Patients at risk for vascular dementia should be targeted for prevention and treatment. Patients suitable for prevention include the elderly, smokers, and patients with hypertension, diabetes, atrial fibrillation, cardiac disease, and asymptomatic extracranial arterial disease. In addition, patients with TIAs, stroke, subtle cognitive impairment, silent cerebral infarctions, systemic lupus erythematosus or other causes of stroke should be targeted for preventive intervention.

Depending on the etiology of the risks, different methods of prevention and treatment are suggested. In terms of prevention, several strategies are suggested depending on risk factors. For example, medications that adversely affect serum lipids (such as beta-blockers and thiazide diuretics) should be avoided when treating at-risk patients for hypertension. Anticoagulants or antiplatelet drugs should be considered in patients with atrial fibrillation or who have suffered a stroke.