Which statement describes vascular dementia pathophysiology?

Demyelinating disease of the CNS

Neurodegenerative disease limited to hippocampus

Tauopathy causing global cortical atrophy

Damage to brain due to cerebrovascular events leading to brain infarcts

Vascular dementia stems from cerebrovascular injury that causes brain infarcts and ischemic damage. When a person experiences strokes or progressive small vessel disease, chunks of brain tissue die or become dysfunctional, and the affected networks—often those governing executive function and processing speed—suffer cumulative damage. This leads to cognitive decline that can be stepwise, aligning with new vascular events, rather than a smooth, uniform progression.

This fits best because the core problem is blood vessel–related injury to the brain, not demyelination, a disease confined to the hippocampus, or a primary tau-driven neurodegenerative process with widespread cortical atrophy. In vascular dementia, imaging typically shows infarcts and white matter changes from vascular disease, reflecting the vascular basis of the impairment.

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