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Dement Neuropsychol. 2017 Oct-Dec;11(4):364-370. doi: 10.1590/1980-57642016dn11-040005.

Mixed dementia: A review of the evidence.

Author information

1
Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia. Instituto Peruano de Neurociencias. Lima, Perú.
2
Servicio de Neurología. Instituto Peruano de Neurociencias. Lima, Perú.
3
Servicio de Medicina de Rehabilitación. Instituto Peruano de Neurociencias. Lima, Perú.
4
Unidad de Diseño y Elaboración de Proyectos de Investigación. Instituto Nacional de Salud del Niño. Lima, Perú.
5
GESID. Lima, Peru.
6
Unidad de Geriatría. Instituto Peruano de neurociencias. Lima, Perú.
7
Unidad de Neuropsicología. Instituto Peruano de Neurociencias. Lima. Perú.

Abstract

in English, Portuguese

Mixed dementia is the coexistence of Alzheimer's disease and cerebrovascular disease (CVD) in the same demented patient. Currently, its diagnosis and treatment remains a challenge for practitioners. To provide an overview of the epidemiology, pathogenesis, natural history, diagnosis, and therapy of Mixed Vascular-Alzheimer Dementia (MVAD). The literature was reviewed for articles published between 1990-2016 by using the keywords linked to MVAD. Neuropathological studies indicate that MVAD is a very common pathological finding in the elderly with a prevalence about of 22%. The distinction between Alzheimer's dementia and vascular dementia (VD) is complex because their clinical presentation can overlap. There are international criteria for the MVAD diagnosis. The pharmacologic therapy shows modest clinical benefits that are similar among all drugs used in patients with Alzheimer's dementia and VD. The non-pharmacologic therapy includes the rigorous management of cardiovascular risk factors (especially hypertension) and the promotion of a healthy diet. The diagnosis and treatment of MVAD cannot be improved without further studies. Currently available medications provide only modest clinical benefits once a patient has developed MVAD. In subjects at risk, the antihypertensive therapy and healthy diet should be recommend for preventing or slowing the progression of MVAD.

KEYWORDS:

Alzheimer's disease; cerebrovascular disease; mixed dementia; vascular dementia

Conflict of interest statement

Disclosure: The authors report no conflicts of interest.

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