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Vascular Dementia, Mixed Dementia, and Research

Last week’s article focused on Alzheimer’s Disease, which many consider to be the most common type of dementia., affecting about 60% of individuals.   After Alzheimer’s Disease, vascular dementia is usually considered the second most common type, comprising about 20% of dementia cases. Unlike Alzheimer’s Disease, which progresses slowly, vascular dementia has a sudden onset.  Vascular dementia occurs when the blood flow to the brain is compromised, thus depriving the brain of oxygen.  This compromise can result from stroke, in which a clot blocks blood flow, or damage and breakdown of blood vessel walls due to the build-up of plaque. Either way, damage to nerve cells results in symptoms of dementia.   Vascular dementia is more common when multiple strokes affecting both sides of the brain have occurred (multi-infarct dementia), but it can also occur from a single, large stroke.  Another form of vascular dementia occurs when “hardening of the arteries” causes thickening and narrowing of the small blood vessels found in brain tissue where special cells exist which help nerves communicate with each other.     The important factor to remember is that some of risk factors for stroke and this type of dementia can be controlled with lifestyle choices and medications, thus lowering your chances of developing either condition.  These risk factors include hypertension, diabetes, smoking, atrial fibrillation, and high cholesterol. 

As researchers have continued to study dementia, some have found that when looking at autopsy results, in a significant number of cases the neurodegenerative changes of Alzheimer’s Disease and vascular changes coexisted.  This condition is known as mixed dementia.   Because some of the dementia-related changes in the brain are difficult to determine and study while individuals are alive, people experiencing dementia are often diagnosed with only one type.  When mixed dementia is present, it is not yet understood how the different types of dementia influence each other, or how to determine which symptoms are attributable to which type of dementia.  It is possible that mixed dementia is actually the most common type of dementia in the elderly, which has important implications for future research.

Until a method of prevention or a cure is found, continued research is vital to help understand the risk factors, physical and cognitive effects, and treatment possibilities for all types of dementia.  In May, 2013, a Research!America poll reported that although 76% of Americans believe that research is important, only 16% have participated themselves or had a family member participate in a research study.  Participation in some research studies is as simple as completing a ten minute online questionnaire.  Information about current research studies and clinical trials can be found at,, and (TrialMatch service).  These registries are funded in part by the National Institutes of Health and other reputable health organizations, and seek to match eligible participants with current research studies.  The Alzheimer’s Prevention Registry reports that 80% of studies fail to attract enough participants.  Older adults are especially encouraged to consider joining the fight against Alzheimer’s Disease and other dementias by enrolling in clinical studies and trials.  The Alzheimer’s Association addresses some of the common myths about participating in research studies in the TrialMatch section of their website.  Investigating available opportunities does not obligate you to participate, and the type of participation required varies with the many different studies that are currently in progress. Will you help be part of finding a cure for dementia?

Karen Kaslow, RN
Care Coordinator