What is vascular dementia?

Vascular dementia is a form of dementia. It develops because of problems with the circulation of blood to your brain. It usually occurs after a stroke.

Vascular dementia causes problems with your:

• reasoning
• planning
• judgement
• memory
• thinking

Vascular dementia is the second most common form of dementia in older people.

What are the symptoms of vascular dementia?

The symptoms of vascular dementia are often similar to those of Alzheimer's disease. In fact, the 2 conditions can occur together.

The symptoms of vascular dementia depend on which part of your brain is affected. Symptoms can include:

• confusion
• trouble with attention and concentration
• trouble understanding speech
• trouble finding the right words when speaking
• difficulties in organising thoughts
• memory problems, especially short-term memory
• problems making decisions or problem solving

Other symptoms can include:

• mood swings
• restlessness and agitation
• personality changes
• being unsteady on your feet and having an increased risk of falls
• having problems moving and walking
• needing to urinate (do a wee) urgently, or being unable to control your bladder

The symptoms can affect how you function and can interfere with your daily life.

Symptoms of vascular dementia may start more suddenly or get worse more quickly than with other types of dementia.

What causes vascular dementia?

Vascular dementia happens when restricted blood flow damages the brain.

A build-up of cholesterol and fatty plaques can harden the blood vessels that supply your brain. This reduces blood flow and sometimes causes a stroke.

Sometimes symptoms of vascular dementia develop suddenly after a major stroke.

Symptoms can also develop and get worse over time after a series of small (silent) strokes. You may not have any other symptoms with these small strokes.

What can increase my risk of vascular dementia?

Your chances of having vascular dementia increases as you get older.

You are more likely to develop vascular dementia if you:

• have untreated high blood pressure (hypertension)
• smoke
• live with obesity or overweight
• have diabetes
• have high cholesterol
• have atrial fibrillation

Other risk factors include:

• not getting enough physical activity
• not eating a balanced, healthy diet
• having heart disease

When should I see my doctor?

See your doctor if you are worried about your memory, thinking or other symptoms of dementia.

Getting diagnosed early can help you receive the right support.

How is vascular dementia diagnosed?

Your doctor will ask you about your symptoms and general health. It's a good idea to take a family member or carer with you to help give a description of your symptoms.

Your doctor may do an examination, including checking your blood pressure. They may do a short test to check your thinking and memory. They will ask what medicines you are taking.

There is no single test for vascular dementia. It can be difficult to tell the difference between vascular dementia and other types of dementia. Your doctor will likely refer you to a specialist doctor— this may be a neurologist or a geriatrician.

Tests that may be recommended are:

• blood tests
• brain imaging tests, such as a CT scan or MRI scan — to show any evidence of strokes
• an ultrasound scan — to look for any problems in your carotid arteries (which run up both sides of your neck to your brain)
• neuropsychological testing — to measure your brain function
• an electrocardiogram (ECG) — to check your heart rhythm

Some of these tests are to exclude (rule out) other conditions that can cause similar symptoms.

Learn about the different ways you can manage your life if you are diagnosed with dementia.

How is vascular dementia treated?

There is no cure for vascular dementia, but there are treatments available to help slow the decline.

Treatment will depend on your symptoms.

It's important to prevent future strokes to help prevent further decline. To reduce your risk of stroke, your doctor may recommend treatment to:

• control high blood pressure
• treat high cholesterol or heart disease
• prevent blood clots
• treat diabetes
• help quit smoking

Medicines

If you also have Alzheimer's disease, medicine called cholinesterase inhibitors may be used to help slow changes in your memory or thinking.

Sometimes medicines are used to help treat mood changes, such as depression.

If you become agitated or aggressive, your doctor may recommend a low dose of an antipsychotic medicine.

Talk with your doctor about what is suitable for you.

Supportive care

People with vascular dementia may need therapy and support to help manage day to day.

Occupational therapy can help you make changes at home and stay independent.

It's important to continue social contact with family and friends.

You may need help at home, and eventually, care in a residential care home.

Respite care is also available to help carers. Read about living with dementia.

You can apply for government support for care at home through My Aged Care. If you are aged under 65 years, the National Disability Support Scheme (NDIS) may be able to help.

Can vascular dementia be prevented?

Vascular dementia is the most preventable form of dementia.

To lower your risk of getting vascular dementia, take the same steps that help prevent cardiovascular disease and stroke:

• have a healthy diet
• get regular physical activity
• quit smoking or vaping
• decrease how much alcohol you drink
• manage your cholesterol and blood pressure

It's important to get treatment for any conditions that can increase your risk of vascular dementia, including diabetes and atrial fibrillation.

Other steps that can help prevent dementia include:

• taking care of your vision and hearing
• getting treatment for depression
• staying connected socially
• protecting your head from injury

What are the complications of vascular dementia?

Some of the complications of vascular dementia are:

• depression
• agitation and aggression
• falls

Resources and support

Dementia Australia has a National Dementia Helpline — phone 1800 100 500 for expert information, advice and support.

Information for Aboriginal and Torres Strait Islander peoples

Dementia Australia also has resources about dementia for Aboriginal and Torres Strait Islander peoples.

Languages other than English

Health Translations has information on dementia in languages other than English.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.