What is Mixed Dementia? Symptoms, Causes, Diagnosis and Treatment

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Mixed dementia is a common type of dementia when individuals have two or more types of dementia. The most common types of dementia that cause Mixed Dementia are Alzheimer’s Disease and Vascular Dementia. There are many other possible combinations, but this is the most common. Mixed dementia may also be referred to as dementia-multifactorial.

What is Mixed Dementia?

Individuals living with dementia may have more than one type of dementia. When this occurs, it is called Mixed Dementia. The most common combination is Alzheimer’s Disease and Vascular Dementia. Those living with Mixed Dementia will have symptoms of both types of dementia. Mixed dementia is more common in older individuals over 75 years old.

Most often, Mixed Dementia is caused by the plaques and tangles seen in those with Alzheimer’s and blood vessel changes found in those living with Vascular Dementia.

The plaques and tangles in Alzheimer’s can also be found along with abnormal protein deposits that are found in those living with Lewy Body Disease and Parkinson’s Disease.

Individuals with Mixed Dementia may have signs and symptoms of all three: Alzheimer’s Disease, Vascular Dementia, and Lewy Body Dementia.

Individuals living with Mixed Dementia will likely be affected more than those living with one type of dementia. The combination of more than one dementia has a more significant impact on the brain that quickly causes more damage. Those with Mixed Dementia may go through the stages of dementia at a quicker rate.

How Many People Have Mixed Dementia?

How Many People Have Mixed Dementia

It is unclear to researchers how many people living with one type of dementia actually have Mixed Dementia. However, autopsy studies indicate that Mixed Dementia is more common than what researchers initially thought.

Why are Autopsy Studies Performed?

Autopsy studies are performed because, currently, researchers cannot measure changes in the brain caused by dementia in living individuals. Therefore autopsy studies allow researchers to understand Mixed Dementia better and why it may occur.

How do I know if I have Mixed Dementia?

How do I know if I have Mixed Dementia

Mixed dementia is difficult to diagnose. If you suppose you or a loved one is living with Mixed Dementia, you will want to make a list of the Dementia Symptoms that you notice and talk with your doctor about your concerns.

As per experts, individuals with symptoms of cardiovascular disease and dementia, getting worse over time, can be diagnosed with Mixed Dementia because it is a strong indication that Alzheimer’s Disease and Vascular Disease are both present.

Common Types of Mixed Dementia

Most often, Mixed Dementia is a combination of two types of dementia. On occasion, individuals may have three types of dementia.

The two most common types of mixed dementia are

  • Alzheimer’s Disease and Vascular Dementia
  • Alzheimer’s Disease and Lewy Body Dementia

Symptoms of Mixed Dementia

Symptoms of Mixed Dementia

Since Mixed Dementia is the combination of more than one type of dementia, symptoms vary from person to person based on the types of dementia that the individual has.

 To know the symptoms of Mixed Dementia, it is vital to recognize the signs in the most common types of dementia that make up Mixed Dementia.

Alzheimer’s Disease Symptoms

Alzheimer’s disease is a brain disorder that affects your thinking, memory, and behavior. It is the 6th leading cause of death in the United States. Researchers believe that more than 65 million Americans are living with this disease.

Alzheimer’s disease is caused by abnormal buildups of proteins that form amyloid plaques and tangles. Neurons then begin to die, and affected brain parts start to shrink. This causes healthy neurons to stop functioning correctly.

The most common Alzheimer’s Disease symptom is memory loss. Short-term memory is the first thing that is affected.

Common signs include:

  • Memory loss
  • Repeating questions
  • Repeating statements
  • Becoming more forgetful
  • Misplacing items
  • Becoming lost in familiar places
  • Forgetting names of close friends and family
  • Thinking and Reasoning
  • Trouble concentrating and thinking
  • Struggle to multitask
  • Struggle when managing finances (Paying bills/ balancing checkbook)
  • Judgment and Decisions
  • Wearing Inappropriate clothes for the weather/ season
  • Making Quick judgments become difficult
  • Difficulty with Familiar Tasks
  • Trouble following a recipe
  • Trouble playing a familiar board game
  • Changes in Personality and Behavior

Vascular Dementia Symptoms

Vascular Dementia Symptoms

Vascular dementia is the second or third most common type of dementia that affects your memory and thinking. It’s caused when your brain is not receiving enough oxygen and nutrients that it needs by poor blood flow or a blockage.

Strokes are a common cause of Vascular Dementia because oxygen to the brain is cut off immediately. Things that can cause Vascular Dementia include blood clotting, bleeding from ruptured vessels, high blood pressure, and infections.

Vascular Dementia symptoms vary depending on the location of the damaged tissue. The symptoms may suddenly appear or be visible gradually.

These symptoms include:

  • Struggle to carry out day-to-day activities
  • Memory Problems, although short-term memory may not be affected
  • Sundown syndrome
  • Stroke Symptoms may be present.
  • Personality changes.
  • Disoriented
  • Changes in mood
  • Trouble balancing
  • The trouble with movements/ getting around
  • Tremors
  • Urinary Problems

Lewy Body Dementia Symptoms

Lewy Body Dementia is the second or third most common type of dementia. It takes place when protein deposits called Lewy Bodies start to develop in the nerve cells in the brain that affect your thinking, memory, and movement. It is common for those living with Lewy Body Dementia to have visual hallucinations.

Symptoms of Lewy Body Dementia include:

  • Hallucinations
  • Movements
  • Muscle stiffness
  • Shuffle Walk
  • Slow movements
  • Tremors
  • Uncontrolled shaking
  • Poor balance
  • Frequent falling
  • Hunched posture
  • Lack of coordination
  • Weak/ tired voice
  • Changes in concentration
  • Sleep
  • Mood/ Behavior
  • Changes in Body Temperature
  • Fainting
  • Dizziness
  • Sexual Dysfunction
  • Constipation
  • Bladder leaks/ accidents

Stages of Mixed Dementia

Stages of Mixed Dementia

Mixed dementia is a progressive disease that worsens over time. It typically follows the stages of dementia, including early-stage Dementia, Middle-stage Dementia, and late-stage Dementia.

Although it follows these stages of dementia, those living with Mixed Dementia typically go through the stages much quicker because the brain is affected by two different diseases.

Diagnosing Mixed Dementia

At least one in ten individuals living with dementia are diagnosed with more than one type of dementia, or Mixed Dementia. It is more common to be diagnosed in individuals over 75 years old.

Many older people have Alzheimer’s Disease and Vascular problems, although few are actually given the “Mixed Dementia” Diagnosis. It is common for healthcare providers to only use the Mixed Dementia diagnosis if there are definite clinical signs that two types of Dementias are present.

A study conducted by NIA that involved long-term cognitive assessments followed by brain autopsies showed that 94% of participants were diagnosed with Alzheimer’s Disease. Of that 94%, 54% had other abnormalities such as undetected blood clots or other signs of vascular disease. Lewy Bodies were the second most common noticeable brain change.

Tips for Visiting Your Doctor

To get the most out of your visits with your doctor, be sure to use these tips:-

  • Create a list of any new symptoms you or your loved ones see. Discuss these with your doctor at your visit.
  • Before your visit, write down any questions you have to remember to ask them.
  • Know the reason why you are seeing the doctor.
  • Bring someone with you to your appointment. They can help you remember to ask your questions and the critical points of the visit.
  • Write down any new diagnosis, new medications, and available treatments.
  • Understand why new medications are prescribed as well as their side effects.
  • Ask if there are any available new treatments or clinical trials that you may be a candidate for, if interested.
  • Understand current tests that are recommended and how they may be able to help.
  • Write down all future appointments. Write the date, time, and the purpose of the visit.
  • Get a care summary from your doctor to remember all the important points of the visit.
  • Know the best way to contact your doctor if you have questions before your next visit.

Treatment of Mixed Dementia

Treatment of Mixed Dementia

There is no cure or treatment for those living with Mixed Dementia. Some medications may be taken to help cope with symptoms but not to stop or treat the damage that is occurring within the brain.

Medications

The most common type of medication for those living with Mixed Dementia that is prescribed is cholinesterase inhibitors. This medication helps boost the chemical levels within the brain that helps cells communicate with one another.

Currently, no medication can help with Vascular disease symptoms. With that being said, your healthcare provider may recommend continuing to take your medication for high blood pressure or diabetes.

Therapies

For those living with Mixed Dementia, therapy may help with your quality of life but will not help symptoms improve.

These therapies include:

  • Cognitive Therapy
  • Stimulation Therapy
  • Reminiscence Therapy
  • Physiotherapy Therapy may be an option for those living with Lewy Body Disease.

Living with Mixed Dementia

Living with Mixed Dementia

It can be very frustrating for those living with Mixed Dementia as they experience many different frustrations and symptoms.

It is important to remember that those living with Mixed Dementia cannot control certain behaviors and moods. When these changes occur, please take a deep breath, take a step back and remember that it is the disease and not the person.

It is essential to build a good support network for those living with Mixed Dementia. The network should include:

  • Caretakers
  • Doctors
  • Therapists

Each of these individuals will play an essential part in helping those living with Mixed Dementia.

If you have not done so already, it is crucial to do all advanced medical and financial planning to ensure that your loved ones know your future wishes. The following questions should be addressed:

  • Who do you want to make your healthcare decisions when you no longer can?
  • What kind of medical treatment do you want? What type of treatment do you not want?
  • How comfortable do you want to be?
  • Who would you like to make all your financial decisions?
  • What do you want your loved ones to know?

Key Points of Mixed Dementia

  • Mixed dementia is when individuals are diagnosed with two or more types of dementia.
  • The most common types of Mixed Dementia are Alzheimer’s Disease and Vascular Dementia and Alzheimer’s Disease, and Lewy Body Dementia.
  • Mixed dementia is more common in 75 years of age or older.
  • It is unclear how many people are living with Mixed Dementia. However, autopsies show that many more people live with it than those diagnosed.
  • Those living with Mixed Dementia will go through the stages of dementia, but at a much quicker rate.
  • Symptoms of Mixed Dementia vary drastically depending on the type of dementia individuals have.
  • At least 1 in 10 individuals living with Dementia are Diagnosed with Mixed Dementia.
  • There is no current cure or treatment for Mixed Dementia. Medications and therapies help cope with symptoms.
  • Those living with Mixed Dementia should have a good support network in place that consists of caretakers, healthcare providers, and therapists. 
  • It is essential to do all advanced planning necessary to be prepared for the future.

References

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