Dementia Support Line
What is mixed dementia?
‘Mixed dementia’ is a condition in which a person has more than one type of dementia. A combination of Alzheimer’s disease and vascular dementia is the most common type.
At least 1 in 10 people with dementia is diagnosed as having mixed dementia.
Other combinations are also possible – particularly Alzheimer’s disease and dementia with Lewy bodies.
Getting a mixed dementia diagnosis
A lot of people have more than one type of disease in their brain, particularly as they get older. The most common types are Alzheimer’s disease, vascular or blood vessel disease, and Lewy body disease.
When an older person has dementia, it’s probably not because of a single type of brain disease but rather a combination of different ones. Unfortunately, it’s still very difficult to see all the different types of disease in the brain of a living person.
This is why a doctor is likely to base their diagnosis on the main type of disease they think is present and causing symptoms. The most common diagnoses are Alzheimer’s disease or vascular dementia.
Sometimes, a doctor may find that a person has clear signs and symptoms of at least two different types of dementia. When this happens, they will make a diagnosis of mixed dementia.
What are the symptoms of mixed dementia?
There’s no fixed set of symptoms for mixed dementia. This is because a person’s symptoms depend on the relative contributions of each type of dementia that they have.
To know more about the likely symptoms of mixed dementia, you need to learn about the symptoms of the different types involved. It’s common to have more symptoms of one type than another.
Common types of mixed dementia
Most diagnoses of mixed dementia tend to be a combination of two different types. Here, we look at the two most common types of mixed dementia – Alzheimer's disease with vascular dementia, and Alzheimer’s disease with Lewy body disease.
Alzheimer’s disease with vascular dementia
This is the most common type of mixed dementia. It’s caused by a person developing Alzheimer’s disease and at the same time having diseased or damaged blood vessels supplying their brain.
The two different types of disease combine to make symptoms worse than they would be on their own.
Understanding Alzheimer’s disease
Alzheimer’s disease is caused by a build-up of faulty proteins in and around brain cells. The most common and well-known symptom of Alzheimer’s disease is having problems with memory – particularly memories of recent events or conversations.
However, a person with Alzheimer’s is also likely to get lost easily, have trouble finding words when they’re speaking and become confused about time or place.
Understanding vascular dementia
The ‘vascular’ part of mixed dementia is caused by problems with the supply of blood throughout the brain.
These can be caused by a stroke or a series of strokes when blood vessels in the brain become blocked or bleed. More often it’s caused by thousands of tiny and fragile blood vessels in the brain gradually becoming damaged and worn out over time. Either way, vascular disease stops brain cells from getting the oxygen and nutrients they need to work properly.
The symptoms of vascular dementia depend on what part of the brain is affected. Generally, the condition tends to make it harder to think quickly and process a lot of information at once. A person may have difficulties with planning, solving everyday problems and making decisions. They may struggle to focus and easily lose the thread of a conversation. It’s also common for someone with vascular dementia to have depression.
Alzheimer’s disease and dementia with Lewy bodies (DLB)
Less often, dementia can be caused by a mixture of Alzheimer’s disease and Lewy body disease.
Lewy body disease is the brain disease that can either cause dementia with Lewy bodies (DLB) or Parkinson’s disease dementia.
Understanding Lewy body disease
Lewy bodies are the clumps of faulty proteins that build up in the brain cells of people who have dementia with Lewy bodies (DLB) or Parkinson’s disease. Lewy body disease has quite different symptoms to other types of dementias.
People with Lewy body disease often have very disturbed sleep and visual hallucinations. They may also experience rapid ‘fluctuations’ in their ability to function properly, feeling confused or disorientated quite suddenly. Memory tends to be less affected than in people with Alzheimer’s disease.
What are the treatments for mixed dementia?
There is currently no cure for any type of dementia, including mixed dementia. Some medications and other therapies may help to improve dementia symptoms for a while. However, there is currently no medicine that can slow down the underlying diseases and prevent further damage from happening in the brain.
Medication for mixed dementia
The most common medication used to treat mixed dementia is called donepezil.
This boosts levels of a chemical in the brain that helps the cells to communicate with each other better. There are also two other medications that work similarly to donepezil. Another one called memantine is often prescribed when it’s not possible for a person to take donepezil. It can also be used in combination with donepezil as dementia symptoms get worse over time.
Unfortunately, there’s currently no medication that has been shown to improve the symptoms of vascular dementia or frontotemporal dementia.
Therapies for mixed dementia
There are several type of therapies that may help to improve a person’s abilities or their quality of life. These include occupational therapy, talking therapies and emotional support, cognitive stimulation therapy, cognitive rehabilitation, and reminiscence therapy. Some locations may also offer music and arts-based therapies.
A person with mixed dementia involving Lewy body disease may be offered physiotherapy to help with movement problems.
Learn more about the different approaches for coping with dementia symptoms.
No matter what type of dementia you have, we’re here for you.
Sharon
saysHi
So sad to read everyone’s stories and how hard it is it is a horrible disease. My mum was diagnosed with mixed dementia in January although we think she has had it for at least 2-3 years. She isn’t able to live alone so my sister gave up her job, sold her house and moved in to care for her. She has been through phases of not knowing any of her 4 children and talking to us about us as if we are carers and not family, asking if we all had the same dad, then a couple days later she knows us again. Sometimes she is aggressively argumentative, very confused and absolutely not the person she was. She wears multiple layers of interesting clothes but it keeps her happy. I know it is hard for my sister so I try to help and give respite. I have frustrations with one family member who keeps telling my mum she doesn’t have to speak to the dementia nurse when she comes and she could refuse the visit. I don’t understand why she would say that as it is confusing for my mum who thinks she is fine and gets angry if anyone tells her otherwise. We can clearly see decline when it happens. We have a great package from the council where we pay £7 a month and have access to as much equipment as needed. At the moment that includes a sensor on the bed and lasers at the doors because she was starting to walk out at night when my sister was in bed and a video monitor so if the bed sensor goes off my sister can see if she has fallen. She used to be very prudish and now talks inappropriately and about things she would never have done and doesn’t think about taking off clothes. I know it’s difficult to say how each person will decline because everyone is different but there is more support than we realised out there it just isn’t offered and we had to try and find out ourselves but the nurses are great help.
We were advised to get a scrap book with photos of the family etc when they were younger and also what they look like now which apparently helps with the recognition. I know a lot of times my mum doesn’t know who my sister is and thinks she has 3 different carers even thought it’s one person and her daughter. I just wanted to share, you are in such a hard position and are doing what you can, I know we r so proud of my sister and couldn’t manage without her. We were lucky because she worked in a closed dementia unit before she gave her job up but it’s very different when it’s your own mum. I think anyone caring for a loved one with dementia is amazing and selfless
Georgina
saysHi, I’d love to try and connect with you.
My Dad was diagnosed with mixed dementia in Jan too x
Sharon Smith
saysHi Georgina
Sorry to hear that. Happy to connect it’s sometimes good to talk to someone else going through the same thing x.
Marisa McCulloch
saysHi Sharon
Your mums story sounds just like my mum. Over the past year we have seen a real decline in her. My wonderful sister Margaret who has already seen my Dad through Vascular Dementia who passed almost 5 years ago is now main carer for mum. I completely agree with your sentiments as she truly is an amazing and selfless person. Oh and she has been diagnosed and gone through treatment for bowel cancer while looking after mum.
Beverley Pinnick
saysMy 86 year old father is registered blind and was diagnised with vascular dementia March 2020, following a few falls. Symptoms had been present for a while prior to diagnosis. His GP referred to a memory clinic who assessed him and ran tests inc MRI for the results. Results since changed to mixed dementia (vascular & dementia).
My 82 year old mum is his sole carer in their home. My sister sadly died just before his formal diagnosis. I live 3.5 hour drive away and due to covid and not having a car have been severely restricted in being able to visit them. Mum has 'coped' admirably but as his symptoms match on and his presentation declines i am very concerned for her own health and state of mind. I have been suggesting that she at least starts the ball rolling re considering a care home. In the last 2 days she has told me she doesn't think she can cope 'much longer'. I have suggested she speaks to their gp and also age uk. Is there anyone else she should speak to re this next stage? Also, because of being registered blind and mixed dementia would he meet criteria for any funding?? I understand that local authorities can do deferred payment schemes, paid off on death of both parties when house is sold- so you have info on this please?
Many thanks
Hi Beverley,
Thanks for getting in touch. We would recommend calling our Dementia Connect support line on 0333 150 3456. Our dementia advisers can listen to the situation about your mum's needs, as well as your father's, and provide information and advice on the next steps. The support line is available seven days a week: https://www.alzheimers.org.uk/dementia-connect-support-line
We hope this is helpful.
Alzheimer's Society blog team
Geoff Coope
saysHello
My wife of 54 years has had mixed dementia, (Vascular and Alzheimer's,) for the last 3 of those. She also has Rheumatoid Arthritis and Osteoporosis, and uses Rivastigmine patches along with other medication, I am her full time carer and we have managed things well so far. however, just recently there seem to have been a sudden, noticeable deterioration. She has less mobility now, and doesn't want to communicate sometimes, she still remembers people, but has difficulty with names, and walking is more difficult.
Is this deterioration a gradual situation, and is it likely to worsen quickly, or does it go in stages and level out for a while at each stage?
My main worry is what comes next, and how long can I cope.
Eva D. Buck
saysMy mother, who lives with me, has mixed dementia (Vascular and Alzheimer's) as well. My mother's gerontology doctor has stated that declines can be gradual then sudden and that there is no warning to what precipitate these changes. This makes it scary and difficult to plan for. I can tell you I am planing for my mother one day not walking since we were told that there is a strong liklihood that would happen. Therefore, I had a contractor come in and create wider doorways and a zero entry shower so mom can age in place. With the changes tou are seeing, I would contact your wife's doctor. They might choose to see her and perform either cognitive tests or like my mothers doctor an MRI .
Lastly, you expressed concern about if this becoming overwhelming. There are several steps that you might take.
Let your wife's doctor know. He/She might be able to refer you to services in your area such as:
Area Agency on Aging,
Alzheimer's Association, or
Thru you hospital there might be a dementia family support group that can help you with your concerns.
Lastly, some churches and synagogues can also provide some assistance.
This disease isn't just hard on the ones experiencing it but on the carers too. Our lives can revolve so much around them, we often can't find joy or focus on anything that reminds us of our lives before. I play music and dance for 10 minutes, or download a book. This helps me not get overwhelmed. I hope this helps. Please take care of yourself. My thoughts and prayers are with you both.
Geoffrey Coope
saysHello Eva
I must apologise for not responding to your message sooner. I must have missed it earlier and have only just seen it when I was alerted to another response. Once again, my apologies.
Thanks for your advice, there are a few things that I never thought about. Since posting my question, we have been given funding for a personal assistant who does three, two hour sessions which is a great help with bathing my wife every couple of days, and also gives me a bit of time to do things for me.
I too have music as my hobby, and have a baby monitor video and can watch her when I play my piano, or I am on my computer.
My wife doesn't seem to have deteriorated much more just recently, so life is a little better for me. Hope things go well for you. Good luck.
Geoff
Claire Roberts
saysHello Geoff
How are you? Did you receive a comment or advice? I am going through similar with my Dad with my mum being faced with similar dilemma. It’s really hard and I feel for you. Talking to those who know and have been in same situation previously helps I find. Take care
Geoffrey Coope
saysHello Claire
Yes I had a couple of replies, one which I missed until just now when I got the alert about your message. I'm doing fairly well thanks, I hope you are too. This terrible disease is difficult for us all, and the only thing to do is give our best care and lots of love to them. Hope things go well for you and your mum. Best wishes. Take care.
Geoff
Susan Rouse
saysHow important is it to have a dementia patient staged regularly? My husband has recently had a camera test via his throat due to swallowing problems. He was diagnosed as having MCI 5 years ago but then they said that was a mistake, that he has mild vascular dementia. Since then he has declined slowly but recently the decline is more rapid. At this procedure they questioned his capacity because he couldn’t tell them what procedure he was having and why or what the risks were despite a nurse explaining this and me doing so umpteen times before he went. Originally they said I couldn’t accompany him due to Covid regs, then they relented. I hold LPA which I had registered with the hospital, I strongly advise others to do that, but they wouldn’t accept this. Instead they wanted him to make DNR which we both agreed we wouldn’t do due to first hand experience of the Liverpool Care Plan which was anything but care when my mother in law died. If he hasn’t got capacity to sign a consent form, why would he capacity to make a DNR? I was told they wouldn’t need my signature, that a doctor would sign for the test. It really worries me that someone who doesn’t know him, probably has never even met him, can make such decisions on his behalf when someone who has been married to him for 54 years can’t. Whose more likely to know what his wishes are?
Nic
saysHi, I think I would seek a solicitors opinion on that as you do get the first 20 mins free telephone consultation.
John
saysDNR aka "Do Not Resuscitate"
Make sure that your Solicitor and /or whoever keeps details of your Will etc. is fully aware of your attitude to DNR.
Now everyone can/ and hopefully will donate their body at death ( New Legislation)
I would recommend this in your Will and have done for over 50 years
Miles
saysMy wife was diagnosed with mixed dementia a year ago. She was put on 4.6mg rivastigmine patches which were ok for a while although they did not show any noticeable improvement. But eventually she started to have hallucinations and visions and we stopped the patches. She has tried rivastigmine capsules and galantamine but both cause instant unpleasant side effects, nausea and sickness for 48 hours, so now she doesn't want any medication and I quite understand. But I worry that she is missing something that could help. Consultations with GPs and clinics are almost impossible in these Covid times.
Kate
saysMy husband is 71 and has mixed dementia.( Alzheimer’s and vascular). We’ve been married 50 years ( high school sweethearts). He’s not recognizing me as his wife of 50 years but thinks I’m his girlfriend and he walked out on his family. It’s called capgras syndrome. He thinks one of us, prob me, is an imposter. At least he likes me but this is heartbreaking for me and my daughters. ( they are married with kids). He’s also failing physically. I’m his sole care giver. I’m sad . He can’t be left alone. I do everything now. I’m tired. My girls are not close by. I don’t know what to do next to help him. I guess I just needed to vent. Thank you
Cara
saysHey, Kate. I just wanted to say that you’re entitled to all the support you can get. This is a nasty disease and you shouldn’t feel like you have to cope with it on your own. Sometimes there’s a stigma around getting help from the networks dedicated to these sorts of things. When you call in help, like carers or even a care home, you’re handing over the care of your husband to people who have shifts and get paid for doing it. They’re able to go home and have their own lives alongside their job. It seems like you may be backing yourself into a corner where you don’t have any sort of room in your life for your own self care - which is essential to being a good carer. You matter too. It can be best to hand over the care, partially or wholly, to people with experience in these things and you both may end up better off.
I hope you’re taking care of yourself, and making time to do so.
Alison Clarke
saysI am wondering whether dementia is hereditary. My mother has mixed dementia. Her father had Alzheimer’s and her mother on hindsight had early stage vascular dementia. On my fathers side two of my aunts had Alzheimer’s. 3 of my nieces and nephews had a grandmother who had Alzheimer’s. Seeing/hearing the affects of dementia with my mother in the last few months is stressful. She no longer sounds like my mother and is more or less restricted to a care home bedroom.
Hi Alison,
Thanks for you comment. We're really sorry to hear you've been having a stressful time with your mother.
We have a page on this which you may find helpful: https://www.alzheimers.org.uk/about-dementia/risk-factors-and-preventio…
The majority of dementia is not inherited. In rarer types of dementia there can be a strong genetic link, but it's small percentage of overall cases of dementia.
We also have some other pages on risk factors for dementia, as well as advice on prevention: https://www.alzheimers.org.uk/about-dementia/dementia-risk-factors-and-…
Hope this is useful, Alison. If you need more advice or would like to talk to somebody about your mother's care - please call our Dementia Connect support line on 0333 150 3456. The opening hours and (other ways to contact us) are available here: https://www.alzheimers.org.uk/get-support/national-dementia-helpline
Thanks,
Alzheimer's Society blog team
Julie
sayslisa
saysthis disease is breaking my heart.
Vanda
saysThat sounds like a cry from the heart...and my heart goes out to you. It sounds like you are somewhere I’ve been and still am sometimes. Any help or support I can offer? My mum has mixed dementia and, after living with us for a while, is now in a home.
Ray Holmes
saysMy wife had Encephalitis when the shingles virus attacked her brain.
They put her down as having mixed dementia.The doctors in Oxford that saved her live never
Mentioned dementia,only memory loss.Telford doctors say mixed .My question what has she?
Hi Ray, thanks for your comment.
This sounds like a confusing situation, but you're doing the right thing to seek a formal diagnosis.
We would recommend speaking to your GP (Is that the Telford doctors?) for a diagnosis. We have some information on why that's important and what the next steps are here: https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/dem…
Once you have a diagnosis, you'll be in a better position to access the right support and information. If you have any questions or concerns about this or your wife's memory problems, please do call our Dementia Connect support line on 0333 150 3456. A dementia adviser will be able to learn more about your situation and give tailored information, advice and support: https://www.alzheimers.org.uk/get-support/national-dementia-helpline
Hope this is helpful, Ray.
Alzheimer's Society blog team
Gary Morgan-Jones
saysMy wife is 57 and was diagnosed with mixed dementia last November, but was diagnosed with dementia nearly 4 years ago, what does this do with life expectancy, I understand that from final diagnosis of mixed dementia the clock is really ticking, I assume 4 to 5 years if I'm correct but is her life expectancy massively reduced 4 years ago or when she received the final diagnosis of mixed dementia, confusing question I know but I'm still trying to get my head around all this
Hi Gary,
Thanks for getting in touch. We're sorry to hear about your wife's dementia diagnosis.
It is very difficult for us to comment on individual cases, so we would recommend speaking with the GP. In the meantime, you may find these 'How dementia progresses' webpages useful: https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/how…
For further information, advice and support, we recommend speaking with a dementia adviser on 0333 150 3456. You can read more details about our Dementia Connect support line (including opening hours) here: https://www.alzheimers.org.uk/get-support/dementia-connect-support-line
We hope this helps, Gary.
-
Alzheimer's Society blog team
Debra Nicholson
saysHi my mum was diagnosed with mixed dementia at the memory clinic in 2016/17 I can't quite remember. She is still living with me and is 89 I also care for my husband. I just cannot cope with her much longer, she repeatedly heads off for Scotland with just her credit card in hand and I have to go and get her once she is tired enough,otherwise she wont get back in the car. What help is out there? I have today dropped off a letter to the doctors as I cant talk on the phone without her getting aggressive. I also care for my husband 67 with late stages of MS... this is hell and I think the time has come for me to settle mum into a home, but where and how? please help me.
Hi Debra,
Thanks for getting in touch. We're sorry to hear about the situation with your mum, especially as you're also trying to care for your husband.
We recommend speaking with a dementia adviser. You can call our Dementia Connect support line on 0333 150 3456 and somebody will be able to give you tailored information, advice and support. You can read more details about the support line (including opening hours) here: https://www.alzheimers.org.uk/get-support/dementia-connect-support-line
In the meantime, we have some advice on our website on care homes, titled 'Care homes: When is the right time and who decides?' This information is also available as a downloadable factsheet: https://www.alzheimers.org.uk/get-support/help-dementia-care/care-homes…
We hope this is helpful, Debra.
-
Alzheimer's Society blog team
Tracey Wilson
saysMy 80yr old dad has mixed dementia and recently he has been very dizzy lightheaded and unsteady on his feet.i was wondering would this be all related to dementia
Hi Tracey,
Thanks for getting in touch.
It might be worth speaking with one of our dementia advisers on 0333 150 3456. They can listen to your concerns about your dad, provide advice and support. Our advisers are available seven days a week. You can find opening hours for our Dementia Connect support line here: https://www.alzheimers.org.uk/get-support/dementia-connect-support-line
We hope this helps, Tracey.
-
Alzheimer's Society blog team
Jill Frankie Simonite
saysHi ,my Husband is 77 years old and he had a TIA some 8 or 10 years ago,I thought I saw changes in him at that time ,but nothing too significant.
Four years ago he had a stroke which left him half blind ( he can only see to his left,unless of course he turns his head ), since then he has been diagnosed with Vascular Dementia ,went to a memory clinic once and refuses to go again.
Our GP prescribed him Donepezil but it made him worse and refused to take anymore.
My problem is he was always a little bit jealous if I got to know a man (any man ) even though we were never apart from one another and have been married for 57 years.
So now he has dementia he has it in his head (quite wrongly ) that I'm having an affair with our Son in Law. No amount of denying this will he believe ,I've even sworn on the Bible a few times, trying to convince him it's all in his head. Our daughter knows what her dad thinks and has just shrugged it off ,saying " he's always been like this ".
It's really getting me down ,I can cope with everything that dementia throws at us ,but to have to keep denying something day after day 8s soul destroying.
Also does Vascular Dementia mean he will get violent as the illness progresses.
Julie Porter
saysHello, my mum is 83 and was diagnosed with advanced Alzheimer's in August 2019 and then vascular dementia too in September 2019. No medication due to advanced and we look after her at home as a family. Mum sleeps probably 20hrs a day. While asleep she is often restless and screws up her face as if in pain but she isn't able to tell us if she is which worries and concerns us. She is also just starting to not always want/can't eat a meal. All a worry when not knowing about this illness.
Evie Owen
saysHello,
My mum died in November 2019 soon after her 69th birthday. She had been diagnosed with early on-set AD when she was 58; after a long period of what appeared to be profound depression.
I donated her brain tissue for Dementia research as I felt this was a positive thing to do.
Anyway, I have just received a letter from the research institute telling me that not only did mum have AD, she also had Dementia with Lewy Bodies and mild limbic-age related TDP-43 encephalopathy (LATE).
How common is it to have this type of mixed dementia, particularly at such a young age?
Does anyone else on here have experience of having a relative with this type of mixed dementia?
And, do we know how likely these diseases are to be passed on in families (either together or separately)? I worry both my myself and my son.
Thanks,
Evie