No medication treats vascular dementia itself, and cholinesterase inhibitors are not routinely recommended for it. The treatment that affects the course is controlling vascular risk factors to prevent further events causing additional decline. Blood pressure control, antiplatelet or anticoagulant treatment where indicated, statins, diabetes management and smoking cessation are the dementia treatment in this condition.
No medication treats vascular dementia itself, and cholinesterase inhibitors are not routinely recommended for it. The treatment that affects the course is controlling vascular risk factors to prevent further events causing additional decline. Blood pressure control, antiplatelet or anticoagulant treatment where indicated, statins, diabetes management and smoking cessation are the dementia treatment in this condition.
This is the useful reframe. There is no drug licensed for vascular dementia, and the cholinesterase inhibitors used in Alzheimer's disease show limited benefit here and are not routinely recommended. What does influence the course is preventing further vascular damage: blood pressure control, antiplatelet or anticoagulant treatment where indicated, statin therapy, diabetes management, smoking cessation and treating sleep apnoea. Those are the dementia treatment in this condition.
Mixed pathology is common, particularly in older adults, and where there is a significant Alzheimer's component alongside the vascular damage, a cholinesterase inhibitor may be tried. That is a reasoned trial in mixed dementia rather than treatment for vascular dementia as such, and it is worth understanding the distinction so expectations are accurate. Benefit, where it occurs, is modest.
Low mood is common after vascular events and is treatable rather than an inevitable response. Emotional lability, including crying or laughing out of proportion to the situation, sometimes responds to specific treatment and is worth raising. Gait disturbance and urinary urgency appear earlier in this condition than in others and have their own management. Reviewing medications for anticholinergic burden matters as much here as in any dementia.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: Alzheimer disease; National Institute of Neurological Disorders and Stroke; MedlinePlus: memory.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.