Functional decline is most often referred to as the impaired ability to perform activities of daily living (ADL), including instrumental activities of daily living (IADL), motor and sensory status. A diagnosis of vascular dementia implies activity limitations and participation restrictions. Assessment and measurement of disability, functional abilities and decline is of importance for diagnosis, treatment planning, and the analysis of treatment outcomes in vascular dementia. Assessments of ADL/IADL are conducted through various techniques, most commonly through formal assessments, but also through observations and informal interviews. Rehabilitation with the aim of maintaining an optimum level of physical, psychological and social functioning facilitates participation in preferred activities and social roles among persons who suffer from vascular dementia. New technology needs to be adaptable to the individual's needs, and introduced early after the onset of cognitive decline. However, of special interest for the future is the provision of cognitive support through built-in-the-home ICT.