[2][4] Restricted blood flow due to strokes reduces oxygen and glucose delivery to the brain, causing cell injury and neurological deficits in the affected region.

[4] Dementia may occur when neurodegenerative and cerebrovascular pathologies are mixed, as in susceptible elderly people (75 years and older).

[4][5] The neurological signs localizing to certain areas of the brain that can be observed are hemiparesis, bradykinesia, hyperreflexia, extensor plantar reflexes, ataxia, pseudobulbar palsy, as well as gait problems and swallowing difficulties.

Consequently, people with vascular dementia tend to perform worse than their Alzheimer's disease counterparts in frontal lobe tasks, such as verbal fluency, and may present with frontal lobe problems: apathy, abulia (lack of will or initiative), problems with attention, orientation, and urinary incontinence.

People with vascular dementia may also present with general slowing of processing ability, difficulty shifting sets, and impairment in abstract thinking.

In addition, infectious disorders, such as syphilis, can cause arterial damage, strokes, and bacterial inflammation of the brain.

[10] Vascular dementia can be caused by ischemic or hemorrhagic infarcts affecting multiple brain areas, including the anterior cerebral artery territory, the parietal lobes, or the cingulate gyrus.

[2][6][14] The recommended investigations for cognitive impairment include: blood tests (for anemia, vitamin deficiency, thyrotoxicosis, infection, among others), chest xray, ECG, and neuroimaging, preferably a scan with a functional or metabolic sensitivity beyond a simple CT or MRI.

[4][6] Differentiating dementia syndromes can be challenging, due to the frequently overlapping clinical features and related underlying pathology.

Ischemic changes in the brain are irreversible, but the person with vascular dementia can demonstrate periods of stability or even mild improvement.

[medical citation needed] A 2023 review found that therapy with statin drugs was ineffective in treating or preventing stroke or dementia in people without a history of cerebrovascular disease.

The studies were frequently small and limited, which caused contradictory results in the connection of mortality to the type of dementia and the person's gender.

One 2015 study found that the one-year mortality was three to four times higher in people after their first referral to a day clinic for dementia, when compared to the general population.

[23] Vascular dementia may be a direct cause of death due to the possibility of a fatal interruption in the brain's blood supply.