Vascular Dementia

Confirming a diagnosis of vascular dementia needs evaluation by a specialist. There are many forms of dementia, and several of its symptoms overlap with other conditions.

Your healthcare provider will:

• Ask about the course of your symptoms.
• Ask about your medical history.
• Review your current medications. Some medications can cause dementia-like symptoms.
• Ask about your biological family’s medical history.

They’ll then likely recommend a variety of tests, including laboratory, imaging and neurocognitive tests. You may need to see dementia specialists, like neurologists and geriatricians to get a diagnosis.

Laboratory tests

Laboratory tests rule out other conditions as the cause of dementia symptoms, like infection, inflammation, hypothyroidism and vitamin deficiency (especially vitamin B12).

Sometimes, providers order cerebrospinal fluid (CSF) tests (via a spinal tap) to check for autoimmune conditions and neurodegenerative diseases.

Brain imaging tests

Your provider may order the following imaging tests of your brain:

• Computed tomography (CT) and magnetic resonance imaging (MRI): These imaging tests look for evidence of stroke, bleeding, tumors and fluid in your brain. Providers prefer to use MRIs to check for vascular dementia when possible.
• Amyloid PET scan: This is a special type of PET scan. It aids in detecting an abnormal buildup of amyloid proteins in your brain, which is often present in Alzheimer’s disease. Providers sometimes recommend this test if they suspect co-existing Alzheimer’s disease.

Neuropsychological testing

During neuropsychological testing, your provider uses written and computerized tests to evaluate your mental abilities, including:

• Problem solving.
• Learning.
• Judgment.
• Memory.
• Planning.
• Reasoning.
• Language.

Specially trained psychologists — neuropsychologists — then look at the results to better understand the relationship between your brain health and thinking (cognition).

Receiving a vascular dementia diagnosis

Healthcare providers use the following criteria to diagnose vascular dementia:

• Neurocognitive testing confirms the diagnosis of dementia or MCI.
• There’s brain imaging evidence (usually with MRI) confirming a recent stroke or other vascular brain changes that are consistent with the types of cognitive impairment you have.
• There’s no evidence that other factors may be contributing to cognitive decline.

These criteria suggest the greatest likelihood that mild cognitive impairment (MCI) or dementia is due to vascular damage and not another cause.