Information about Vascular Dementia & Memory Loss

After Alzheimer's disease, the most common cause of significant memory loss is vascular dementia—a disorder often resulting from a series of tiny strokes( known as infarcts) that destroy brain cells. Each small infarct may be inconsequential alone, but the cumulative effect of many infarcts can destroy enough brain tissue to impair memory, language, and other intellectual abilities.

Symptoms of vascular dementia often develop suddenly, and they are not limited to brain functions. Noncognitive hallmarks include loss of bladder or bowel control (incontinence), a mask-like facial expression, and weakness or paralysis on one side of the body. Vascular problems account for 10 to 20 percent of all dementia cases.

Vascular dementia can also result from lupus and other collagen-vascular diseases—and may be at least partially reversible in these conditions—as well as a major stroke. Many people suffer from vascular dementia as a result of chronic high blood pressure, diabetes, or coronary heart disease (a narrowing of the coronary arteries that reduces blood flow to the heart). People who survive a cardiac arrest can also suffer from memory deficits.

The Alzheimer's drugs known as cholinesterase inhibitors are not approved for use in people with vascular dementia, though some evidence suggests they may be beneficial. A review article published in Neurological Research, for example, concluded that the Alzheimer's drugs donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne) appear to have benefits in people who have vascular dementia alone and in those who have it in conjunction with Alzheimer's disease.

Results of a study reported in Alzheimer's Disease and Associated Disorders suggest that memantine (Namenda), a new Alzheimer's drug, may have modest benefits in people with vascular dementia.

Other possible causes of irreversible dementia include infectious diseases (such as Creutzfeldt-Jakob disease) and amnesia.

Ask the Doctor about Microvascular Dementia

Q: I was recently diagnosed with microvascular dementia. What does this mean?

A: Vascular dementia can result from a series of very small strokes in the brain. These strokes, also known as infarcts, reduce blood flow to brain tissue, causing the death of brain cells. Depending on where the strokes occur, the resulting brain tissue damage results in impairment or loss of brain functions such as language, motor skills, and memory.

Dementia that's caused by a single large stroke is sometimes referred to as macrovascular dementia or single-infarct dementia. This kind of vascular dementia generally has a sudden onset and an immediate, profound effect on mental functioning and the activities of daily living.

Microvascular dementia, sometimes known as lacunar dementia, is usually associated with high blood pressure or diabetes and may occur along with other types of dementia. Because the strokes associated with microvascular dementia are so small, they might not be noticed when they occur. It is when the effects of multiple small strokes combine that the consequences become apparent in memory impairment, difficulties with communication, or problems with everyday tasks.

Publication Review By: Peter V. Rabins, M.D., M.P.H.

Published: 08 Mar 2011

Last Modified: 10 Sep 2015