Mixed Dementia

What is Mixed Dementia?

Mixed dementia is a condition where an individual has more than one type of dementia at the same time. Each disease impacts the brain in different ways, which can make symptoms more complex. The most common combinations include Alzheimer’s Disease and Vascular Dementia as well as Alzheimer’s Disease and Lewy Body Dementia, but other combinations are also possible.

Who is Affected?

Like most dementias, mixed dementia most often affects older adults (75+).

What are the Causes and Risk Factors?

Mixed dementia develops when multiple brain diseases occur at the same time. The conditions may damage the brain through different mechanisms, build-up of different proteins or reduced blood flow. Common contributing conditions include Alzheimer’s Disease, Vascular Dementia and Lewy Body Dementia.

Uncontrollable Risk Factors

• Increasing age
• Genetic factors & family history
• History of neurological disease
• History of stroke 

Controllable Risk Factors

• High blood pressure
• Diabetes
• High cholesterol
• Smoking
• Heart disease

Who is Most at Risk?

• Older adults and individuals with cardiovascular disease
• People with risk factors for both Alzheimer’s Disease and vascular disease

What Steps Can You Take to Reduce Your Risk?

Managing vascular risk factors may help you reduce the likelihood or impact of mixed dementia.

• Manage chronic conditions including high blood pressure, high cholesterol or diabetes
• Stay physically active
• Stop or do not start smoking
• Maintain heart-healthy habits

What are the Signs & Symptoms?

Signs and symptoms of mixed dementia will vary depending on which brain diseases are present, the severity of the brain diseases and the areas of the brain impacted.

Symptoms may include:

• Memory loss
• Difficulty thinking or problem solving
• Trouble with attention or concentration
• Changes in judgement, personality or behavior changes
• Problems with movement or balance
• Visual hallucinations

How is Mixed Dementia Diagnosed?

Mixed dementia can be difficult to diagnose, as many forms of dementia have similar symptoms. Diagnosis is based on medical history, symptom patterns and neurological evaluation.

Diagnostics tests may include:

• Neurological examination
• Cognitive and memory testing
• Brain imaging (such as MRI or CT)
• Blood tests to rule out other conditions
• Evaluation of cardiovascular health

In many cases, a definitive diagnosis is not able to be determined until after death.

How is Mixed Dementia Treated?

There is no cure for mixed dementia. Treatment focuses on managing the symptoms and addressing the underlying conditions.

Lifestyle

• Maintaining daily routines
• Managing cardiovascular risk factors
• Creating a safe living environment

Devices

• Memory aids
• Mobility and safety devices as needed

Medical

• Medications for Alzheimer’s Disease
• Medications to manage vascular disease and risk factors
• Medications to address mood, behavior or movement symptoms

Surgical

• None

Other

• Physical therapy
• Occupational therapy
• Speech therapy
• Caregiver education and support services

When to See Your Doctor

If you suspect any type of dementia, talk to your healthcare provider about your concerns. You may be referred to a neurologist for further evaluation and testing. Early evaluation can help guide treatment decisions, manage risk factors and connect patients and families with supportive resources.

When to Seek Emergency Medical Care

Seek emergency medical care if symptoms appear suddenly, worsen rapidly or include signs of a stroke, such as weakness on one side, balance problems or difficulties with speech.

If you're concerned about changes in your memory, start by talking with your primary care provider. While occasional forgetfulness can be a normal part of aging, memory changes that interfere with your daily life should be evaluated. Many conditions, not just dementia, can affect memory, and your provider can help determine the cause and whether a referral to a neurologist is needed.

Visit Understanding Memory to learn more about the many things than can impact memory.

To learn more and connect with support, visit Riverside Health’s Martha W. Goodson Center.