# Vascular dementia

Vascular dementia is cognitive decline severe enough to disrupt your daily life, caused by problems with the brain's blood supply. It is the second most common dementia after Alzheimer's. The underlying damage takes many forms. These include large strokes and small deep strokes (lacunes). They also include white-matter changes, microbleeds, tiny infarcts, enlarged fluid spaces, and a leaky blood-brain barrier. Doctors often group these under 'small vessel disease'. Mixed pathology is common in older adults. When Alzheimer's amyloid and tau coexist with vascular damage, each worsens the cognitive hit of the other. The VICCCS-2 consensus criteria (2018) define diagnosis across mild and major vascular cognitive impairment. They recognize post-stroke, subcortical, multi-infarct, and mixed subtypes. Management targets your vascular risk factors. No disease-modifying drug is approved. And the 2024 Lancet Commission on Dementia Prevention (Livingston et al.) raised the modifiable risk factors to 14. It added untreated vision loss and high LDL, both directly relevant here.

## Sources

- Iadecola C. (2013). The Pathobiology of Vascular Dementia. Neuron. https://doi.org/10.1016/j.neuron.2013.10.008
- Iadecola C, Duering M, Hachinski V, Joutel A, Pendlebury ST, Schneider JA, Dichgans M. (2019). Vascular Cognitive Impairment and Dementia: JACC Scientific Expert Panel. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2019.04.034
- Skrobot OA, Black SE, Chen C, DeCarli C, Erkinjuntti T, Ford GA, et al.. (2018). Progress toward standardized diagnosis of vascular cognitive impairment: Guidelines from the Vascular Impairment of Cognition Classification Consensus Study. Alzheimer's & Dementia. https://doi.org/10.1016/j.jalz.2017.09.007

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_Canonical: https://usa-longevity.com/en/glossary/vascular-dementia · Part of Longevity Cities · Updated 2026-06-22_