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Vascular dementia is the second most prevalent type of dementia in the United States today. This article includes a review of its pathophysiology, which involves the damage of small vessels in the brain, an abundance of which are in the subcortical region, thus creating a subcategory called subcortical vascular dementia (SVD). Various diseases, such as diabetes and high blood pressure, predispose the individual to damage to these small vessels. The symptoms of SVD are included as a review and helpful outline to differentiate SVD from Alzheimer's dementia and depression. Additionally, evidence-based interventions are reviewed. Nurses play a unique role in preventing and minimizing this dementia, which afflicts such a large percentage of our elderly population.