• Vascular Dementia

    (Binswanger’s Disease; Senile Dementia; Binswanger’s Type; Vascular Cognitive Impairment; Arteriosclerotic Dementia; Atherosclerotic Disease)


    Vascular dementia is a type of dementia. It is caused by disease of the small blood vessels in the brain. Parts of the brain called white matter along with grey matter are injured by multiple small strokes.
    Healthy and Injured Brain Blood Vessels
    Blood Flow and Lack of Blood Flow to the Brain
    Copyright © Nucleus Medical Media, Inc.


    Vascular dementia occurs when cells below the surface of the brain's cortex die because they do not receive enough oxygen and nutrients. This process is due to hardening and narrowing of the blood vessels within the white matter of the brain. This affects the blood supply.

    Risk Factors

    Factors that may increase your chance of vascular dementia include:


    In some people, symptoms appear suddenly with neurological changes like those caused by a stroke. Sometimes, the small strokes that lead to vascular dementia can happen without other symptoms. This makes the condition difficult to detect.
    In some cases, symptoms may stabilize or even improve. However in most people, the disease continues to progress.
    The main symptoms of vascular dementia include:
    • Progressive loss of intellectual abilities, processing speed, and cognitive and motor abilities
    • Progressive memory loss
    • Slow, unsteady walking
    Other symptoms that may be present include:
    • Incontinence
    • Personality changes
    • Laughing, crying, or smiling during inappropriate times
    • Difficulty speaking
    • Swallowing difficulties
    • Paralysis or weakness of one or both sides of the body
    • Inactivity
    • Depression, which may cause a loss of interest in activities
    • Tremors, loss of coordination, loss of trunk mobility
    • Seizures
    • Nighttime confusion
    • Paranoia
    • Disorientation


    The symptoms of vascular dementia can resemble other causes of dementia, such as Alzheimer's.
    Your doctor will ask about your symptoms and medical history. A physical exam will be done.
    Pictures may be taken of your brain and bodily structures. This can be done with:
    Your heart and brain activity may be evaluated. This can be done with:
    Your bodily fluids may be tested. This can be done with blood tests.


    There is no known cure for vascular dementia. Reducing risk factors and symptoms are important in trying to slow disease progression and improve quality of life.
    Medications can be given to help limit or control symptoms and possibly slow progression of the disease. These include:
      Medications to control:
    • Antidepressants
    • Nimodipine—may help improve cognitive function in the short term, but lacks evidence to support its long-term use
    • Medications used to treat Alzheimer's


    There are no definitive guidelines to prevent vascular dementia. However, the following may help reduce your risk:
    • If you smoke, talk to your doctor about how you can successfully quit.
    • Eat a diet that is low in fat and low in salt.
    • If you drink alcohol, do so only in moderation. Moderate alcohol intake is two drinks per day for men and one drink per day for women.
    • Have your blood pressure and blood cholesterol levels checked at least once a year.
    • If you have diabetes, maintain your blood glucose in your target range.
    • Avoid low blood pressure. If you get lightheaded when you stand up, or have a history of fainting, talk to your doctor.


    Alzheimer’s Association http://www.alz.org

    National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov


    Alzheimer Society of Canada http://www.alzheimer.ca

    Heart & Stroke Foundation http://www.heartandstroke.com


    Caplan LR. Binswanger’s disease—revisited. Neurology. 1995;45(4):626-633.

    Kirschner H. Vascular dementia: a review of recent evidence for prevention and treatment. Curr Neurol Neurosci Rep. 2009;9(6):437-442.

    Roman GC. Brain hypoperfusion: a critical factor in vascular dementia. Neurol Res. 2004;26(5):454-458.

    Roman GC, Erkinjuntti T, Wallin A, Pantoni L, Chui HC. Subcortical ischaemic vascular dementia. Lancet Neurol. 2002;1(7):426-436.

    Smith EE. Leukoariosis and stroke. Stroke. 2010;41(10 Suppl):S139-S143.

    Tomassoni D, Lanari A, Silvestrelli G, Traini E, Amenta F. Nimodipine and its use in cerebrovascular disease: evidence from recent preclinical and controlled clinical studies. Clin Exp Hypertens. 2008;30(8):744-766.

    Vascular cognitive impairment. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115874/Vascular-cognitive-impairment. Updated May 16, 2016. Accessed September 23, 2016.

    Vascular dementia. Alzheimer's Association website. Available at: http://www.alz.org/dementia/vascular-dementia-symptoms.asp. Accessed July 29, 2013.

    Vascular dementia: A resource list. National Institute on Aging website. Available at: https://www.nia.nih.gov/alzheimers/vascular-dementia-resource-list. Accessed July 29, 2013.

    9/3/2014 DynaMed's Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T115874/Vascular-cognitive-impairment: Wippold FJ, Brown DC, Broderick DF, et al. American College of Radiology (ACR) Appropriateness Criteria for dementia and movement disorders. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/DementiaAndMovementDisorders.pdf. Updated 2014. Accessed September 3, 2014.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.