Vascular Dementia
Vascular dementia is a common type of dementia caused by reduced blood flow to the brain. It's estimated to affect around 180,000 people in the UK. Dementia is the name for problems with mental abilities caused by gradual changes and damage in the brain. It's rare in people under 65. Vascular dementia tends to get worse over time, although it's sometimes possible to slow it down. Symptoms of v
What it is
Vascular cognitive impairment ranges from mild post-stroke cognitive change to multi-infarct dementia, subcortical small-vessel disease and mixed Alzheimer's-vascular pathology. The unifying theme is that cerebrovascular disease is the (or a) cognitive driver. Aggressive vascular risk-factor management slows or arrests progression.
Symptoms and signs
- Stepwise cognitive decline after vascular events, with intervening plateaus.
- Executive dysfunction — planning, sequencing, multitasking — often more prominent than memory.
- Gait disturbance, urinary symptoms and pseudobulbar features in small-vessel disease.
- Coexisting depression, apathy and emotional lability.
- Strong vascular risk-factor history — hypertension, diabetes, atrial fibrillation, smoking, hyperlipidaemia.
How we investigate
Cognitive examination (Addenbrooke's, MoCA), cardiovascular risk assessment, MRI brain (assessing white-matter disease, lacunar infarcts, microbleeds, atrophy), bloods including lipids and HbA1c, ECG and 24-hour Holter for atrial fibrillation, carotid Doppler in selected cases.
Treatment options at The Vesey
- Aggressive vascular risk reduction — BP, lipids, diabetes, atrial fibrillation anticoagulation, smoking cessation.
- Treatment of underlying conditions — sleep apnoea, depression, alcohol use disorder.
- Cholinesterase inhibitor or memantine — for mixed Alzheimer's-vascular dementia where appropriate.
- Cognitive rehabilitation and care planning — coordinated with our partner OT and care-planning teams.
- Long-term cognitive surveillance — repeat assessment at 6 and 12 months.
Is vascular dementia the same as Alzheimer's disease? +
No. Alzheimer's is caused by protein deposits (amyloid and tau) in the brain. Vascular dementia is caused by reduced or interrupted blood supply — from strokes, TIAs or small-vessel disease. Mixed pathology is common. The distinction matters because the treatments and modifiable risk factors differ.
Can vascular dementia be stopped from progressing? +
Progression can be significantly slowed, and sometimes temporarily arrested, by aggressive vascular risk-factor management: blood pressure control to target, statin therapy, anticoagulation for atrial fibrillation, HbA1c optimisation, and stopping smoking. Protecting the blood supply protects cognitive function.
What does MRI show in vascular dementia? +
MRI typically shows white-matter hyperintensities (leukoaraiosis), lacunar infarcts in the basal ganglia and thalamus, or cortical infarcts from large-vessel strokes. The Fazekas scale quantifies white-matter disease burden. Microbleeds on gradient echo sequences suggest small-vessel disease and guide anticoagulation decisions.
Does treating high blood pressure really make a difference to vascular dementia? +
Yes — it is the single most evidence-based intervention. Multiple large trials show that lowering systolic BP to below 130 mmHg reduces new vascular events and slows cognitive decline. This is why we include a full cardiovascular risk panel and 24-hour blood pressure recording in our assessment.
Pricing at a glance
Initial neurology / cognitive consultation £260 (90-minute slot). MRI brain from £450. Cardiovascular risk panel from £190. Follow-up reviews £190. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
Book an appointment
When to see a specialist
Book if there has been cognitive change after a stroke or TIA, if vascular risk factors are accumulating without structured review, or if you want a second opinion on diagnosis or care planning.
Cost and pathway
Initial neurology / cognitive consultation £260 (90-minute slot). MRI brain from £450. Cardiovascular risk panel from £190. Follow-up reviews £190.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with our neurology team
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.88/5 on Doctify from 700+ verified reviews
Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
Open 7 days · 8am–8pm · 0121 387 3727