The aim of the study was to determine the features of cognitive functions in patients with vascular dementia with different localization of brain damage. 157 people with a diagnosis of vascular dementia were examined. Group 1 (G1) included 22 people with localization of the pathological process in the frontal lobe, group 2 (G2) — 18 patients with lesions of the temporal lobe, group 3 (G3) — 17 patients with lesions of the parietal lobe, group 4 (G4) — 15 patients with lesions of the occipital lobe, group 5 (G5) — 68 people with total defeat. Research methods: clinical-psychopathological, clinical-instrumental, experimental-psychological, anamnestic, clinical-statistical. In G1, the most affected cognitive domain is abstraction, in addition, a significant cognitive decline is observed in domains such as “delayed recollection”, “attention (numbers)” and “speech (repeating)”. For G2, the most pronounced decline in cognitive functioning occurred in such domains as “delayed recollection”, “fluency” and “counting”. There is also a decrease in the domains “speech (repeating)” and “attention (numbers)”. In G3, the most affected cognitive domains are fluency and speech (repetition), which is apparently due to the location of the Brock center, responsible for language, in the parietal lobes; in addition, a significant cognitive decline is observed in such a domain as “delayed recollection”. For G4, the most pronounced decrease in cognitive functioning occurred in such domains as “visual-constructive skills” and “naming objects”, which is a direct consequence of the defeat of visual centers. In G5, in general, there was the strongest cognitive decline, compared with individuals from the groups with localized pathology, which corresponded to moderate dementia. Most cognitive domains showed a statistically significant decrease compared to other groups.