Alzheimer disease (AD) is a neurodegenerative disease of the central nervous system, with complicated etiologies. Recent studies have found that vascular disease has a great impact on AD, and abnormal vascular endothelial growth factor (VEGF) expression is thought to play an important role in the course of AD. MicroRNAs expression has greatly changed in the brain of AD patients. This paper reviewed the latest advance in the effects of vascular and genetic factors on the occurrence and progression of AD, with discussion also on the probable pathogenesis, therapeutic targets and strategies of AD.