It is common for people with dementia to have mixed dementia—a combination of two or more types of dementia. A number of combinations are possible. For example, some people have both Alzheimer's disease and vascular dementia.
Some studies indicate that mixed dementia is the most common cause of dementia in the elderly. For example, autopsy studies looking at the brains of people who had dementia indicate that most people age 80 and older probably had mixed dementia caused by a combination of brain changes related to Alzheimer's disease, vascular disease-related processes, or another neurodegenerative condition. Some studies suggest that mixed vascular-degenerative dementia is the most common cause of dementia in older adults.
In a person with mixed dementia, it may not be clear exactly how many of a person's symptoms are due to Alzheimer's or another disease. In one study, researchers who examined older adults' brains after death found that 78 percent had two or more pathologies (disease characteristics in the brain) related to neurodegeneration or vascular damage. Alzheimer's was the most common pathology but rarely occurred alone.
Researchers are trying to better understand how underlying disease processes in mixed dementia influence each other. In the study described above, the researchers found that the degree to which Alzheimer's pathology contributed to cognitive decline varied greatly from person to person. In other words, the impact of any given brain pathology differed dramatically depending on which other pathologies were present.
For More Information About Mixed Dementia
NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center
The National Institute on Aging’s ADEAR Center offers information and free print publications about Alzheimer’s disease and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.
It’s a conversation no family wants to have, but one that can be vitally important — talking to a loved one about memory loss or cognitive decline.
Mary Foss said she knew it was time to broach this sensitive topic with her husband Darrell when she noticed he was having difficulty doing the home improvement projects he had enjoyed all his life.
“Darrell would spend hours building and fixing things around the house — it was his hobby,” Mary said. “But it got to point where he was having trouble doing even routine tasks. He would get frustrated and soon began doing less and less. I knew something was wrong, but dismissed it for a while.”
As Darrell’s retreat from activities he once loved grew, so did Mary’s concern. Eventually, Mary and the couple’s adult daughter, Michele, decided to share their concerns.
“We just told him that something is not right, and you need to see a doctor and figure out what it is,” Foss said. “I thought maybe he had a mini-stroke or a brain tumor. We were shocked when the diagnosis came back as mild cognitive impairment, possibly Alzheimer’s.”
The Fosses’ story is not uncommon. Talking about memory or cognition problems with a family member can be daunting for many families. Denial, fear and difficulty initiating conversations about this sensitive subject are common barriers.
“Alzheimer’s disease is challenging, but talking about it doesn’t have to be,” said Ruth Drew, director of Information and Support Services at the Alzheimer’s Association. “Family members are typically the first to notice when something is not quite right and it’s important to discuss these concerns and follow up with your doctor.”
During Alzheimer’s & Brain Awareness Month the Alzheimer’s Association is offering these six tips to help families facilitate conversations about Alzheimer’s and other dementias:
If you have a loved one with Alzheimer’s disease, the decline you will see in this person is caused by brain cells dying. This changes how a person acts. Some of the common changes in
personality and behavior include Getting upset, worried, and angry more easily. Your loved one may act depressed or not interested in things. He may hide things or believe other people are hiding things. She may imagine things that aren’t there, wander away from home, or pace the floors. More extreme ways of behaving may include Showing unusual sexual behavior, hitting you or other people, or misunderstanding what he or she sees or hears. You also may notice that the person stops caring about how he or she looks, stops bathing, and wants to wear the same clothes every day.
In addition to changes in the brain, other things may affect how people with Alzheimer’s behave. They may be having health-related problems, including illness, pain, new medications, or lack of sleep. Other physical issues like infections, constipation, hunger or thirst, or problems seeing or hearing can affect behavior.
Too much noise, such as TV, radio, or many people talking at once can cause frustration and confusion in Alzheimer’s sufferers. Stepping from one type of flooring to another or the way the floor looks may make the person think he or she needs to take a step down. Mirrors may make them think that a mirror image is another person in the room. For tips on creating an Alzheimer’s-safe home, visit Home Safety and Alzheimer’s Disease.
Caregivers cannot stop Alzheimer’s-related changes in personality and behavior, but they can learn to cope with them. Here are some suggestions for understanding and coping with these changes:
With many types of senior care available today, the types and services they include can be confusing. Although assisted living communities may have memory care units on the premises, there are important differences between this type of senior home and memory care facilities.
Memory care is a particular type of long-term, skilled nursing that is designed specifically for patients with Alzheimer’s disease, dementia and other types of memory problems. Also called special care units (SCUs), memory care units usually provide 24-hour supervised care. The staff in memory care are specially trained to assist people with dementia or impaired cognition.Assisted living is defined as a long-term care option that combines housing, support services and health care, as needed. Care is available 24 hours a day, and personal care services often include medication management and transportation.
The physical layout and security of memory care facilities is designed to better suit Alzheimer’s and dementia patients, so that wandering behavior is minimized, and the environment is pleasant and easy to navigate. Some memory care facilities offer “neighborhoods”, which are laid in such a way as to be familiar and easy to navigate.
Regulations regarding what services are offered vary from state to state in all senior care communities, but generally, both memory care and assisted living offer basic supervised care, medical monitoring, and help with daily activities such as dressing, mobility, and hygiene. Other services that are usually offered in both types of care include:
- Access to medical care
- Emergency call systems
- Health and exercise programs
- Housekeeping and laundry service
- Social activities and programs
- 24-hour staff supervision and security
- Three daily meals
Memory care often includes structured activities or programs designed to nurture residents suffering from Alzheimer’s or dementia.
If your loved one is still relatively independent and Alzheimer’s or dementia is not an immediate concern, then assisted living may be an appropriate choice. However, if they have complex care needs associated with memory impairment, then you may want to consider memory care, or an assisted living community that also includes a special care unit for persons with dementia.
South Mountain Memory Care focuses on high-quality, personalized care. The brand new building is a stand-alone memory care community, meaning that the entire building, staff and programs are designed to serve residents with cognitive issues. To ensure person-centered care and attention, we have accommodations for up to 28 residents. The building is divided into two neighborhoods (wings), each offering 10 private suites and 2 semi-private suites. South Mountain Memory Care is located in the Allentown suburb of Emmaus, Pennsylvania, and it is easily accessible from the Lehigh Valley, New Jersey and Philadelphia. For more information, go to http://www.southmountainmemorycare.com/
Join us Wednesday, May 23, 2018 at 2 pm for a free informational session.
The featured speaker with be Wendy Scott, MA CPD, Elder Life Educator from LVPG Geriatric Medicine – The Fleming Memory Center.
There will be light refreshments served and participants will receive a free gift for attending.
RSVP today to 610-965-7662.