What Is Mixed Dementia?

Since different factors can cause different kinds of Dementia, a person may experience more than one form of Dementia at once. Whenever this occurs, the patient is diagnosed with mixed Dementia, clinically known as dementia-multifactorial.

At least one out of every ten people with Dementia has more than one type. Unfortunately, mixed Dementia is significantly more common in older adults, particularly those over the age of 75. 

A Closer Look at Mixed Dementia

Doctors often use the term “mixed dementia” only when a person has evident clinical signs of two types of disease that contribute directly to dementia symptoms. In some circumstances, a patient’s brain changes may relate to all four dementia types – Alzheimer’s disease, Vascular Dementia, Frontotemporal Dementia and Dementia with Lewy bodies. Mixed Dementia can result in a wide range of symptoms due to the possibility of a combination.

However, the most common type of mixed Dementia is the coexistence of Alzheimer’s disease and vascular Dementia. Furthermore, Alzheimer’s disease brain changes frequently interact with Lewy bodies. The neurodegenerative condition worsens with age and can gradually impair your loved one’s ability to carry out daily tasks.

What Causes Mixed Dementia?

Many types of Dementia, such as Alzheimer’s disease, vascular Dementia, Lewy Body Dementia, Frontotemporal Dementia and Dementia-multifactorial, are no longer considered a normal part of aging. However, Dementia can result from brain-related changes, which often occur with aging. In fact, up to half of all people aged 85 and above may have some Dementia. 

In simple terms, the brain degenerates when healthy neurons (nerve cells) stop working, disconnect from other brain cells, and die. There is a greater loss of healthy nerve cells in dementia patients. 

Furthermore, the presence of Vascular Dementia-related symptoms suggests that vascular risk factors such as high blood pressure, irregular heartbeat, diabetes, and high cholesterol may increase the likelihood of having mixed Dementia.

What is the Prevalence of Mixed Dementia?

The NIA-funded Memory and Aging Project has discovered that mixed Dementia is actually more common than previously taught.

According to data from the 141 volunteers in a research trial, more than half of those whose brains matched pathological criteria for Alzheimer’s exhibited diagnostic evidence of one or more coexisting forms of Dementia.

Female home carer supporting old woman to stand up from the armchair at care home

Symptoms

The symptoms of mixed Dementia may vary based on the types of brain alterations involved and affected brain regions. In many situations, the symptoms are similar to, if not identical, those of Alzheimer’s disease. The main symptom of Alzheimer’s disease include: 

  • Loss of memory 
  • Learning difficulties
  • Impaired cognitive ability
  • Understanding 
  • Delusion, confusion, disorientation 

Alzheimer’s disease behavioural problems include: 

  • Mood changes
  • Altered personality
  • Suspicious behaviour 
  • Restlessness
  • Depression 
  • Hallucination
  • Paranoia

Long-term studies will continue to provide insight into the link between cognitive performance and underlying brain abnormalities, allowing researchers to understand mixed dementia symptoms better. 

Diagnosis

The majority of people whose autopsies reveal they had mixed Dementia were diagnosed with only one type of Dementia throughout their lives, most often Alzheimer’s disease. Meanwhile, researchers are performing brain autopsies to determine the link between a participant’s cognitive health and problems they have been diagnosed with throughout their lives.

In general, Dementia is diagnosed primarily by taking the patient’s medical history, followed by physical examinations and neurological tests. Knowing whether someone has mixed Dementia is vital since the combination of two or more forms of Dementia will likely have a bigger impact on their brain than having one disease alone. This can have an impact on how a person’s general health declines through dementia progression. For more on this, check out Early Diagnose Alzheimer’s & Dementia.

Young carer walking with the elderly woman in the park, Mixed dementia

Treatment and Outcomes

The FDA has not approved any particular drug for treating multifactorial Dementia. As a result, treatment options vary by the type of Dementia that has been diagnosed. For example, suppose that your loved one’s symptoms are consistent with Alzheimer’s. In that case, the doctor might prescribe medication to treat precisely that. In some cases, physicians may also write a prescription to treat heart or blood vessel diseases. This procedure aims to control vascular changes in the brains of people suffering from vascular and other types of Dementia.

Unfortunately, there is no drug that can treat Frontotemporal Dementia or Vascular Dementia. However, someone with vascular Dementia may still be able to avoid strokes. That is, if they continue to take blood pressure or diabetic medication.

Therapies for Mixed Dementia

The progress of mixed Dementia can appear to be quicker, depending on the part of the brain affected. Therefore, mixed dementia patients may benefit from various therapies, in addition to medicine, to improve mobility and quality of life. Examples include cognitive rehabilitation, cognitive stimulation treatment, cognitive behavioural therapy, and remembrance therapy.

Through occupational therapy, for example, seniors with Mild Dementia can learn coping behaviours and strategies to compensate for memory loss.

Final Words

A greater understanding of mixed Dementia could benefit patients and their families greatly. The realization that vascular changes are the most prevalent coexisting brain change, according to many specialists, could result in a decline in the number of people with Dementia. Preventing all cardiovascular and blood vessel diseases may also shield the brain against vascular changes.

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Source Alzheimer's Association Alzheimer's Society Alzheimer Calgary
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