Vascular dementia and Alzheimer’s are the two most common types of dementia. While they share some symptoms, they have key differences. They also differ in their causes, treatment approaches, and how they progress.

Vascular dementia and Alzheimer’s disease are types of dementia, but they have some distinct differences. While both conditions can cause cognitive decline, there are differences in how they present.

Vascular dementia often presents with more prominent problems in cognitive functions such as attention and thinking speed. In contrast, Alzheimer’s disease usually begins with memory problems, especially with recent events.

Read on to learn more about vascular dementia and Alzheimer’s disease, including the similarities, differences, and the link between vascular dementia and Alzheimer’s disease.

Vascular dementia is the second most common type of dementia. It occurs when there is damage to regions in the brain, for example, after a stroke, resulting in the death of nerve cells (neurons).

Brain damage from small or large strokes can cause vascular dementia. Atherosclerosis, which is the hardening of the arteries, can lead to multiple small strokes throughout the brain. This accumulated damage causes vascular dementia.

The damage due to stroke can lead to problems with memory, attention, and decision making.

Alzheimer’s is the most common form of dementia, affecting millions of people worldwide. It’s an irreversible, progressive disorder characterized by the buildup of unusual proteins in the brain.

Protein buildup leads to the impairment of brain cells, eventually resulting in memory loss, cognitive decline, and behavioral changes.

Symptoms of vascular dementia may include:

  • problems with memory, attention, and concentration
  • difficulties with problem-solving and decision making
  • slowed thinking
  • mood swings
  • difficulty speaking or understanding language

Symptoms of Alzheimer’s disease may include:

  • memory loss, especially recent events
  • confusion and disorientation
  • difficulty with language and finding words
  • disabled judgment and decision making
  • changes in mood and personality
  • withdrawal from social activities

To diagnose vascular dementia and Alzheimer’s disease, a doctor will take a thorough medical history, perform a physical examination, and order various tests to rule out other potential causes of cognitive impairment and dementia symptoms.

These may include:

  • Cognitive tests: A doctor uses these tests to assess cognitive function, memory, thinking, and problem-solving skills.
  • Brain imaging: Doctors use imaging techniques like MRI, CT, or PET scans to look for signs of brain changes. Evidence of a stroke on an MRI scan may suggest vascular dementia, while buildup of irregular proteins on a PET scan may suggest Alzheimer’s. Imaging can also help rule out other conditions.
  • Blood tests: Blood tests can help identify underlying conditions contributing to memory problems, such as vitamin deficiencies or thyroid problems.
  • Neurological evaluation: A doctor will examine your reflexes, balance, coordination, and sensory function to assess overall brain health.
  • Psychiatric evaluation: This assesses your mental health, as symptoms of depression or anxiety can overlap with dementia.
  • Spinal fluid analysis: Sometimes, a doctor may perform a lumbar puncture to analyze cerebrospinal fluid for biomarkers associated with Alzheimer’s disease.
  • Genetic testing: In certain situations, a doctor may recommend genetic testing to identify gene mutations that increase the risk of developing Alzheimer’s disease.

While there is no cure for vascular dementia and Alzheimer’s, the various treatment options aim to manage symptoms and slow cognitive decline. These may include:

  • Medications: A doctor can prescribe cholinesterase inhibitors like donepezil to treat Alzheimer’s. Memantine, another medication, may help regulate brain chemicals involved in memory and learning in vascular dementia and Alzheimer’s.
  • Lifestyle modifications: Encouraging changes in lifestyle strategies can have a significant impact. Regular exercise, a balanced diet, and sufficient sleep are essential. Mental stimulation, such as puzzles and reading, can also be beneficial.
  • Managing other health conditions: Managing conditions like high blood pressure, diabetes, and high cholesterol can help reduce the risk of further brain damage in Alzheimer’s disease.
  • Cognitive training: Participating in cognitive training programs can help you strengthen your cognitive abilities and manage daily tasks more effectively.
  • Supportive therapies: Occupational, speech, and physical therapy can help you maintain independence and manage your daily activities.

Vascular dementia is often a result of damage to blood vessels in your brain. Brain cells can die when these vessels get damaged or blocked, leading to cognitive impairment. Blood clots or bleeding cause strokes in the brain, which are a common cause of vascular dementia.

The exact cause of Alzheimer’s disease is unclear, but research suggests it involves a buildup of proteins in the brain. The protein beta-amyloid accumulates to form plaques between nerve cells. The protein tau also aggregates to form a material called tangles within the neurons. These plaques and tangles can damage brain cells, leading to cognitive decline.

Although vascular dementia and Alzheimer’s disease can affect people of different ages and backgrounds, certain risk factors can increase the likelihood of developing these conditions.

Experts estimate that approximately 15–17% of dementia cases are due to vascular factors. Common risk factors for vascular dementia include the following:

Alzheimer’s disease is the most common cause of dementia, affecting more than 6 million adults in the United States. Age is the most significant risk factor. However, other factors may increase your risk of developing Alzheimer’s, including:

  • a family history of the disease
  • history of head injury
  • having Down syndrome
  • not engaging in mental and physical activities

The outlook for people with vascular dementia and Alzheimer’s disease can vary. In vascular dementia, the progression of symptoms may be more unpredictable or can occur in a step-like manner after each stroke or vascular event.

People with Alzheimer’s disease tend to gradually and progressively decline in cognition and memory.

An old study from 2016 also suggests that people with vascular dementia may have more rapidly progressing mobility problems than people with Alzheimer’s.

Here are some frequently asked questions about vascular dementia and Alzheimer’s.

Can you have both vascular dementia and Alzheimer’s?

Yes, it’s possible to have both vascular dementia and Alzheimer’s disease. This condition is called mixed dementia.

Does vascular dementia progress faster than Alzheimer’s?

The progression rate of vascular dementia compared with Alzheimer’s can vary. However, vascular dementia may progress faster due to the nature of the underlying vascular damage and the potential for additional strokes or vascular events.

Can I prevent dementia?

While it is not possible to prevent dementia completely, lifestyle choices may help reduce your risk. Strategies include having a balanced diet, exercising regularly, staying mentally active, and managing chronic conditions.

While vascular dementia and Alzheimer’s disease share specific symptoms, they have different causes and vary in their progression and treatment approaches.

Strokes, which can occur due to impaired blood flow to a region of the brain, cause vascular dementia. The hallmark of Alzheimer’s disease is the buildup of amyloid plaques and tau tangles in the brain.

Early detection and adopting lifestyle changes can help reduce the risk of developing dementia and promote brain health.