The disorder of mixed dementia is complex, as it is characterized by signs and symptoms of more than one form of dementia that occur simultaneously. It is most common for individuals with mixed dementia to exhibit protein deposits most typically seen among individuals with Alzheimer’s disease, as well as abnormalities of the blood vessels within the body most notable among those who suffer from vascular dementia.
Symptoms of mixed dementia can range from mild forms of memory loss to more severe cognitive impairments that have begun to have an impact on the individual’s ability to manage day-to-day tasks without some form of assistance. These symptoms of dementia and memory loss can be thought of as falling along a continuum, where they can be grouped into stages as a way to provide a guide for physicians and caregivers.
The seven stages of mixed dementia are as follows:
- In this stage of mixed dementia, there are no clear, outward signs of the disorder. The individual is still able to function independently.
- In this stage, symptoms of dementia are barely noticeable. In most cases, they will appear as typical signs of forgetfulness that occur with aging. For instance, the individual may begin misplacing their keys, though are able to find them after some searching.
- In this stage of mixed dementia, symptoms of dementia are still not very noticeable and the individual is generally able to perform normal activities of daily functioning. Some typical symptoms noted at this stage in disease progression include:
- Some forgetfulness
- Some signs of memory loss
- Some difficulty with managing finances, such as trouble balancing a checkbook
- Increasingly losing things, without being able to go back and retrace steps to find the item
- Loss of concentration
- Difficulty with managing medications
- Confusion with and trouble driving
- In this stage, individuals are beginning to show signs that they are having trouble completing routine tasks that they were previously able to manage, such as using the telephone, doing the laundry, or cooking. Some typical symptoms noted at this stage in disease progression include:
- Increasing signs of forgetfulness and memory loss
- Incontinence or difficulty holding urine
- Difficulty with finding the right words or phrases
- Trouble with mental math exercises, such as counting backwards
- Increasing social withdrawal
- In this stage of mixed dementia, individuals need at least some assistance with performing daily activities. Some typical symptoms noted at this stage in disease progression include:
- Confusion regarding location and history of events
- Increases in memory loss, such as difficulty remembering one’s own phone number, home address, or other personal information
- Difficulty with even less challenging mental math problems
- Increased need for assistance when choosing appropriate clothing for the weather or occasion
- In this stage, individuals with mixed dementia need a significant among of assistance with performing daily functions. Some typical symptoms noted at this stage in disease progression include:
- Needing assistance with toileting and dressing
- Frequently wandering around and becoming lost when left unsupervised
- Sleep problems
- Being unable to recall names of family members or other close individuals, though still able to recognize familiar faces
- Changes in personality or behavior
- The final stage of mixed dementia is generally characterized by:
- Losing awareness of one’s own surroundings
- Loss of language ability
- Needing assistance when eating
- No control over urination
- Loss of muscle control, such as inability to swallow, smile, walk, or even sit upright
If you have begun to notice any of these signs and symptoms of mixed dementia in yourself or someone you love, it is important to schedule an appointment with your doctor right away.
- Fernando MS, Ince PG. Vascular pathologies and cognition in a population-based cohortof elderly people. J NeurolSci 2004; 226(1-2):13-7.
- Langa KM, Foster NL, Larson EB. Mixed dementia: emerging concepts and therapeuticimplications. JAMA 2004; 292(23):2901-8.
- Nadeau Y, Black SE. Mixed dementia: The most common cause of dementia? Can J Diagnosis 2010.
- Kotsoris H, Barclay LL, Kheyfets S et al. Urinary and gait disturbances as markers for early multi-infarct dementia. J NeurolNeurosurg Psychiatry 1988;1:138-141.
- Zekry D, Hauw JJ, Gold G. Mixed dementia: epidemiology, diagnosis, and treatment.J Am GeriatrSoc 2002; 50(8):1431-8.
- Rockwood K, Macknight C, Wentzel C et al. The diagnosis of “mixed dementia”in the consortium for the investigation of vascular impairment ofcognition (CIVIC). Ann N Y AcadSci2000;903:522–528.
- Meyer J, McClintic K, Rogers R et al. Aetiological considerations and riskfactors for multi-infarct dementia. J NeurolNeurosurg Psychiatry 1988;51:1489–1497.