With increasing understanding of BPSD, the question of whether there are differences between BPSD of AD and VaD may be raised. The available evidence from the Cache County Study, the role of vascular risk factors in late-life depression, and vascular pathology in AD and VaD all converge to explore the impact of vascular burden on cerebral function and BPSD. This article argues that there may be domain differences in BPSD between AD and VaD and suggests that BPSVaD may be a concept to be pursued with possible useful clinical implications.