Nutrition and vascular dementia



The objective of this review was to elucidate the relationship between VaD and various nutritional factors based on epidemiological studies.


Vascular dementia (VaD) is the second most common type of dementia. The prevalence of VaD continues to increase as the US population continues to grow and age. Currently, control of potential risk factors is believed to be the most effective means of preventing VaD. Thus, identification of modifiable risk factors for VaD is crucial for development of effective treatment modalities. Nutrition is one of the main modifiable variables that may influence the development of VaD.


A systematic review of literature was conducted using the PubMed, Web of Science, and CLNAHL Plus databases with search parameters inclusive of vascular dementia, nutrition, and vascular cognitive impairment (VCI).


Fourteen articles were found that proposed a potential role of specific nutritional components in VaD. These components included antioxidants, lipids, homocysteine, folate, vitamin B12, and fish consumption. Antioxidants, specifically Vitamin E and C, and fatty fish intake were found to be protective against VaD risk. Fried fish, elevated homocysteine, and lower levels of folate and vitamin B12 were associated willi increased VaD. Evidence for dietary lipids was inconsistent, although elevated midlife serum cholesterol may increase risk, while late-life elevated serum cholesterol may be associated with decreased risk of VaD.


Currently, the most convincing evidence as to the relationship between VaD and nutrition exists for micronutrients, particularly Vitamin E and C. Exploration of nutrition at the macronutrient level and additional long term prospective cohort studies are warranted to belter understand the role of nutrition in VaD disease development and progression. At present, challenges in this research include limitations in sample size, which was commonly cited. Also, a variety of diagnostic criteria for VaD were employed in the studies reviewed, indicating the need for constructing a correct nosological definition of VaD for consistency and conformity in future studies and accurate clinical diagnosis of VaD.

This is a preview of subscription content, log in to check access.


  1. 1.

    U.S Census Bureau. International Database. Table 094. Midyear population, by age and sex. Accessed 22 August 2010

  2. 2.

    Meyer A (1937) The histological criteria of vascular disturbances in the brain. J Ment Sci. 83:509

    Google Scholar 

  3. 3.

    Jellinger KA, Alterns J (2005) Prevalence and pathogenic role of cerebrovascular lesions in Alzheimer disease. J Neurol Sci 229–230: 37–41

    PubMed  Article  Google Scholar 

  4. 4.

    Esiri MM, Nagy Z, Smith MZ, Bametson L, Smith AD (1999) Cerebrovascular disease and threshold for dementia in the early stages of Alzheimer’s disease. Lancet 354(9182): 919–920

    PubMed  Article  CAS  Google Scholar 

  5. 5.

    Cairns NJ, Bigio EH, Mackenzie IR. et al. (2007) Neuropathologic diagnostic and nosologic criteria for frontotemporal lobar degeneration: consensus of the consortium for frontotemporal lobar degeneration. Acta Neuropathol 114(1): 5–22

    PubMed  Article  Google Scholar 

  6. 6.

    Pantoni L, Sarti C, Alafuzoff I, Jellinger K, Munoz DG, Ogata J, Palumbo V (2006) Postmortem examination of vascular lesions in cognitive impairment: a survey among neuropathological services. Stroke 37(4): 1005–1009

    PubMed  Article  Google Scholar 

  7. 7.

    Román GC (2002) Vascular dementia may be the most common form of dementia in the elderly. J Neurol Sci 203–204: 7–10.

    PubMed  Article  Google Scholar 

  8. 8.

    Plassman BL, Langa KM, Fisher GG, et al. (2007) Prevalence of dementia in the United States: the aging, demographics, and memorv study. Neuroepidemiology 29:125–132

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    Fitzpatrick AL, Kuller LH, Lopez OL, Kawas CH, Jagust W (2005) Survival following dementia onset: Alzheimer’s disease and vascular dementia. J Neurol Sci 229–230:43–49

    PubMed  Article  Google Scholar 

  10. 10.

    Hill J, Fillit H, Shah SN, del Valle MC, Futterman R (2005) Patterns of healthcare utilization and costs for vascular dementia in a community-dwelling population. J Alzheimers Dis 8(1): 43–50

    PubMed  Google Scholar 

  11. 11.

    Kirshner HS (2009) Vascular dementia: a review of recent evidence for prevention and treatment. Curr Neurol Neurosci Rep 9(6): 437–442

    PubMed  Article  Google Scholar 

  12. 12.

    Lin JC, Hsu HP, Fung HC, Chen ST (2007) Risk factors for vascular dementia: a hospital-based study in Taiwan. Acta Neurol Taiwan 16:22–26

    PubMed  CAS  Google Scholar 

  13. 13.

    Watanabe T, Koba S, Kawamura M, Jlakawa M, Idei T, Nakagawa Y, Iguchi T, Katagiri T (2004) Small dense low-density lipoprotein and carotid atherosclerosis in relation to vascular dementia. Metabolism. 53(4): 476–482

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Watanabe T, Miyazaki A, Katagiri I, Yamamoto H, Idei T, Iguchi T (2005) Relationship between serum insulin-like growth factor-1 levels and Alzheimer’s disease and vascular dementia. J Am Geriatr Soc 53: 1748–1753

    PubMed  Article  Google Scholar 

  15. 15.

    Hayden KM, Zandi PP, Lyketsos CG, Khachaturian AS, Bastian LA, Charoonruk G, et al (2006) Vascular risk factors for incident Alzheimer disease and vascular dementia: the Cache County study. Alzheimer Dis Assoc Disord 22: 93–100

    Article  Google Scholar 

  16. 16.

    Anstey KJ, von Sanden C, Salim A, O’Kearney R (2007) Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies. Am J Epidemiol 166: 367–378

    PubMed  Article  Google Scholar 

  17. 17.

    Whitmer RA, Gunderson EP, Quesenberry CP, Zhou J, Yaffe K (2007) Body mass index in midlife and risk of Alzheimer disease and vascular dementia. Curr Alzheimer Res 4:103–109

    PubMed  Article  CAS  Google Scholar 

  18. 18.

    Chiang CJ, Yip PK, Wu SC, Lu CS, Liou CW, Liu HC, et al. (2007) Midlife risk factors for subtypes of dementia: a nested case-control study in Taiwan. Am J Geriatr Psychiatry 15(9):762–771

    PubMed  Article  Google Scholar 

  19. 19.

    Van Dyk K, Sano M (2007) The impact of nutrition on cognition in the elderly. Neurochem Res 32(4–5): 893–904

    PubMed  Article  CAS  Google Scholar 

  20. 20.

    Van der Beek EM, Kamphius PJ (2008) The potential role of nutritional components in the management of Alzheimer’s Disease. Eur J Pharmacol 585(1): 197–207

    PubMed  Article  Google Scholar 

  21. 21.

    Masaki KH, Losonczy KG, Izmirlian G, Foley DJ, Ross GW, Petrovitch H, Havlik R, White LR (2000) Association of vitamin E and C supplement use with cognitive function in elderly men. Neurologv 54:1265–1272

    CAS  Google Scholar 

  22. 22.

    Maxwell CJ, Hicks MS, Hogan DB, Basran J, Ebly EM (2005) Supplemental use of antioxidant vitamins and subsequent risk of cognitive decline and dementia. Dement Geriatr Cogn Disord 20:45–51

    PubMed  Article  CAS  Google Scholar 

  23. 23.

    Laurin D, Masaki KH, Foley DJ, White LR, Launer LT (2004) Midlife dietary intake of antioxidants and risk of late-life incident dementia: the Honolulu-Asia Aging Study. Am J Epidemiol 159: 959–967

    PubMed  Article  Google Scholar 

  24. 24.

    Ryglewicz D, Rodo M, Kunicki PK, Bednarska-Makaruk M, Graban A, Lojkowska W, Wehr H (2002) Plasma antioxidant activity and vascular dementia. J Neurol Sci 203–204:195–197

    PubMed  Article  Google Scholar 

  25. 25.

    Koseoglu E, Karaman Y (2007) Relations between homocysteine, folate and vitamin B12 in vascular dementia and in Alzheimer disease. Clin Biochem 40: 859–863

    PubMed  Article  Google Scholar 

  26. 26.

    Ouadri P, Fragiacomo C, Pezzari R, Zanda E, Forloni G, Tettamanti M, Lucca U (2004) Homocysteine, folate, and vitamin B-12 in mild cognitive impairment, Alzheimer disease, and vascular dementia. Am J Clin Nutr 80:114–122

    Google Scholar 

  27. 27.

    Malaguarnera M, Ferri R, Bella R, Alagona G, Carnemolla A, Pennisi G (2004) Homocysteine, vitamin B12 and folate in vascular dementia and Alzheimer disease. Clin Cbem Lab Med 42:1032–1035

    Article  CAS  Google Scholar 

  28. 28.

    Kalmijn S, Launer LJ, Ott A, Witteman JC, Hofman A, Breteler MM (1997) Dietary fat intake and the risk of incident dementia in the Rotterdam Study. Ann Neurol 42:776–782

    PubMed  Article  CAS  Google Scholar 

  29. 29.

    Engelhart MJ, Geerlings MI, Ruitenberg A, Van Swieten JC, Hofman A, Witteman JC, Breteler MM (2002) Diet and risk of dementia: Does fat matter?: The Rotterdam Study. Neurology 59:1915–1921

    PubMed  CAS  Google Scholar 

  30. 30.

    Otsuka, M, Yamaguchi K, Ueki (2002) Similarities and differences between Alzheimer’s disease and vascular dementia from the viewpoint of nutrition. Ann N Y Acad Sci. 977:155–261

    PubMed  Article  CAS  Google Scholar 

  31. 31.

    Huang TL, Zandi PP, Tucker KL, Fitzpatriek AL, Kuller LH, Fried LP, Burke GL, Carlson ML (2005) Benefits of fatty fish on dementia risk are stronger for those without APOE epsilon4. Neurology. 65:1409–1414

    PubMed  Article  CAS  Google Scholar 

  32. 32.

    Reitz C, Tang MX, Luchsinger J, Mayeux R (2004) Relation of plasma lipids to Alzheimer disease and vascular dementia. Arch Neurol 61: 705–714

    PubMed  Article  Google Scholar 

  33. 33.

    Solomon A, Kivipelto M, Wolozin B, Zhou J, Whitmer RA (2009) Midlife serum cholesterol and increased risk of Alzheimer’s and vascular dementia three decades later. Dement Geriatr Cogn Disord 28:75–80.

    PubMed  Article  CAS  Google Scholar 

  34. 34.

    Mielke MM, Zandi PP, Sjogren M, Gustafson D, Ostling S, Steen B, Skoog I (2005) High total cholesterol levels in late life associated with a reduced risk of dementia. Neurology 64:1689–1695.

    PubMed  Article  CAS  Google Scholar 

  35. 35.

    Deschamps V, Barberger-Gateau P, Peuchant E, Orgogozo JM (2001) Nutritional factors in cerebral aging and dementia: epidemiological arguments for a role of oxidative stress. Neuroepidemiology 20(1): 7–15

    PubMed  Article  CAS  Google Scholar 

  36. 36.

    Beydoun MA, Kaufman JS, Satia JA, Rosamond W, Folsom AR (2007) Plasman-3 fatty acids and the risk of cognitive decline in older adults: the Atherosclerosis Risk in Communities Study. Am J Clin Nutr 85(4): 1103–1111

    PubMed  CAS  Google Scholar 

  37. 37.

    Cole GM, Frautschy (2010) DILA May Prevent Age-Related Dementia. J. Nutr 140(4): 869–874

    PubMed  Article  CAS  Google Scholar 

  38. 38.

    Herrmann W, Lorenzl S, Obeid R (2007) Review of the role of hyperhomocysteinemia and B-vitamin deficiency in neurological and psychiatric disorders-current evidence and preliminary recommendations. Fortschr Neurol Psychiatr 75(9): 515–527

    PubMed  Article  CAS  Google Scholar 

  39. 39.

    Herrmann W, Obeid R (2011) Homocysteine: a biomarker for neurodegenerative diseases. Clin Chem Lab Med 49(3): 435–441

    PubMed  Article  CAS  Google Scholar 

  40. 40.

    Mattson MP, Shea TB (2003) Folate and homocysteine metabolism in neural plasticity and neurodegenerative disorders. Trends Neurosci 26(3): 137–146

    PubMed  Article  CAS  Google Scholar 

  41. 41.

    Wiederkehr S, Simard M, Fortin C, van Reekum R (2008) Validity of clinical diagnostic criteria for vascular dementia: a critical review. Part II. J Neuropsychiatry Clin Neurosci 20:162–177

    PubMed  Article  Google Scholar 

  42. 42.

    Lopez OL, Kuller LH, Becker JT, Jagust WJ, DeKosky ST, Fitzpatrick A, Breitner J, Lyketsos C, Kawas C, Carlson M (2005) Classification of vascular dementia in the Cardiovascular Health Study Cognition Study. Neurology 64:1539–1547

    PubMed  Article  CAS  Google Scholar 

  43. 43.

    Tang WK, Chan SS, Chiu HF, Ungvari GS, Wong KS, Kwok TC, Mok V, Wong KT, Richards PS, Ahuja AT (2004) Impact of applying NINDS-AIREN criteria of probable vascular dementia to clinical and radiological characteristics of a stroke cohort with dementia. Cerebrovasc Dis 18: 98–103

    PubMed  Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to A. Dean Sherzai.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Perez, L., Helm, L., Sherzai, A.D. et al. Nutrition and vascular dementia. J Nutr Health Aging 16, 319–324 (2012).

Download citation

Key words

  • Vascular dementia
  • nutrition
  • diet