There are currently no treatments that can reverse the brain cell damage that causes vascular dementia. However, a doctor may prescribe or monitor medicines used to treat underlying conditions that can lead to vascular dementia.

These include medications for diabetes, stroke, high blood pressure, high cholesterol and heart problems.

A doctor will also advise making healthy lifestyle changes to help limit the damage caused by these underlying conditions. This could include stopping smoking, doing more exercise, maintaining a healthy weight and eating a balanced diet.

Memory and thinking

People diagnosed with vascular dementia may benefit from cognitive therapy. These activities are designed to stimulate thinking skills and engage people. They are often group-based and include games and discussions to encourage socialising. Speech therapy may also help to improve communication problems.

For people with both vascular dementia and Alzheimer’s (mixed dementia), there are some drugs used to treat Alzheimer’s disease that may help with the symptoms of mixed dementia. If you’ve been diagnosed with mixed dementia you can discuss these treatment options with your doctor.

Depression

Depression is common in all forms of dementia. Your doctor may consider recommending cognitive behavioural therapy (CBT). CBT provides an opportunity for people to talk about their worries and concerns with a specialist practitioner. It aims to help people develop different ways of thinking and behaving.

There may also be other therapies offered in your local area that could help; these might include exercise or group activities such as music therapy.

You may be offered an antidepressant drug, either as an alternative to CBT or in combination with it. There are different types, or classes, of antidepressant; some are not suitable for people with dementia. Your doctor will be able to advise you if an antidepressant could help and which type would be best.

Agitation, anxiety and aggression

Some people with dementia experience agitation, aggression, delusions (negative or mistaken beliefs), severe anxiety, hallucinations, sleep disturbances and other behavioural symptoms. They are also known as neuropsychiatric symptoms or behavioural and psychological symptoms of dementia (BPSD).

While these symptoms can be difficult for the person living with dementia and their loved ones, there are simple things that might help. It may be possible to identify the cause or trigger of aggression or agitation. A person’s physical health may affect their behaviour – for example pain, being constipated or needing the toilet. Someone’s surroundings can also affect their behaviour, as well as their feelings towards certain situations.

Finding out if there are triggers that cause aggressive or agitated behaviour means it might be possible to remove, treat or avoid them. Mild behavioural symptoms can often be helped with adjustments to physical surroundings, reassurance or changes to daily routine. Possible triggers could include:

  • undetected pain or discomfort
  • infection
  • depression
  • social situations
  • factors in the environment
  • disruption to routine.

Complementary treatments, tailored to the person’s preference, that promote wellbeing may also be helpful for people with anxiety, agitation, and aggression. This may include aromatherapy, music therapy and outdoor activities. You can speak to your doctor about any of the therapies mentioned and what might be suitable and available.

If someone experiences severe and distressing symptoms that can’t be controlled without medication, then antipsychotic drugs may be considered. These drugs help correct the imbalance of chemicals in the brain that cause symptoms like aggression. However, there are severe side effects, and they are not suitable for everyone. Anyone taking antipsychotics should be carefully and regularly monitored by the doctor.

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Treatments for dementia

Read more about treatments for dementia, including information on treating depression, anxiety and agitation and for information on antipsychotics.

What is vascular dementia?

This booklet aims to help you understand more about vascular dementia. It gives an overview of the causes, symptoms and treatments.

Sue Strachan - Photo credit Alex Wallace
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Order health information

Alzheimer’s Research UK has a wide range of information about dementia. Order booklets or download them from our online form.

This information was updated in December 2023 and is due to be reviewed in December 2025. It was written by Alzheimer’s Research UK’s Information Services team with input from lay and expert reviewers. Please get in touch if you’d like a version with references or in a different format.

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