Advice
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.
Bev Burnham
saysClare
saysHazel McDowell
saysAlison Bojang
saysSharon
saysLouise
saysNicky
saysAdedolapo Oyebade
saysJanet
saysMichelle
saysHi Michelle,
We're really sorry to hear this. Please know that you aren't alone, and we are here for you.
We would strongly recommend calling our support line on 0333 150 3456 and speaking with one of our trained dementia advisers. They will listen to you, provide emotional support, and can offer further information and practical advice to help with your situation.
You can find more details about the support line (including opening hours and other methods of contact) here: https://www.alzheimers.org.uk/dementia-connect-support-line
We hope this helps, Michelle. Please do call our support line.
Alzheimer's Society website team
Lyn Fisher
saysCaroline and Mark Hickman
saysHi Caroline and Mark,
We're very sorry to hear about your mum - it sounds like such a difficult situation for you all. Please know that we are here to provide you with advice and support.
You might find our web page on Benefits for people affected by dementia useful: https://www.alzheimers.org.uk/get-support/legal-financial/benefits-dementia/disability-mobility-benefits It contains information about the types of benefits available to people with dementia, what the current rates are and how you can apply.
You might also benefit from calling our dementia support line on 0333 150 3456 and speaking to one of our trained dementia advisers. They will listen to you and provide specific information, advice and support. You can find more details about the support line (including opening hours and other methods of contact) here: https://www.alzheimers.org.uk/dementia-connect-support-line
We hope this helps for now.
Alzheimer's Society website team
Catherine
saysBruce Robinson
saysHi Bruce,
We're very sorry to hear about your dad, it sounds like you are both going through a very tough time.
We'd recommend calling our support line on 0333 150 3456 to speak with one of our trained dementia advisers. They will listen to you and provide specific information, advice and support that's relevant to your dad's situation. You can find more details about the support line (including opening hours) here: https://www.alzheimers.org.uk/dementia-connect-support-line
We also have some information on drinking, hydration and dementia, which you might find useful: https://www.alzheimers.org.uk/get-support/daily-living/drinking-hydration
We hope this helps for now. Please do call our support line if you need to.
Alzheimer's Society blog team
Bruce Robinson
saysJo
saysHi Jo,
We're very sorry to hear about your Mum's recent diagnosis.
We'd recommend calling our support line on 0333 150 3456 to speak with one of our trained dementia advisers. They will listen to you and provide specific information, advice and support that's relevant to your Mum's situation.
Alzheimer's Society blog team
Jo
saysLouise Priest
saysLouise, we're very sorry to hear this. Please know that you aren't alone, and we're here for you if you need support.
We'd recommend calling our support line on 0333 150 3456 to speak with one of our trained dementia advisers. They will listen to you and provide specific advice and support. You can find more details about the support line (including opening hours and other methods of contact) here: https://www.alzheimers.org.uk/dementia-connect-support-line
We hope this helps for now, Louise. Please do call our support line if you need to.
Alzheimer's Society blog team
Caitlin
saysJacqueline Brotherton
saysHi Jacqueline, we're sorry to hear you and your mum have been having a difficult time.
It sounds you might benefit from talking with other people who are in similar situations. Our online community, Talking Point, is a place where carers and other people affected by dementia can share their stories and offer advice and support. It is free to use and open day and night. You can read more about it and join the conversation here: https://www.alzheimers.org.uk/get-support/dementia-talking-point-our-online-community.
You can also call our Dementia Connect support line on 0333 150 3456 to speak with one of our dementia advisers. They can answer any questions you might have about support services and provide dementia information relevant to you and your family. More information about the support line can be found here: https://www.alzheimers.org.uk/dementia-connect-support-line.
Ray Holmes
saysJoanne Bentley
saysSteve Morley
saysDebbie
saysHi Debbie,
Thanks for your question, and we're sorry to hear about your grandad.
In general, a person with mixed dementia involving both Alzheimer’s disease and vascular dementia is more likely to die sooner than someone who just has Alzheimer’s disease. However, there is a lot of variation from person to person and it’s very difficult to predict ‘how long someone has’, either in terms of their decline over time or when they are likely to die.
This can make planning for the future after a diagnosis difficult, both practically and emotionally. Any figures you see on life expectancy in dementia will be very broad averages, with some people dying sooner and others much later than the number of years given.
In general though, an older person in their 80s – particularly if they have other life-limiting health conditions, such as heart disease or stroke – is less likely to live as long as a younger person who has dementia but is otherwise healthy.
For more general information, see our webpages on the progression and stages of dementia: https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/how-dementia-progresses/progression-stages-dementia
If you need any further support, please know that you can always call our support line on 0333 150 3456 to speak with one of our trained dementia advisers. You can find more details about the support line (including opening hours and other methods of contact) here: https://www.alzheimers.org.uk/dementia-connect-support-line
We hope this helps for now, Debbie. Please do call our support line if you need to.
Alzheimer's Society Knowledge team
Martin Hatchell
saysMary melvin
saysHi Mary,
We're very sorry to hear about your husband, it sounds like you are going through a very difficult time.
We'd recommend calling our support line on 0333 150 3456 to speak with one of our trained dementia advisers. They will listen to you and provide specific information, advice and support that's relevant to your husband's situation. You can find more details about the support line (including opening hours) here: https://www.alzheimers.org.uk/dementia-connect-support-line
We also have some information on poor appetite and dementia, which you might find useful: https://www.alzheimers.org.uk/get-support/daily-living/poor-appetite-dementia
We hope this helps for now, Mary. Please do call our support line if you need to.
Alzheimer's Society blog team
Tracy
saysMy mum was diagnosed with mixed dementia in October 2019, vascular and Alzheimer's. She has had a few falls recently and the latter causing a significant break to her femur. Previously, 2 years ago, she fell and broke both arms. She has had surgery and had been discharged to a rehabilitation bed. We have noticed a rapid decline in cognition making us wonder if perhaps a TIA caused her to fall - strange how she didn’t try to break her fall using her arms.
Anyway. We are now wondering if she is actually safe to transition to living independently. She keeps falling, has had several episodes eg put an electric kettle on an electric hop (melting it), put a bag of sugar in the microwave for 10 mins etc.
We have carers usually 4 times a day but it’s the in between that we don’t feel she’s safe - nevertheless she wants to come home.
How do we make such a huge decision, holding LPA for health and wealth? Is she entitled to continuing NHS care as she’s not safe? Who can we talk to?
Hi Tracy,
We're very sorry to hear about your mum, it sounds like you are going through a very difficult time. We'd strongly recommend calling our support line on 0333 150 3456 to speak with one of our trained dementia advisers. They can listen to your situation and provide specific information, advice and support. You can find more details about the support line (including opening hours) here: https://www.alzheimers.org.uk/dementia-connect-support-line
You may also benefit from joining our online community, Talking Point, where people affected by dementia can share their experiences. You can browse the conversations within the community or sign up for free: https://forum.alzheimers.org.uk
We hope this helps for now, Tracy. Please remember to call the support line on 0333 150 3456 if you need someone to talk to.
Alzheimer's Society blog team