vascular dementia. It may be more helpful to think of how dementia has affected your loved one holistically. By the later stage of dementia, it’ll have a severe impact on most aspects of your loved one’s life. They’ll need full-time care and support.
Late-stage or end-of-life symptoms may include:
- Severe memory loss.
- Physical challenges that make it nearly impossible to do activities of daily living without help, like eating, washing and dressing.
- Near or total loss of language skills.
- Depression and apathy.
- Hallucinations and delusions.
- Restlessness, anger or agitation.
Your loved one’s healthcare team, hospice nurse or palliative care provider are the best people to ask about timelines. They can tell what signs to watch for, so you have a general idea of what to expect.
Can I prevent vascular dementia?
You can’t change some of the risk factors for the condition, like your age or genetics. But you can manage many other risk factors for the condition to try to prevent it — mainly those that damage your blood vessels. Steps you can take include:
- Keeping your blood pressure, cholesterol and blood sugar (glucose) levels within a healthy range. You’ll need to work closely with your healthcare provider to do this.
- Reaching and maintaining a weight that’s healthy for you.
- Getting regular physical activity. Try to aim for 30 minutes on most days.
- Eating heart-healthy foods, like those in the Mediterranean or DASH diets.
- Quitting smoking.
- Limiting alcohol consumption.
- Managing your stress.
- Seeing your provider regularly for checkups and taking your medications as prescribed.
Vascular dementia is unique from many other forms of dementia in that it’s partly preventable. If you have any of these risk factors, talk to your provider about what you can do to manage them.
What is the first noticeable symptom of vascular dementia?
Typically, the first sign is trouble with decision-making, problem-solving, or focus—often more than memory loss at the start.
Can vascular dementia come on suddenly?
Yes, especially if it follows a stroke or series of mini-strokes.
Is vascular dementia reversible?
Unfortunately, no. But early treatment can slow its progression and help manage symptoms.
How fast does vascular dementia progress?
It varies. Some people decline rapidly after a stroke, while others may experience a slower, stepwise decline.
What age does vascular dementia usually start?
Most cases begin after age 65, but it can start earlier in people with significant risk factors like hypertension or diabetes.
When should I call my healthcare provider?
You or your caregiver should call your healthcare provider if you notice any worsening of your symptoms or when new symptoms appear. Your provider or healthcare team will want to assess any changes and make adjustments to your treatment plan if needed.
Living with Vascular Dementia
It’s not just the patient who is affected—family members and caregivers face challenges too. Here’s how to cope:
Establish routines for predictability
Use reminder notes or alarms
Join support groups
Practice patience and compassion
Conclusion
Vascular dementia can sneak up on you, but being informed gives you the power to act early. If you spot any of these 10 early warning signs in yourself or a loved one, don’t brush them off. Early diagnosis and lifestyle changes can slow down the progression and improve quality of life.
Remember, your brain is like a muscle—keep it strong, and it’ll serve you well for years to come.
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