Differential Diagnosis of Mixed Dementia

Key features

• The term "mixed dementia" is most commonly applied when hallmark pathologies of Alzheimer's disease and vascular dementia coexist but can also describe Alzheimer's and coexisting pathology of other forms of dementia.
• These pathologies may interact in important ways to increase likelihood of clinically significant cognitive decline.
• Recent studies suggest that the prevalence of mixed dementia is greater than previously appreciated.
• Mixed dementia prevalence may also become more common with increasing age.

Treatment

• As with vascular dementia, lifelong attention to cardiovascular risk factors and overall health of the heart and blood vessels could play a key role in preventing mixed dementia. These measures might also help delay or prevent progression of symptoms in older adults.
• Since most of the drugs approved to treat Alzheimer's disease have shown a similar benefit in treating vascular dementia, there is reason to believe they may also be of help in mixed dementia.
• No drugs are currently approved by the FDA to treat mixed dementia.

Pathology

A combination of Alzheimer's neuropathologies – including amyloid plaques and neurofibrillary tangles – and neuropathologies of another form of dementia are likely present.

For your patients and families: Mixed Dementia and Vascular Dementia