Vascular dementia (VaD) and Alzheimer”s disease (AD) are often described as distinct entities. Recent literature suggests that they may be part of a continuum, where pure VaD is quite rare, Alzheimer”s disease is only 40% of the total and AD with cerebrovascular disease makes up the majority of cases that present to memory clinics. This relationship between VaD and AD is highlighted by their common risk factors – especially cardiovascular. Pure VaD is a heterogeneous entity, now separated clinically and radiologically into cortical, subcortical and strategic infarct subtypes. The treatment of VaD includes the primary and secondary prevention of cardiovascular and cerebrovascular disease; and early signs of a dementia may not always involve memory loss. This can lead to late presentations of patients when the more obvious signs and symptoms occur. Consequently, dementia services should work more closely with cardiology and stroke services in order to detect early cases of VaD. This will be increasingly important as new treatments become available.