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Mixed Dementia Treatment

It is not uncommon for individuals suffering from mixed dementia to be diagnosed with a single form of dementia, such as Alzheimer’s disease or vascular dementia. Because of this, most physicians will base their prescribing decisions on the type of dementia that has been diagnosed.

It should be noted that there are currently no medications specifically approved by the US Food and Drug Administration (FDA) for treating mixed dementia. Under the belief that Alzheimer’s disease contributes to some degree to mixed dementia, most physicians will prescribe one of the medications that are FDA-approved to treat Alzheimer’s disease.

Findings from a number of clinical trials have revealed that donepezil can provide some benefit for patients suffering from Alzheimer’s disease. Donepezil can also go by the brand name Aricept. It is a cholinesterase inhibitor whose mechanism of action is in its role in increasing acetylcholine within the brain.

Previous studies have also provided support for the role of galantamine in providing patients with benefits in terms of both the cognitive symptoms and functional impairment associated with a diagnosis of dementia. Galantamine can also go by the brand name Razadyne. Similar to donepezil, it is a cholinesterase inhibitor and works by increasing levels of acetylcholine within the brain. One study in particular provided evidence that galantamine may be particularly beneficial for patients with mixed dementia.

Rivastigmine has also received some support for treating mild to moderate dementia. Rivastigmine is also distributed under the brand name Exelon. Similar to the other medications used to treat symptoms of dementia, rivastigmine is a cholinesterase inhibitor.

Lastly, memantine has shown promising results among individuals suffering from moderate to severe symptoms of Alzheimer’s disease. Memantine can also be distributed under the brand name Namenda and is an N-methyl-D-aspartate (NMDA) receptor antagonist. The mechanism of action of memantine is in its role in blocking excessive activity of glutamate within the brain.

It is important to note that none of these medications are intended to cure the disease, as there is currently no cure for the disease. Rather, these medications are intended to reduce the severity of the symptoms or to slow the progression of symptoms.

If you have begun to notice any of these signs and symptoms of mixed dementia in yourself or someone you love, it is important to schedule an appointment with your doctor right away in order to discuss which of these medications is right for you.

 

Sources

  1. Langa KM, Foster NL, Larson EB. Mixed dementia: emerging concepts and therapeutic implications. JAMA 2004; 292(23):2901-8.
  2. Nadeau Y, Black SE. Mixed dementia: The most common cause of dementia? Can J Diagnosis 2010.
  3. Zekry D, Hauw JJ, Gold G. Mixed dementia: epidemiology, diagnosis, and treatment. J Am GeriatrSoc 2002; 50(8):1431-8.
  4. Rockwood K, Macknight C, Wentzel C et al. The diagnosis of “mixed dementia” in the consortium for the investigation of vascular impairment of cognition (CIVIC). Ann N Y AcadSci2000;903:522–528.
  5. Meyer J, McClintic K, Rogers R et al. Aetiological considerations and risk factors for multi-infarct dementia. J NeurolNeurosurg Psychiatry 1988;51:1489–1497.

 

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