Mixed Dementia – What Is It?

While many people associate the term “dementia” with Alzheimer’s disease, dementia is actually a comprehensive category that includes a number of types of brain disorders. Alzheimer’s is the most common form of dementia, accounting for 60 to 80 percent of all dementia diagnoses.

Several other common types of dementia are:

  •     Lewy body dementia 
  •     Frontotemporal dementia
  •     Vascular dementia

Diagnosing the correct form of dementia a senior is exhibiting can be challenging, because symptoms can overlap between different forms of memory impairment. However, it’s also possible for someone to have mixed dementia, which means they have more than one type of dementia occurring at the same time.

Typically, mixed dementia entails a combination of Alzheimer’s and vascular dementia, though in some instances mixed dementia might mean Alzheimer’s co-existing with Lewy body dementia (LBD). And in some cases, brain changes could indicate the presence of all three conditions at once. 

Autopsy studies indicate that mixed dementia is most likely caused by a combination of brain changes related to Alzheimer’s disease, vascular disease-related processes (problems with the circulatory system that can lead to cardiovascular issues, for example) or other neurodegenerative conditions.

Diagnosis Can Be Difficult

Because symptoms of other dementias can be indistinguishable from Alzheimer’s disease — and because a definitive diagnosis can only be made on autopsy — determining whether someone has mixed dementia can be challenging.

A National Institute on Aging-funded study conducted by the Rush Alzheimer’s Disease Center and the Rush Institute for Healthy Aging in Chicago revealed that more than half of the volunteers whose brains met pathological criteria for Alzheimer’s disease also had evidence of one or more coexisting dementias.

Yet 94 percent of participants had been diagnosed with only Alzheimer’s disease while alive. Dr. Patricia Boyle, who led the study, explains: “Most people who live to be in their 80s will have some combination of neuropathologies in the brain. We need to understand how these neuropathologies work together to impair cognition in order to develop effective interventions to prevent cognitive decline in old age.”

It may be easier to understand these related types of dementia by examining how symptoms overlap. Below are the kinds of symptoms that typically present in people with Alzheimer’s disease, vascular dementia, and Lewy body dementia, respectively:

Symptoms of Alzheimer’s Disease

  • Disruptive memory loss. Inability to retain new information, or forgetting important dates and events.
  • Problem-solving difficulties. 
  • Getting lost driving to a familiar location.
  • Temporal or seasonal confusion: Is it spring already?
  • Challenges with visual or spatial relationships.
  • Vocabulary issues: Trouble finding common words, such as calling a toaster, “the thing that makes bread dark.”
  • Odd placement: Putting car keys in the freezer.
  • Loss of judgment: Giving money to phone scammers.
  • Social withdrawal.
  • Personality changes: confusion, anxiety, suspicion, fear. 

Symptoms of Vascular Dementia

  • Tremors 
  • Leg or arm weakness
  • Balance problems, shuffling steps. 
  • Loss of bladder or bowel control.
  • Sluggish thinking: Forgetfulness, confusion.
  • Personality changes: Hallucinations, delusions, depression, irritability. 
  • Language problems and slurred speech.
  • Inappropriate emotional response.
  • Difficulty planning or following instructions.
  • Becoming lost in familiar surroundings.

Symptoms of Lewy Body Dementia

  • Mental decline: reduced alertness and lowered attention span.
  • Visual hallucinations, usually related to people or animals. These hallucinations occur in 80 percent of LBD patients, often at night.
  • Poor response to antipsychotic medications (neuroleptics), which are usually given to people with mental health problems. In the case of LBD, however, this class of drugs may amplify rigidity and confusion, and can even cause sudden death.
  • Increasing problems handling activities of daily living.
  • Repeated falls.
  • Sleep disturbances, including insomnia and acting out dreams.
  • Delusions or depression.
  • Fluctuations in autonomic bodily processes, including blood pressure, body temperature, urinary difficulties, constipation, and difficulty swallowing.

Defending Against Dementia

Although Alzheimer’s and other forms of dementia are not yet curable, current research indicates that making powerful lifestyle changes in midlife can go a long way in both preventing the onset of dementia, and in treating symptoms:

  • Socialize and exercise. These often go hand-in-hand. Walking or bicycling with a friend, or participating in an exercise class, not only help keep your body in shape and your mind sharp; they also help reduce the risk of dementia. In one study, women who connected with friends and family daily had half the dementia risk of their more solitary peers. 
  • Prevent head trauma. This may seem an unlikely cause of dementia, but traumatic brain injury (TBI) can happen in unexpected places, with long-term consequences. To protect your brain:
    • Always wear a helmet when riding a bicycle.
    • Make floors and bathtub skid-proof.
    • Add handrails in the shower and elsewhere as needed.
  • Eat healthy. Nutrition plays a key role in memory care, and is a core aspect of premier elder care at Kensington Place: superb, healthy meals that nourish our senior residents on every level.
  • Sleep well. Quality sleep is crucial for optimum mental health. During sleep, your glymphatic system helps your brain “take out the trash” by removing proteins that can turn into the hallmark plaques of Alzheimer’s disease.
  • Stimulate your mind. Crossword puzzles and jigsaw puzzles are good; learning a new language or a new skill, such as playing the piano, is even better, because it engages your brain on every level.
  • Quit smoking! It’s not too late to quit and restore your lung health, as well as protect your brain.
  • Treat depression. People with a history of anxiety or depression are at higher risk for dementia. Seek professional help if necessary.
  • Manage existing health problems, such as high blood pressure and diabetes. These lifestyle changes will help bring other health conditions under control, too.

The Kensington Difference

At Kensington Place Redwood City we understand memory care from the inside out. And while we go above and beyond for our residents with Alzheimer’s or other forms of dementia, we seek ways to capitalize on strengths

We help residents and their families find ways to enjoy the beauty of special times, even if only in moments. We honor the past, savor the present, and look toward making the times that lie ahead manageable, comfortable, and ultimately, peaceful.

Come visit us soon, and let us show you how we can enrich your loved one’s life.

Further Reading:

Memory loss is life changing for all involved. At Kensington Place, we provide a state-of-the-art memory care program, a higher staff-to-resident ratio than industry standards, and more advanced care services. Our promise is to love and care for your family as we do our own.

For additional resources regarding your loved one’s condition, please read on about our Memory Care, Alzheimer’s Care and Dementia Care.

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