Dementia due to brain damage from vascular disease
Vascular dementia can occur after strokes or from ongoing damage to small blood vessels, leading to changes in thinking, memory and daily functioning.
Vascular dementia can result in slowed thinking, reduced processing speed, and difficulty with planning, organisation and multi-step tasks. These symptoms may be more prominent than memory loss.
Walking difficulties, poor balance and falls are common, along with mood changes such as low motivation or depression. Symptoms may develop gradually over time or appear suddenly after a new stroke.
What happens in the brain?
Vascular dementia is caused either by gradual damage to small blood vessels over time (small vessel disease), or by larger strokes, which can lead to more sudden, step-by-step decline.
Risk factors may include:
- diabetes
- high blood pressure
- high cholesterol
- smoking.
What increases the risk of vascular dementia?
Vascular dementia is closely linked to the health of your blood vessels, and many of the same factors that increase the risk of stroke and heart disease also increase the risk of vascular dementia, some of which can be managed or improved.
Factors that can’t be changed include:
- age – risk increases as people get older, particularly from the mid-60s onward
- family history – having a close relative with stroke or vascular disease may slightly increase risk
- prior stroke – having had one or more strokes, including small 'silent' strokes that may not have caused obvious symptoms at the time, increases the risk of vascular dementia.
Which risk factors may be modifiable?
Factors that may be modifiable, meaning they can potentially be reduced through lifestyle changes or medical care, include:
- being overweight or physically inactive – both are linked to a higher risk of vascular disease generally
- diabetes – poorly controlled blood sugar can damage blood vessels over time, including those supplying the brain
- excessive alcohol intake – heavy or long-term alcohol use is associated with a higher risk
- heart conditions – irregular heart rhythms (such as atrial fibrillation) and other heart disease can increase the risk of blood clots reaching the brain
- high blood pressure – one of the most important risk factors; well-managed blood pressure can help protect the brain’s small blood vessels
- high cholesterol – contributes to narrowing and hardening of blood vessels, reducing blood flow
- smoking – damages blood vessels throughout the body, including the brain, and increases stroke risk.
Managing modifiable risk factors, particularly blood pressure, cholesterol and diabetes, is one of the most effective ways to reduce the risk of further vascular damage and may help slow the progression of vascular dementia, even though it cannot reverse damage that has already occurred.
Common patient questions
Yes, progression varies depending on ongoing vascular damage and overall health.
Some causes of vascular damage can be reduced by managing risk factors, but existing brain injury may remain.