Mixed Dementia

Dementia causes abnormal changes in the brain. When this happens, it can impact a person’s behavior, the way they think, and their relationships. The condition’s progression, and what, if any, type of treatment can help depends on the specific type of underlying disease.

Mixed dementia is a condition in which multiple forms of dementia are present in a person. Some doctors may also use the term “dementia – multifactorial” to describe this condition.

What Is Mixed Dementia?

This form of dementia is simply defined as an incident in which a person has more than one type of dementia. Some people may suffer from vascular dementia, for example, but also have characteristics of Alzheimer’s disease.

Researchers believe it is more likely for older adults to have mixed dementia than to have just one form of the condition. Research from the National Institute on Aging indicates that most men and women over the age of 80 will have mixed dementia brought on by vascular dementia or Alzheimer’s disease, or in some cases, one of several other neurodegenerative conditions.

What Are the Symptoms of Mixed Dementia?

What’s unique about mixed dementia is that symptoms vary based on the combination of dementia forms that a person has. The symptoms you may notice will be different when different areas of the brain are affected by different types of dementia, for instance. That makes definitive symptoms hard to pinpoint. Most of the time, individuals will experience symptoms like the following:

  • Serious memory loss
  • Confusion
  • Mood and behavior changes
  • Disorientation
  • Unfounded concerns or suspicions about family and friends
  • Trouble speaking
  • Difficulty with walking or swallowing
  • Loss of cognitive function

It’s difficult for family, friends and even physicians to tell the difference between mixed dementia and other forms. Often, a person may exhibit some symptoms of several forms of dementia and, due to the complexity, doctors may diagnose mixed dementia without identifying each individual type.

What Are the Stages of Mixed Dementia?

Like most forms of dementia, mixed dementia will progressively get worse. How fast this occurs depends on the severity of the condition but also on the underlying forms of dementia present in the individual.

Early Stages: Also known as “mild” stages, individuals may have mild symptoms but still remain functional for day-to-day activities. In the early stages, individuals may have some evidence of the condition, especially in vascular dementia with the presence of underlying cardiovascular disease.

Middle Stages: In this stage, which generally lasts the longest, an individual will experience symptoms that continue to worsen over time. They may begin to lose cognitive function, forget things often, and suffer episodes of confusion and disorientation. Over time, this can worsen to being unable to remember people or events and time distortion.

Severe or Final Stages: During the final stages, a person’s mental capacity and physical health diminish quickly. They may suffer a complete break from daily life and be unable to function normally.

The progression of dementia rarely follows the same path from one person to the next, and researchers continue to work to understand why that happens. Maintaining brain health through engaging intellectual activities throughout life may help to slow progression in some people. Additionally, there are advances being made in the treatment of mixed dementia, as with all forms of dementia, that may help provide better treatment options in the future.

What Are the Causes of Mixed Dementia?

Like other types of dementia, mixed dementia causes are not fully understood. Doctors do know that when more than one dementia-related change occurs, there is a higher likelihood of someone exhibiting symptoms from mixed dementia.

As a whole, dementia is brought on by damage to the nerve cells in the brain and their connections within the brain’s makeup. Any area of the brain can be impacted, which often determines which type of symptoms are present. Many times, with mixed dementia, doctors must pinpoint these changes on a wider scale.

Most often, dementia occurs as a result of protein deposits on the brain, specifically in the area of the brain impacted. In those with Alzheimer’s disease, tangles and plaques buildup in the brain. These clumps damage the neurons present along with the fibers that connect them. In vascular dementia, blood vessel problems tend to be a big factor. Strokes, for example, can cause damage to the fibers located in the white matter of the brain.

Most commonly, mixed dementia will have several causes, including damage to more than one type of nerve cell in the brain. That damage can cause a person to have Alzheimer’s disease and Lewy Body dementia, or Alzheimer’s disease and frontotemporal dementia at the same time, resulting in mixed dementia, for example.

What Are the Risk Factors for Developing Mixed Dementia?

Because the causes of dementia aren’t fully understood, neither are the risk factors. However, research has identified several indicators that someone is at a higher risk of developing dementia, such as having a family member with dementia. Risk may be considered higher for people who have multiple risk factors, instead of just one. A few risk factors for dementia include:

  • Genetics – having one or more family members with dementia indicates higher risk
  • Heart health – this is especially important for vascular dementia
  • Aging – those over the age of 80 are at a much higher risk for developing this condition
  • Smoking
  • Obesity
  • Sleep problems
  • Other health problems – those with existing health concerns such as those with diabetes, cardiovascular disease, high cholesterol, and atherosclerosis are at higher risk

While these risk factors can help individuals gauge their likelihood of getting dementia, they are not telltale signs. Many times, doctors do not know what brings on mixed dementia in one person and not another.

What Is the Diagnosis Process for Mixed Dementia?

There is no way to know 100 percent if a person has mixed dementia during their lifetime. Only an autopsy can provide a definitive diagnosis. However, doctors can learn a great deal about a person’s mental health and cognitive function from examining symptoms. If a person displays typical Alzheimer’s disease symptoms, including cognitive changes, and also has blood vessel problems, they may be at a higher risk of mixed dementia from Alzheimer’s and vascular dementia. If they begin presenting with symptoms from both types, doctors can make a diagnosis of mixed dementia

There is some imaging technology available to help with diagnosing dementia, but there is still a lot of research necessary in this area. Researchers continue to look for ways to detect the presence of dementia earlier in life with the ultimate goal of slowing progression or even treating the cause before it leads to the onset of this condition.

What Is the Treatment Plan for Mixed Dementia?

Treatment for mixed dementia may help to slow the progression of the underlying disease but there is no cure for it. Many times, a person with mixed dementia will receive a diagnosis of a single type of dementia. He or she will then begin treatment for that condition.

There are no medications available to specifically treat mixed dementia, but doctors will likely treat the individual co-occurring diseases at the same time. However, medications such as galantamine and rivastigmine are often used in treatment for mixed dementia because they are commonly used for Alzheimer’s and vascular dementia, the two most common forms.

Though there is no cure for mixed dementia, a person may see some benefits and reduced progression speed by incorporating healthy lifestyle changes and working to support brain health. This may include supplements recommended by a doctor. Others may see improvements through exercise and overall fitness. There is also the case for wellness-focused care, such as reducing stress, utilizing meditation, and incorporating programs such as yoga.

In cases of vascular dementia, doctors may be able to minimize the risk of progression quickly by addressing the underlying cause of the condition, such as treating high cholesterol and blood pressure to improve overall cardiovascular health.

What Type of Care Does a Person with Mixed Dementia Need?

Those with one form of dementia can often function well on their own during the early stages of the disease but require medical care to monitor the progression of the condition.

Over time, the condition will worsen. Those with later stages of the disease and mixed dementia diagnoses may need supportive living arrangements that can provide 24-hour monitoring and both medical and emotional support. It is very common for individuals who have mixed dementia to progress at their own rate, so making the decision to obtain more advanced care can be hard to do. Memory care support in a structured environment is often necessary, especially at later stages of the disease. Most often, enrichment programs, supportive living environments, and an overall focus on wellness and quality of life are important to those who have mixed dementia.

Care type and extent also depend on the individual’s needs. In the early stages, a person could have few symptoms, so no changes may be necessary. By the mid to late stages of disease, a person’s abilities are often limited, requiring help with day-to-day routines, medication management, mealtimes and other essential tasks. Safety may become a concern, as individuals with mixed dementia may not be able to care for themselves, could become confused while out of the house, or be unable to help themselves after an accident in the home.

Over time, emotional changes and psychological needs must also be met in a care setting. Providing a reassuring, supportive environment is important to maintaining a high quality of life. A memory care location that provides an enriching lifestyle can help a person to maintain a higher quality of life throughout this stage and on.

During the final stages of mixed dementia, 24-hour support becomes necessary in nearly every situation. A person may experience episodes of limited function, loss of mobility, and pain. They may no longer recognize family and friends, requiring a strong memory care atmosphere that addresses their underlying needs.

If you’re looking for a memory care environment that helps a friend or relative live an exceptional life with mixed dementia, contact us. At Homestead at Hilton, we provide the care those living with dementia need, along with holistic wellness, social and cultural programs that encourage every resident to live a life filled with joyful moments.

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