Welcome to episode 16 of my series of Tiny Talks about Dementia,
And today I will be speaking about Mixed Dementia.
Mixed dementia is chosen as the diagnosis when the brain changes occur from two or more distinct causes.
My previous supervisor at the Aged Mental Health Research Center,
Old age psychiatrist Prof O'Connor,
Once shared that he felt that most people with dementia live with mixed dementia.
As certain diagnoses can only be established after death,
This often remains unseen.
Autopsies do indicate that mixed dementia may be significantly more common than previously realized.
The most common combination underlying mixed dementia is the presence of both Alzheimer's syndrome and vascular dementia.
You may wonder why I keep stressing the importance of what type or cause if you like,
Underlies the symptoms of dementia.
I guess I feel a need to be as precise as possible to prepare people for what is awaiting them,
And to put physical and social prompts and rams in place to assist them or ourselves to maintain independence and quality of life.
Let's zoom in on the example of mixed Alzheimer's and vascular dementia.
In terms of progression,
The two develop differently.
Alzheimer's results in a slow but steady decline of cognitive and other functions.
Vascular dementia shows a more stepwise deterioration,
Where someone may function on the same level for an extended period of time,
Then has an incident like a TIA or a mini stroke,
And loses many more functions at once.
If someone has both,
The progression will be a combination of that steady decline and drops after incidents.
As mentioned before,
Not until autopsy the real dementia can be identified.
People who turn out to have mixed dementia are often diagnosed with one specific type of dementia during life,
Most commonly Alzheimer's syndrome.
A NIA study consisting of long-term cognitive assessments followed by brain autopsy,
Revealed that 94% of participants who were diagnosed with dementia were diagnosed with AD,
Alzheimer's disease,
Yet their autopsies showed that 54% had co-existing pathology in addition to hallmark Alzheimer's brain changes.
The most common co-existing signs were those of vascular dementia,
And Lewy bodies were the second most common co-existing brain change they noticed.
Although mixed dementia is infrequently diagnosed during life,
Many researchers believe it deserves more attention,
Because the combination of dementia-related brain changes may have a greater impact on the brain than from one type alone.
