Mixed dementia

Abstract

Mixed dementia (MD) is co-existance of both Alzheimer's disease (AD) and vacular dementia (VD) in the same patient. With aging of popularion, this diagnostic cathegory will continue to be problem in clinical practice. Neuropathological studies indicate that MD represents a very common pathology, especially in the elderly. The differentiation between AD and VD is complex since their clinical presentations may overlap and diagnostic criteria do not provide adequate differentiation. There are also overlapping pathological processes in AD and VD, and both conditions share vascular risk factors. Treatment of MD patients is challenging, and there is a potential for use of cholinestherase inhibitors, risk factor management and also for use of other medications. MD remains challenging clinical diagnosis.

Mešovita demencija (MD) je zajedničko postojanje Alchajmerove bolesti (AB) i vaskulne demencije (VaD) kod istog bolesnika. Sa starenjem populacije, ovaj dijagnostički entitet će se sve više postavljati kao problem u praksi. Neuropatološke studije ukazuju da je MD veoma čest patološki nalaz, posebno kod starijih. Razlikovanje AB i VaD je složeno budući da njihove kliničke prezentacije mogu da se preklapaju, a da dijagnostički kriterijumi ne omogućavaju afekvatnu diferencijaciju. Patološki procesi u AB i VaD se takodje preklapaju i obe bolesti dele vaskulne faktore rizika. Poseban izazov je problem lečenja bolesnika sa MD, gde svoje mesto imaju inhibitori holinesteraze, tretiranje faktora rizika, a moguće je i neki drugi lekovi. Postavljanje dijagnoze MD i dalje je izazov za lekara praktičara.