Vascular dementia and Alzheimer's: can a mixed diagnosis bring any benefits?

A retired nurse was diagnosed with both vascular dementia and Alzheimer's after episodes of confusion and testing; the mixed diagnosis made her eligible for memantine, and researchers are studying biomarkers to improve detection.

Fran Murt, a former senior nurse, began having unusual lapses in memory and routine skills late in her career. Initial checks led to scans that showed small-vessel changes in the brain. Further testing of cerebrospinal fluid found Alzheimer’s-related biomarkers and clinicians diagnosed mixed vascular dementia and Alzheimer’s disease. The diagnosis ended her nursing career but also opened treatment options. Key facts: - Fran experienced disorientation and difficulty with everyday nursing tasks and travel on familiar routes. - CT and MRI scans showed changes linked to small blood vessel blockages; a lumbar puncture identified Alzheimer’s biomarkers. - Clinicians diagnosed mixed vascular dementia and Alzheimer’s and prescribed memantine for Alzheimer’s symptoms. - A study funded by Alzheimer’s Society at Imperial College is analysing brain samples and biomarkers to better identify mixed dementia and potentially develop simpler tests. Summary: The mixed diagnosis allowed access to a medication that the patient and her family say has helped stabilise some symptoms, while also changing her daily life and work prospects. Research into biomarkers is ongoing and aims to improve identification of mixed dementia so that diagnoses better reflect the different processes affecting the brain.