Always Tired? It Might Be Vascular Dementia

Written by Nguyenjessica

Published on June 17 2025

Always feeling tired? Trouble focusing or making decisions? These could be more than just stress — they might be early signs of vascular dementia. Unlike Alzheimer’s, this form of dementia stems from poor blood flow to the brain.

Memory loss isn’t always the first clue. In this article, we’ll break down what vascular dementia really is, how it shows up, who’s at risk, and what can be done about it. You’ll learn how to spot symptoms early, what treatment options exist, and which simple lifestyle changes can help protect the brain. Keep reading to stay one step ahead.

Always Tired? It Might Be Vascular Dementia

Key Points

Vascular dementia is mainly caused by reduced blood flow to the brain, unlike Alzheimer’s which is linked to protein buildup. It usually affects thinking speed and decision-making before memory issues appear.

Constant fatigue may be an early clue of vascular dementia, but it's not a reliable sign on its own. If tiredness comes with memory or behavior changes, a medical check is a good idea.

There’s no cure, but treatments can slow down the disease. Lifestyle changes and medications to manage blood pressure, cholesterol, and blood sugar can help protect the brain and reduce future damage.

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Table of content

What is vascular dementia, and how is it different from other types of dementia?

Can feeling constantly tired really be an early sign of vascular dementia?

What are the most common symptoms of vascular dementia to watch for?

Who is at risk for vascular dementia, and why?

How is vascular dementia diagnosed?

What treatments are available?

What is vascular dementia, and how is it different from other types of dementia?

Vascular dementia happens when blood flow to the brain is reduced or blocked. Without enough oxygen and nutrients, brain cells get damaged or die. This often happens due to strokes, mini-strokes, or narrowing blood vessels.

The symptoms can be different for everyone, but common signs include:

Slower thinking, trouble planning or making decisions
Poor concentration, confusion, or getting disoriented
Difficulty expressing thoughts clearly
Emotional changes like depression, apathy, or anxiety

Some people might walk unsteadily, fall often, or lose bladder control. Others may experience changes in personality or speech problems.

Sometimes symptoms come on suddenly after a stroke. Other times, they worsen bit by bit, often after new blood vessel damage.

Unlike Alzheimer’s, which is linked to protein buildup in the brain, vascular dementia is caused by blood flow issues. Memory isn’t usually the first problem — instead, thinking speed and decision-making are often affected early on.

Some people may have both vascular dementia and Alzheimer’s, a condition called mixed dementia.

There are a few types. Some people develop it after many small strokes, others from a single major stroke. One type, called Binswanger’s disease, is caused by damage to small deep brain vessels, often due to high blood pressure or diabetes.

What is vascular dementia, and how is it different from other types of dementia?

Can feeling constantly tired really be an early sign of vascular dementia?

Feeling constantly tired or sleepy during the day might be related to vascular dementia, but it’s not enough on its own to make a diagnosis.

Research shows that vascular dementia affects blood flow to the brain, and that can disrupt how the brain controls sleep. As a result, excessive daytime sleepiness can occur.

In some cases, this sleepiness shows up even before noticeable memory or thinking problems. But more often, it's seen in the middle or later stages of the disease. Some studies link severe daytime sleepiness to a higher chance of developing dementia, including vascular dementia — but not everyone who feels tired will get it.

Sleep problems in vascular dementia include insomnia, disrupted sleep-wake cycles, sleep apnea, and restless legs. These issues make it hard to rest well at night, leading to more fatigue during the day.

That said, early signs of vascular dementia are usually more about slowed thinking, trouble concentrating, or sudden confusion, rather than just feeling tired. As brain function worsens, sleep-wake cycles get more disturbed, and fatigue becomes more noticeable.

So in short:

Feeling tired all the time may be an early clue, but it’s not specific or reliable on its own.

If tiredness comes with memory issues, changes in focus, or behavior shifts, it’s worth getting a medical checkup to explore possible brain or blood vessel issues.

What are the most common symptoms of vascular dementia to watch for?

Vascular dementia doesn’t always start with memory problems. What you’ll likely notice first is a change in how quickly someone thinks. They might take longer to solve problems or seem confused when making plans.

It gets harder for them to focus or stay organized. Tasks that require multiple steps, like cooking a meal, can become really challenging. They might also struggle to communicate clearly or follow conversations.

Mood changes are also common. You might see signs of depression, anxiety, or even sudden irritation. Some people become withdrawn or show less interest in things they used to enjoy.

Physically, they might walk unsteadily or fall more often. Incontinence can happen too. If the dementia follows a stroke, speech can become slurred or less fluent.

As the condition progresses, confusion gets worse—especially in the evening, a pattern known as sundowning. They might forget familiar faces or places and have trouble understanding simple things.

Communication becomes tougher, and their personality might shift a lot. Some become aggressive or unpredictable. Eventually, walking gets harder, bladder control worsens, and they need help with daily activities.

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Who is at risk for vascular dementia, and why?

Vascular dementia often affects people whose brain blood vessels have been damaged or narrowed, leading to reduced blood flow and brain cell injury. The most important risk factors include:

Age is the biggest factor
Risk rises sharply after age 65 and nearly doubles every five years. It’s uncommon before 65 but becomes much more frequent in the 80s and 90s.

Cardiovascular and metabolic conditions matter most

Stroke or mini-strokes directly damage the brain
High blood pressure strains and damages blood vessels
Atherosclerosis reduces brain blood flow due to hardened arteries
High LDL cholesterol contributes to vascular blockages
Diabetes harms blood vessels throughout the body, including in the brain
Heart disease and atrial fibrillation raise the risk of blood clots and strokes
Metabolic syndrome and obesity worsen heart health and raise dementia risk

Lifestyle choices play a big role

Smoking harms blood vessels and promotes atherosclerosis
Physical inactivity increases stroke and diabetes risk
Unhealthy diet (high in fats, sugar, and salt) fuels high blood pressure and cholesterol
Heavy drinking raises blood pressure and cholesterol, damaging vessels

Other contributing factors

Gender: Men are slightly more at risk
Ethnicity: South Asian, Black African, and Caribbean groups face higher diabetes and heart disease rates
Genetics: Most vascular dementia isn’t inherited, but rare genetic disorders like CADASIL can cause early-onset cases

How is vascular dementia diagnosed?

Diagnosing vascular dementia isn’t just about spotting memory problems. It’s a full process that starts with understanding a person’s health history and symptoms. Doctors look closely at things like past strokes or high blood pressure.

They’ll do physical and neurological exams to check how well the brain and body are working. Then, they use cognitive tests to see how someone handles memory, problem-solving, attention, and language. With vascular dementia, problem-solving and planning usually suffer more than memory in the beginning.

Blood tests are also part of it. These help rule out other issues like vitamin deficiencies or thyroid problems that might cause similar symptoms.

Brain scans are a big part of the diagnosis. MRIs are preferred because they can show small strokes, blood vessel damage, and other changes. CT scans are also used to spot bigger strokes or brain shrinkage. Sometimes, PET scans or EEGs are used to check brain activity more deeply.

If dementia is suspected, the person might be referred to a memory clinic or a neurologist for more specialized testing.

It’s not always easy to tell vascular dementia from Alzheimer’s, since the symptoms can overlap. In many cases, people actually have a mix of both types.

What treatments are available?

There’s currently no cure for vascular dementia, and existing brain damage can’t be reversed. But the good news is, treatment can slow the disease and prevent further harm by managing its root cause — poor blood flow to the brain.

1. Lifestyle Changes to Protect the Brain

Simple everyday habits can go a long way:
Eat a heart-healthy diet (low salt, balanced nutrients)
Lose weight if overweight
Quit smoking
Exercise regularly, even light walks help
Cut back on alcohol
These changes help improve heart and blood vessel health, which protects the brain from future damage.

2. Medications That Target Risk Factors
Doctors may prescribe medicines to protect the brain by controlling blood pressure, cholesterol, and preventing clots:

Blood pressure meds to ease stress on arteries
Statins to lower bad cholesterol and slow artery hardening
Antiplatelets like low-dose aspirin or clopidogrel to prevent clots
Anticoagulants like warfarin for people with atrial fibrillation
Diabetes medications to keep blood sugar stable
Antipsychotics (used cautiously) for severe agitation or aggression
Alzheimer’s drugs like donepezil or memantine aren’t routinely used in pure vascular dementia, but may help in mixed cases where both types of dementia are present.