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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. 

Our dementia advisers are here for you.

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.

Dementia support services
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148 comments

My husband has just been diagnosed with mixed dementia. I have just come off the phone from speaking with the alzheimer's society. I just want to say thank you for helping to make sense of this disease and the encouragement I received has really helped my mindset. I know its not going to be easy, but I would encourage anyone who has any questions to ring. I certainly won't hesitate again. Thank you for all your help.
My mum has been diagnosed with vascular dementia and alzheimers and it has completely devastated me. We suspected vascular due to the damage that diabetes has caused as she was undiagnosed for a few years at a very high level but the alzheimer's has come as a major shock. What are the expectancies with a mixed diagnosis? I want to give as much help and support as I can but currently work 4 days a week and am so confused with everything.
I would like to see the reply to Clare`s question I have been diagnosed with the mixed dementia I have no family my husband dies three years ago so I will have to fight this myself.
Hi Clare. Today my mum was diagnosed the same as your mum I’m devastated to say the least…..I can’t get my head around it because she’s my best friend and the thought of losing her is a complete devastation. I’ve got a million questions but I daren’t know the answer x
My mother was just diagnosed with mixed dementia at the age of 63. I'm broken absolutely broken. I'm a nurse so have some knowledge about this, but honeslty never thought it would come knocking at my door. This is a stage she should be enjoying her retirement, her grandchildren, travelling with her husband. I just feel she's been robbed 😔
I'm so sorry to read this. My mum was diagnosed last year with vascular and alzheimers but she doesn't know she has it - she chose not to know. She's been 'ok' for a while but zi seem to live in constant fear of when it will get worse. She's only 69 and I've already lost my dad, its just horrible. I hope your mum is taking meds to help slow it down.
I’m sorry to read this . I also lost my dad in July and now my mother age 72 has mixed dementia. Vascular and Alzheimer but she low blood pressure’s not high and I thought it was from mini strokes so I don’t understand as she hasn’t had mini strokes . It’s so unfair. She’s just starting on mementine . It’s so hard isn’t it ? It’s been very stressful last 6 months with delusions and hallucinations.
So sorry to hear you are going through this am a mental health nurse and my brother just got diagnosed with a mental illness it is extraordinary when it's affecting you, you are so brave, and am sure your experience is only going to ease her situation, you are so courageous
Hi all I've been reading some of your comments and it's apparent that families are left to cope and manage with our loved ones by ourselves. I've had to fight for 3 years to get a diagnosis for my now 78 Yr old mum. She deteriorated through covid and our GP surgery was no help. She was diagnosed in May 2021 as having normal pressure hydrocephalus, again the GP dis very little. I kept pushing for another memory assessment as I was convinced she had vascular dementia. Finally we got another referral which was relatively quick, but seems an age whilst waiting, and in January 2023 she was diagnosed with vascular dementia and Alzheimer's. It was such a relief but heart breaking. She's had multiple falls and TIAs. We are now nearly end of March and still not heard from our GP about a care plan. I work in healthcare and yet feel let down by it. My mum has got attendance allowance but don't know if I need to inform them of the change in diagnosis. I spoke to social services who werent interested unless it was emergency and my dad needs respite- couldnt get a shower fitted through them as my dad has too many pensions. So money which could be used at a later date for carers is having to be used on a £3k shower. Disgusting that they've paid in and can't get any money back. This disease is awful for both patients and families. Unfortunately my parents are stubborn and I'm banging my head as they won't accept help. I think my dad is in denial and bless my mum hasn't a clue what's going on. I hope that someday a cure will be found to stop this.
My husband has just had a diagnosis if mixed dementia at 56 years of age I'm drowning In what's going to happen next as we also have a son with special needs I have no idea of what he's entitled to.

Hi 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 Please contact your local Citizens' Advice not only will they tell you which benefits you are entitled to they will also help you fill out all the forms which are quite daunting in the first place.
My mum Greta is 79 and was diagnosed last week with mixed dementia - alzheimers and vascular. She currently lives alone and is super stubborn. I offer to help her with things like cleaning and sorting stuff out but she is saying NO to everything. Her flat is a Kym and Aggie job - Mark is sorting that out on Friday whilst I take Mum out. She has just started on Monday on Donepezil 5mg so we are waiting to see how she gets on with this. I totally get it she wants to be independent but I love her and want her to be safe. My husband Mark and I are debating what to do next. I also have a brother who has a mild learning disability who tries his best to help but isn't that helpful. I also have 3 children of my own to consider. Mark and I both work also - we both have a background in nursing - I am an adult nurse and Mark is a mental health nurse - so I know what is coming for Mum I am not sure whether that helps or not? I am debating about whether to apply for attendence allowance and all the other benefits. I am wading through Mum's finances - thankfully I have POA already for health and welfare and finance. She has already missed a few payments for a few things. I am just trying to get to the bottom of it all. Does it the attendence allowance start from diagnosis - last Thursday or when we first started noticing issues with Mum? What about the reduced rate council tax? Any help would be great thanks

Hi 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

Hello Caroline and Mark, there’s a lot to get to grips with once you have a diagnosis. We look after an elderly 87 year old friend who has always been “eccentric “ but was diagnosed with “moderate mixed dementia” last year. We have been able to get him Attendance Allowance backdated to diagnosis. Also a council tax assessed to nil from diagnosis, they checked with his GP. At first we filled in the wrong form for the council tax, using one for disability rather than mental incapacity, so had to reapply. It’s a great help towards his ongoing costs.
My dad is a retired pharmacist who has reached the age of 90. I used to live on my own about 5 minutes away and called in with his paper every day and cooked him a meal at night ( he can't cook). In May 2022 I called in at 11am to find him lying on the landing saying he couldn't get up. We had Care Call at the time but he wouldn't wear the wrist strap. Anyway I called them , 40 mins later they arrived, got him onto the bed and booked an appointment with the hospital. He was diagnosed with Mixed Dementia. I have since sold my house and moved in with him but find he gets up during the night around 2am. He keeps asking 'What's wrong with me?' cos being a former pharmacist he knows he's not right mentally. I tried to explain it to him. Some days he's great - wakes up, downstairs - bowl of cereal + cup of tea - but he never drinks it all, and cannot always understand what they are saying on the TV. He hears them but cannot work it out. I've booked several ski holidays for this season but am worried dad will not be able to look after himself whilst I am away. The District nurses said I should book him in for Resbite ie into a Care Home for my own Peace of Mind. last time I went away he cooked his frozen Southern Fried on the wok burner and felt ill the next day ( it's supposed to go in the oven) I don't think I can trust him to cook a meal when I am away. - he might turn the oven on and forget and go upstairs for a nap. Any advice would be helpful as it's getting nearer to my ski holidays. Thanks.

Hi 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

Ok. Thanks. At the moment I am actively looking for a Care Home that will offer Respite for both of us. Dad says I should 'do what is necessary' so that I have a break and can enjoy my hols. He sleeps most of the time. Don't think he has Lewy bodies ( thank God) as the nurse weighed him yesterday and he's actually gained weight.! We've got all the helping equipment in - walk frames, lift frame for getting off the toilet, a frame to help him get in and out of bed ( thinks that is great) - all of these things are free if you just ask social services - your local council will supply them free of charge. - hope this helps anyone reading this.
Hi. My Mum has been diagnosed with mixed alzheimers and vascular dementia. We only found out 2 weeks ago and now need help to know what are the next steps ie help and advice.

Hi 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

Thank you.
My Mum was diagnosed with mixed dementia about 2 years ago and was given medication to slow the progression. Unfortunately my Dad die this weekend and my Mum is so confused as to where he's gone. Don't know how to help her?

Louise, 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

My mum got diagnosed with advanced mixed dementia in July 2022 and was cared for by my dad and i before being sectioned in a acute unit since July. Thankfully we were able to get a care team when she was at home which was a saviour as she was getting progressively more violent and harder for us to constantly supervise her.
My mum was diagnosed on19 August 2022 with mixed dementia,she was asked to consider taking donepezil tablets but the memory nurse told her what the sidefecks were which put my mum of taking them so she was discharged back to her doctor to take care of her,we were told to put in for Attendance allowance and to get help from citizens advice to fill them in, after the first nurse from Dementia Assessment service said that she could get some one to help fill forms in , I have done the forms myself, I just feel you are left to get on with it your self? I feel that a lot of people are just talk and no reaction, so I will care for my mum with the help from my husband

Hi 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.

We have been let down by our memory service,My wife has been on Donepezil for 5 years and I think it did slow it down for a long time.
I’m in the same boat my mum was diagnosed with mixed Alzheimer’s in march 21, lives with me, but it’s getting harder as it’s me and my son! We have attendance allowance this no pays for 3 daycare sessions but isn’t enough, I’m waiting for adult social services and occupational health to get in touch as she’s deteriorating and I’m not sure how much longer I can cope!! She’s starting to get slightly aggressive too, and incontinent!
I empathize exactly with your situation. My Mum is 92. Prior to Covid and lockdown she was very active, had a busy social life (out every night) and was still able to drive her car. In September 2020 she caught Covid and was hospitalized. She recovered and was discharged home. It immediately became apparent that something wasn’t right. Thanks to a quick referral by the Occupational Therapist to Mum’s GP we were able to get her an appointment with the memory clinic and subsequently for clinical checks and a brain scan. She was diagnosed with Alzheimer’s and vascular dementia. Unfortunately, because of an existing heart condition, she was unable to be prescribed drugs which may have helped. Like you I applied for Attendance Allowance on her behalf. In October 2021 she was hospitalized again and diagnosed with acute heart failure. The consultant pulled me to one side and advised that she may have 6 to 9 months but that he’s put her on a “super drug”. So - 14 months later her heart is still going strong. However, her memory is becoming steadily worse. I am now retired so am able to visit every other day. But contact from Social Services or even her GP surgery have been nonexistent. It pretty much feels like if you’re coping then you’re left to your own devices.
My Grandad has just been diagnosed with alzheimers and vascular dementia. He is 86 . I have looked into prognosis of each of these and the average lifespan but cannot find this info on both combined. Does having both speed up the symptoms and ultimately death ? Thanks in advance

Hi 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

 

How many die of mixed dementia
Hi my husband 62yrs old has mixed dementia he was diagnosed when he was 57 . He had a brain scan and the damage is from one ear across to the other ear .He is refusing to eat since monday he says he is not hungry . Its a worry i see a big decline in him he cant write and his speech is really bad he gets his words all mixed up its a worry

Hi 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

My 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