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Mixed dementia: A review of the evidence

Nilton Custodio1,2, Rosa Montesinos1,3, David Lira1,2

  • 1Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia. Instituto Peruano de Neurociencias. Lima, Perú.

Dementia & Neuropsychologia
|January 23, 2018
PubMed

Insights

Mixed dementia, combining Alzheimer's disease and cerebrovascular disease, is common in the elderly. Management focuses on cardiovascular risk factors and healthy diets, as current drug therapies offer limited benefits for this complex condition.

Area of Science:

  • Neurology
  • Geriatrics
  • Pathology

Background:

  • Mixed dementia involves coexisting Alzheimer's disease and cerebrovascular disease (CVD).
  • Diagnosis and treatment present significant challenges for healthcare professionals.
  • Mixed Vascular-Alzheimer Dementia (MVAD) is a prevalent pathological finding in the elderly.

Purpose of the Study:

  • To provide a comprehensive overview of Mixed Vascular-Alzheimer Dementia (MVAD).
  • To review the epidemiology, pathogenesis, natural history, diagnosis, and therapy of MVAD.
  • To synthesize current knowledge on managing this complex dementia subtype.

Main Methods:

  • Literature review of articles published between 1990 and 2016.
  • Keywords used included "Mixed Vascular-Alzheimer Dementia" and related terms.
  • Analysis of neuropathological studies and clinical presentation data.

Main Results:

  • MVAD has a prevalence of approximately 22% in the elderly population.
  • Clinical differentiation between Alzheimer's dementia and vascular dementia is challenging due to overlapping symptoms.
  • Pharmacologic therapies offer modest, similar benefits for both MVAD and individual dementia types.

Conclusions:

  • Non-pharmacologic therapy, including managing cardiovascular risk factors (hypertension) and promoting healthy diets, is crucial.
  • Current medications provide limited clinical benefits once MVAD is established.
  • Antihypertensive therapy and healthy diets are recommended for preventing or slowing MVAD progression in at-risk individuals.
Keywords:
Alzheimer's diseasecerebrovascular diseasemixed dementiavascular dementia

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