Vascular Dementia

General Information

Vascular dementia refers to disorders of personality and mental processing (memory and reasoning) caused by diseases of the blood vessels which bring blood to the brain. Vascular dementia includes two related conditions: stroke and microvascular disease.

Uncontrolled high blood pressure (hypertension) is a major risk factor for stroke and microvascular disease. In the past, hypertension was diagnosed when blood pressure measurements were consistently above 140/90. More recently, the threshold was decreased to 130/80 or above.

  • It is estimated that 46% of the population in the United States has hypertension.
  • The chance of having hypertension increases with age.
    • An estimated 76% of people aged 56-74 years have hypertension.
    • An estimated 82% of people aged 75 years or greater have hypertension.

The difficulty with management of hypertension is that people feel normal when the blood pressure is above the threshold. People don’t realize that while they are feeling fine, the elevated blood pressure is silently damaging their organs including the blood vessels in the brain. This vascular damage leads to stroke and microvascular disease.


A stroke is the sudden blockage of a blood vessel (ischemic stroke) or rupture of a blood vessel (hemorrhagic stroke) in the brain. The more common form of stroke is the blockage type and accounts for approximately 87% of strokes. Hypertension is a strong risk factor for both types of stroke. Other modifiable risk factors for stroke include smoking, diabetes, high cholesterol, and an abnormal heart rhythm called atrial fibrillation.

  • Every year more than 795,000 people in the United States experience a stroke.
  • Strokes can reduce a person’s mobility, ability to communicate, and independence.
  • Most people who have had a stroke will not be able to work.
  • Some stroke survivors require 24-7 care.
  • Besides causing mobility and/or communication challenges, strokes (especially multiple strokes) can cause or contribute to vascular dementia.

Microvascular disease

Microvascular disease refers to damage of blood vessels that are smaller than the blood vessels that are involved in stroke. When these smallest blood vessels are blocked, people do not experience any symptoms. However, in the long term, after many of these blood vessels have been damaged, people start to develop dementia symptoms.

Preventing strokes and vascular dementia

There are extremely important actions that people can take to prevent strokes and vascular dementia.

  • Establish care with a doctor so that risk factors, especially hypertension, can be identified and treated.
    • The blood pressure goal is 130/80 or less.
  • Learn the symptoms of stroke and the mnemonic BE FAST.
    • B: Sudden difficulty with balance.
    • E: Sudden problems with vision including loss of all vision in an eye, partial loss of vision or double vision.
    • F: Sudden facial droop.
    • A: Sudden weakness of an arm or leg.
    • S: Sudden onset of slurred speech or inability to speak.
    • T: time to call 911.