Behavioral and psychological symptoms of dementia (BPSD) have long been assumed to be an intrinsic clinical feature of vascular dementia. This assumption is based on case histories and selected series of patients with probable vascular dementia, especially those with small vessel disease, and has been further fueled by the inclusion of features of BPSD in clinical diagnostic algorithms (Cummings, 1994; Hachinski et al., 1975; Wallin et al., 1996). However, controlled empiric research on BPSD in vascular dementia is lacking. The existing literature does not fully support the assumption that BPSD are integral to vascular dementia.