Vascular dementia

Vascular dementia explained

Vascular dementia is when the blood supply to your brain is reduced. This stops some of your brain cells from working properly, causing them to die over time. 

It causes symptoms that worsen over time, like memory loss and difficulty concentrating.

Vascular dementia is the second most common type of dementia, and does not have a cure. However, sometimes it's possible to slow down the development of symptoms.

What is mixed dementia?

It’s also possible to have more than one type of dementia. Some people with vascular dementia have another type of dementia too, most often Alzheimer’s disease. This is known as ‘mixed dementia’ and is more common in the oldest age groups.

This does not mean you need to worry about seeing a different doctor. Specialists in dementia care will be able to support you or your loved one in managing the symptoms of both vascular and mixed dementia.

Symptoms of vascular dementia

The symptoms of vascular dementia can develop suddenly or gradually.

Your early symptoms will depend on which part of your brain has been affected. This means different people can experience different symptoms.

Vascular dementia can affect people of all ages, although it's often associated with growing older. If you're under 65 years old, it's known as 'young onset' or 'early onset' vascular dementia.

Early signs of vascular dementia include:

• concentration problems, such as struggling to focus during a conversation
• mood and personality changes, such as irritability or feeling low
• poor short-term memory
• difficulty with everyday skills, such as reading or driving
• difficulty with decision making and planning
• slowing down of thought processes
• difficulty saying your thoughts clearly.

In the later stages, you may experience symptoms such as:

• becoming increasingly confused and disorientated
• long-term memory loss and difficulty concentrating
• increasing difficulty remembering words and communicating
• difficulty with balance or falling frequently
• depression and personality changes
• in some cases, loss of bladder control.

Diagnosing vascular dementia

If you suspect you or a loved one might have vascular dementia, it’s important to talk to your GP as soon as possible.

The GP will:

• explore what your issues are, when they started and how often they have been happening
• ask how these issues have been affecting your life and those around you
• carry out physical examinations, mental ability tests and other routine tests to help them rule out other physical or mental health causes.

Consider taking a loved one to you to the appointment, not only for support, but also to help the GP get a complete picture of how things have been for you.

If you can’t take a loved one, your GP may want to reach out to them on the phone so they can better understand your daily routine and skills. This will only happen with your permission.

If your GP suspects vascular dementia, they will refer you to a specialist or memory clinic. You may then have a CT or MRI scan of your brain to check for any abnormalities.

Unfortunately, getting an accurate diagnosis can sometimes take time. But it’s important you receive this so you can get the correct treatment and support.

Treating vascular dementia

Although we’re funding research to find new treatments, there's currently no cure for vascular dementia. However, there’s lots of help and support to help you to continue to live well.

Medication

You might be given medication to control high blood pressure or high cholesterol. This may have contributed to your condition and controlling it can help slow down the progression.

If you have vascular dementia, medication given for Alzheimer’s disease isn’t recommended. However, you could be given this medication if you have a mixed diagnosis of vascular dementia and Alzheimer’s disease.

Lifestyle changes

Research has shown that improving your lifestyle can help slow down the progression of vascular dementia. There are some small changes you can make that might reduce the chance of more damage to the blood vessels in your brain:

• eat healthily
• be physically active
• keep to a healthy weight and lose weight if necessary
• don't smoke
• cut down on alcohol
• control high blood pressure
• control cholesterol levels
• control blood sugar levels (if you have diabetes). 

Support programmes

Your healthcare team may also suggest a range of social activities to improve your wellbeing and slow down the progression as much as possible.

Some examples include:

• group cognitive (this means the process of thinking, reasoning, or remembering) stimulation therapy – taking part in group activities and discussions to help with memory and connecting with others
• group reminiscence therapy - sharing life experiences, memories and stories from the past to help improve your wellbeing
• cognitive rehabilitation or occupational therapy – getting support in carrying out everyday tasks independently for as long as possible.

Living with vascular dementia

Some people diagnosed with vascular dementia are able to live well for many years. However, it's understandable if you feel overwhelmed and worried about how to cope.

On a practical level, there are many things you can do to support yourself, or someone diagnosed with vascular dementia. Some examples include:

• break complex tasks down into small steps
• use reminders, pill boxes or automatic medication dispensers so you don’t forget to take medications
• be aware of the things that make your symptoms worse, like noisy places
• keep to a regular routine and be sure to include activities you enjoy.

Vascular dementia is a progressive condition (this means it gets worse over time), so it’s likely you’ll need further support at some point. People involved in your ongoing care might include:

• healthcare professionals – your GP, physiotherapist, occupational therapist, or a specialist dementia nurse (such as an Admiral Nurse)
• social services – you and your loved ones or carer might be able to access support by having an assessment of your needs
• charities like Dementia UK can offer information, emotional support or advocacy services
• private care and support services, such as paid care workers or your council. Other local organisations may provide meals delivered to your home, if you are eligible.

It’s important for you and your family to discuss any help you might need, both now and in the future. It's also important that your wishes are considered at every step along the way. 

• Dianne was diagnosed with vascular dementia in 2012. Find out how she’s adapted and what she's doing to support others in her community.

Support for you and your loved ones

Whether vascular dementia is affecting you or someone you love, it’s completely normal for the diagnosis to trigger a range of difficult emotions and questions about the future. Give yourself time to let the information sink in and try to seek support from loved ones.

While this page has covered some of the basics, here are some additional sources of information and support which may be of use to you:

• For emotional support, you may want to talk to someone outside your family or friendship circle, such as a counsellor. If you’re not sure what kind of support you need, or want to learn more about psychological therapies, visit the Mind website.
• You can also visit our emotional support page for advice on topics such as depression, stress and anxiety.
• Get advice from Dementia UK, and speak to an Admiral Nurse through their free helpline. Admiral Nurses are nurses who specialise in dementia care. They will be able to give you information, advice and support with any aspect of dementia.
• Caring for someone who has vascular dementia can be challenging in many ways. For advice on what to do and what to expect, read the NHS guide on looking after someone with dementia.

If you care for someone with vascular dementia, you might feel anxious and uncertain about the future.

Dementia UK Admiral Nurse Kensa Morgan shares practical tips and emotional strategies to help as the condition progresses.

Read more about supporting a loved one with vascular dementia

Causes of vascular dementia

Some conditions can cause the blood supply to your brain to be reduced and increase your chance of developing vascular dementia, such as: 

The causes of a reduced blood supply to your brain include:

• small vessel disease – narrowing of small blood vessels deep inside your brain, often as a result of atherosclerosis (a build-up of fatty material inside your arteries)

• a stroke – where the blood supply to part of your brain is suddenly cut off, due to a blood clot or haemorrhage (a bleed)

• mini-strokes – known as transient ischaemic attacks (TIAs). These can cause tiny but widespread damage over time.

How is vascular dementia linked to atrial fibrillation and stroke?

Atrial fibrillation (AF) is an irregular heart rhythm which increases your risk of stroke.

AF can cause a blood clot to form in one of the top chambers of your heart. This can be pumped out of your heart to your brain where it can cause a stroke.

As vascular dementia often develops after a stroke, people with AF are at higher risk.

Reducing your risk of vascular dementia

Risk factors are conditions or habits that increase your risk of developing a disease. Things that can increase your chances of getting vascular dementia include:

• high blood pressure (hypertension)
• high cholesterol
• diabetes
• atrial fibrillation and other types of heart disease
• drinking too much alcohol
• smoking
• not eating healthily
• not being active
• not managing your weight.

High blood pressure is a risk factor for developing vascular dementia. This is because a high amount of pressure in the blood vessels in your brain can damage your brain and lead to the causes of dementia. However, there's currently no evidence to say that lowering blood pressure will prevent someone from developing vascular dementia. 

Find out more about high blood pressure and the risk of dementia.