Does someone in your family, perhaps your mother, father, or a grandparent, start to forget things? Do they sometimes have trouble finding words? We often think of it as a normal part of getting older. However, sometimes it can be a sign of something more complex. Today we're talking about a slightly different side of dementia, a disease of memory loss. That's a condition called 'mixed dementia.'
What is Mixed Dementia?
Simply put, mixed dementia is when a person's brain is affected by two or more types of dementia at the same time. More precisely, it is when more than one type of brain changes occurs at the same time.
The most common of these is mixed dementia, which is a combination of Alzheimer's disease and vascular dementia . However, Alzheimer's disease can also be accompanied by other conditions, such as dementia with Lewy bodies (DLB) or dementia associated with Parkinson's disease. Sometimes, all three types of dementia can occur together.
How this condition worsens over time (stages of the disease)
Like other types of dementia, mixed dementia is a progressive condition that can be divided into seven main stages.
1. Normal functioning: When the disease first starts, you may not experience any symptoms. Brain function may be completely normal.
2. Mild memory loss: In the second stage, you start to notice very slight memory loss. You may forget things. This may seem like a normal part of aging.
3. Mild memory loss: In the third stage, you start to notice the early signs of dementia. You may have difficulty remembering things and finding words to describe something.
4. Moderate memory impairment: Memory loss becomes more pronounced at this stage. It begins to interfere with daily tasks, such as paying bills and planning things.
5. Moderately severe memory impairment: Even everyday tasks become a challenge. You may need help with personal tasks, such as bathing and dressing.
6. Severe memory impairment: Requires a lot of help to perform daily tasks. Even talking to others may be difficult.
7. Severe memory loss: By this stage, even basic activities like walking and talking may be impossible. At this point, care may be needed 24 hours a day.
Who is most at risk of developing this condition?
There are several main risk factors for developing mixed dementia. Also, the risk factors vary depending on the type of dementia involved. Let's look at these in a table.
| Factor / Type of dementia | Risk Factors |
|---|---|
| Main risk factors | Aging (especially those over 75 years of age), high blood pressure, and damage to blood vessels in the brain. |
| Risks associated with Alzheimer's disease | Family history, genetic influences, head injuries, heart disease, loneliness, untreated depression. |
| Risks associated with vascular dementia | Aging, atherosclerosis, irregular heartbeat (atrial fibrillation), excessive alcohol use, high cholesterol, history of heart attack or stroke, obesity, smoking, uncontrolled diabetes. |
| Risks associated with Lewy Body Dementia (DLB) | Aging, family history of DLB or Parkinson's disease, and family history of REM sleep behavior disorder. |
What are the symptoms of mixed dementia?
The symptoms of mixed dementia can vary greatly from person to person. This is because the condition can be caused by multiple types of dementia, which can damage different parts of the brain. The symptoms are a combination of the types of dementia you have.
Imagine, if someone has both Alzheimer's and vascular dementia, they may experience both the memory loss associated with Alzheimer's and the slow thinking associated with vascular dementia.
Some common symptoms are:
- Behavioral changes
- Confusion even in familiar places
- Depression
- Difficulty performing daily tasks (such as getting dressed)
- Difficulty making decisions
- Difficulty remembering recent or past events
- Difficulty using language
- Forgetfulness
- Irritability
- Mood changes
- Difficulty with body balance and movement
- Personality changes
How does a doctor diagnose this?
To be honest, diagnosing mixed dementia is a bit challenging, because it's difficult to accurately measure changes in the brain tissue of a living person. These changes can only be clearly seen when the brain is examined at autopsy.
Often, a doctor diagnoses one type of dementia (e.g. Alzheimer's) based on symptoms, but later an autopsy confirms that it is mixed dementia.
If you or someone in your family has symptoms of dementia, it's a good idea to make a list of them and go see your doctor. If you're showing symptoms that are consistent with two or more types of dementia, your doctor may suspect mixed dementia.
The following tests are commonly used for diagnosis:
- Blood tests
- Brain scans
- Cognitive testing
- A complete physical examination
- Neurological exams
- Reviewing your and your family's medical history
What are the treatments for this?
Like other types of dementia, there is no cure for mixed dementia. There is also no medicine that can stop the disease from getting worse. However, there are treatments that can help control symptoms and make life easier.
- Medications: If your mixed dementia is also related to Alzheimer's disease, your doctor may prescribe medications such as cholinesterase inhibitors, which are used to treat Alzheimer's symptoms. Also, if you have vascular dementia, your doctor may prescribe medications to control things like high blood pressure.
- Lifestyle changes: Some lifestyle changes can help relieve symptoms.
- Exercising
- Listening to calming music
- Mental wellness methods like meditation
- Spending time with family and friends
- Other Therapies: Things like psychotherapy and occupational therapy can help improve daily functioning, language, memory, and problem-solving skills.
The most important thing is to talk to your doctor before starting any treatment and follow his or her instructions.
How to live with this situation?
Although there is no permanent cure for mixed dementia, there are many things that can be done to improve the patient's quality of life.
- Make things easier to remember: Write down appointments, to-do items, etc.
- Make paying bills easy: Set up automatic bill payments. Enlist the help of a trusted family member or friend.
- Get good sleep: Go to bed and wake up at the same time every day. Limit caffeine, such as tea and coffee, in the evening.
- Enjoy life: Do things you enjoy. Be social. If you live alone, invite others over.
- Ask for help: Ask family and friends for help with things like gardening, driving, and carrying groceries. There's no shame in asking for help.
- Get professional help: If needed, you can get help from home care services or community organizations.
Take-Home Message
- Mixed dementia is when two or more types of dementia affect a person's brain at the same time.
- Symptoms vary from person to person and depend on the type of dementia the patient has.
- Because this is complex to diagnose, it is very important to see a qualified doctor as soon as symptoms appear.
- Although there is no permanent cure for this, medications, therapies, and lifestyle changes can help you manage your symptoms and live a better life.
- It is extremely important for the patient to receive love, support, and understanding from family and friends.
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