Mixed dementia: A review of the evidence

Custodio, Nilton; Montesinos, Rosa; Lira, David; Herrera-Pérez, Eder; Bardales, Yadira; Valeriano-Lorenzo, Lucía

doi:10.1590/1980-57642016dn11-040005

Cited by 152Dementia and Cognitive Impairment ResearchNeurological Disease Mechanisms and TreatmentsAlzheimer's disease research and treatments

Mixed dementia: A review of the evidence

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Custodio, Nilton, Montesinos, Rosa, Lira, David, Herrera-Pérez, Eder, Bardales, Yadira, Valeriano-Lorenzo, Lucía·2017·Dementia & Neuropsychologia

DOI 10.1590/1980-57642016dn11-040005PMC PMC5769994

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Abstract

ABSTRACT. 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.

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Transcranial direct current stimulation (tDCS) combined with language therapy shows some promise for improving word retrieval in logopenic variant primary progressive aphasia (lvPPA).
“Emerging therapies, such as transcranial direct current stimulation (tDCS) combined with language therapy, show some promise for improving word retrieval in lvPPA.53”
From A 2025 update on treatment strategies for the Alzheimer’s disease spectrum (2025) · cites this paper as [53]
The Therapeutic guidelines section discusses medications and vascular-risk management for mixed dementia, not tDCS or language therapy. Searches for tDCS, word retrieval, and logopenic variant primary progressive aphasia found no passage addressing the claimed treatment or outcome; page numbers were not available in our copy. (LLM, conf=0.77)
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Modrego, P. J., Ríos, C., Trullén, J. M. P., Errea, J. M., García-Gómara, M. J., & Sanchez, S. (2008) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317507309274 · Cited by 16 · see citing works
Vascular Cognitive Impairment
Srikanth, V. K., Saling, M. M., & Thrift, A. G. (2007) · Elsevier eBooks · doi:10.1016/b978-012088592-3/50023-2 · Cited by 9 · see citing works
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Hanyu, H. (2012) · PubMed · Cited by 5 · see citing works

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1 of the 77 references couldn’t be matched to a known paper.

Research works printed but not linked: 8

[1]Gorelick PB Scuteri A Black SE arli C Greenberg SM Iaola C Vascular Contributions to Cognitive Impairment and Dementia Stroke 2011 42 9 2672 2713 21778438 PMC3778669
[8]Snowdon DA Greiner LH Mortimer JA Riley KP Greiner PA Markesbery WR Brain infarction and the clinical expression of Alzheimer disease The Nun Study JAMA 1997 277 10 813 817 9052711
[19]Snowdon DA Greiner LH Mortimer JA Riley KP Greiner PA Markesbery WR Brain infarction and the clinical expression of Alzheimer disease The Nun Study JAMA 1997 277 10 813 817 9052711
[21]Jack CR Knopman DS Jagust WJ Petersen RC Weiner MW Aisen PS Update on hypothetical model of Alzheimer’s disease biomarkers Lancet Neurol 2013 12 2 207 216 23332364 PMC3622225
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[48]Snowdon DA Greiner LH Mortimer JA Riley KP Greiner PA Markesbery WR Brain infarction and the clinical expression of Alzheimer disease The Nun Study JAMA 1997 277 10 813 817 9052711
[57]Jack CR Albert M Knopman DS McKhann GM Sperling RA Carillo M Introduction to Revised Criteria for the Diagnosis of Alzheimer’s Disease National Institute on Aging and the Alzheimer Association Workgroups Alzheimers Dement 2011 7 3 257 262 21514247 PMC3096735
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Sorted by citations

The Role of NADPH Oxidases and Oxidative Stress in Neurodegenerative Disorders
Tarafdar, A., & Pula, G. (2018) · International Journal of Molecular Sciences · doi:10.3390/ijms19123824 · Cited by 373 · see citing works
Vascular Dysfunction in Alzheimer’s Disease: A Prelude to the Pathological Process or a Consequence of It?
Govindpani, K., McNamara, L. G., Smith, N. R., Vinnakota, C., Waldvogel, H. J., Faull, R. L. M., & Kwakowsky, A. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8050651 · Cited by 271 · see citing works
“Indeed, it has been suggested that the majority of older patients present with a mixed-dementia with characteristics of both conditions [18].”
BackgroundInfluential
Diagnostic biomarkers of Alzheimer’s disease: A state-of-the-art review
Khoury, R., & Ghossoub, E. (2019) · Biomarkers in Neuropsychiatry · doi:10.1016/j.bionps.2019.100005 · Cited by 157 · see citing works
Machine Learning for Dementia Prediction: A Systematic Review and Future Research Directions
Javeed, A., Dallora, A., Berglund, J., Ali, A., Ali, L., & Anderberg, P. (2023) · Journal of medical systems · doi:10.1007/s10916-023-01906-7 · Cited by 173 · see citing works
“AD and VaD dementia are the two subtypes that are most common in MD [28].”
Background
Sex differences in dementia risk and risk factors: individual-participant data analysis using 21 cohorts across six continents from the COSMIC consortium
Gong, J., Harris, K., Lipnicki, D. M., Castro‐Costa, E., Lima‐Costa, M. F., Diniz, B. S., Xiao, S., Lipton, R. B., Katz, M. J., Wang, C., et al. (2023) · Alzheimer's & Dementia · doi:10.1002/alz.12962 · Cited by 141 · see citing works
Alzheimer's disease and alpha-synuclein pathology in the olfactory bulbs of infants, children, teens and adults ≤ 40 years in Metropolitan Mexico City. APOE4 carriers at higher risk of suicide accelerate their olfactory bulb pathology
Calderón-Garcidueñas, L., González-Maciel, A., Reynoso-Robles, R., Kulesza, R. J., Mukherjee, P. S., Torres-Jardón, R., Rönkkö, T., & Doty, R. L. (2018) · Environmental Research · doi:10.1016/j.envres.2018.06.027 · Cited by 110 · see citing works
Health-related quality of life in people with predementia Alzheimer’s disease, mild cognitive impairment or dementia measured with preference-based instruments: a systematic literature review
Landeiro, F., Mughal, S., Walsh, K., Nye, E., Morton, J., Williams, H. M., Ghinai, I., Castro, Y., Leal, J., Roberts, N. W., et al. (2020) · Alzheimer s Research & Therapy · doi:10.1186/s13195-020-00723-1 · Cited by 109 · see citing works
Biomarkers of dementia in obstructive sleep apnea
Baril, A., Carrier, J., Lafrenière, A., Warby, S. C., Poirier, J., Osorio, R. S., Ayas, N., Dubé, M., Petit, D., & Gosselin, N. (2018) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2018.08.001 · Cited by 96 · see citing works
Vascular Risk Factors and Alzheimer’s Disease: Blood-Brain Barrier Disruption, Metabolic Syndromes, and Molecular Links
He, J., Zhao, X., Xu, L., & Mao, C. (2019) · Journal of Alzheimer s Disease · doi:10.3233/jad-190764 · Cited by 86 · see citing works
“Inreality,mixed dementiaisalsoacommonformofdementiacharac-terizedbythecoexistenceofADandcerebrovascular impairmentintheverysamedementedperson, causingseverecognitivedysfunction[19].”
Atherosclerosis, Hypertension, and Diabetes in Alzheimer’s Disease, Vascular Dementia, and Mixed Dementia: Prevalence and Presentation
Javanshiri, K., Waldö, M. L., Friberg, N., Sjövall, F., Wickerström, K., Haglund, M., & Englund, E. M. (2018) · Journal of Alzheimer s Disease · doi:10.3233/jad-180644 · Cited by 71 · see citing works
A 2025 update on treatment strategies for the Alzheimer’s disease spectrum
Wu, C.-K., & Fuh, J.-L. (2025) · Journal of the Chinese Medical Association · doi:10.1097/jcma.0000000000001252 · Cited by 77 · see citing works
“54 Therapies targeting both AD and vascular pathophysiology are essential.”
Clinical Guidelines for Cognitive Disorders in Elderly and Older Patients
Bogolepova, A. N., Васенина, Е. Е., Gomzyakova, N. A., Gusev, E. I., Dudchenko, N. G., Emelin, А. Y., Zalutskaya, N. M., Isaev, R. I., Kotovskaya, Y. V., Levin, O. S., et al. (2021) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro20211211036 · Cited by 72 · see citing works
Behavioral and Psychological Symptoms in Dementia (BPSD) and the Use of Antipsychotics
Calsolaro, V., Femminella, G. D., Rogani, S., Esposito, S., Franchi, R., Okoye, C., Rengo, G., & Monzani, F. (2021) · Pharmaceuticals · doi:10.3390/ph14030246 · Cited by 67 · see citing works
“Mixed Vascular–Alzheimer Dementia (MVAD) consists in the simultaneous presence of Alzheimer’s disease and cerebrovascular disease (CVD); it is quite common in older patients, with a prevalence of around 22% [4].”
Background
Hypertension and hyperhomocysteinemia as modifiable risk factors for Alzheimer's disease and dementia: New evidence, potential therapeutic strategies, and biomarkers
Carey, A. M., & Fossati, S. (2022) · Alzheimer s & Dementia · doi:10.1002/alz.12871 · Cited by 59 · see citing works
Advances in Deep Neuropathological Phenotyping of Alzheimer Disease: Past, Present, and Future
Shakir, M., & Dugger, B. N. (2022) · Journal of Neuropathology & Experimental Neurology · doi:10.1093/jnen/nlab122 · Cited by 56 · see citing works
Ischemia as a common trigger for Alzheimer’s disease
Elman-Shina, K., & Efrati, S. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.1012779 · Cited by 48 · see citing works
“Vascular risk factors are tightly linked to both cerebrovascular disease and the development of AD (Custodio et al., 2017; Rost et al., 2022).”
Background
The rising burden of Alzheimer's disease mortality in rural America
Ho, J. Y., & Franco, Y. (2022) · SSM - Population Health · doi:10.1016/j.ssmph.2022.101052 · Cited by 45 · see citing works
COVID-19 Crisis Effects on Caregiver Distress in Neurocognitive Disorder
Alexopoulos, P., Soldatos, R. F., Kontogianni, E., Frouda, M., Aligianni, S. L., Skondra, M., Passa, M., Κωνσταντοπούλου, Γ., Stamouli, E., Katirtzoglou, E., et al. (2020) · Journal of Alzheimer s Disease · doi:10.3233/jad-200991 · Cited by 44 · see citing works
“The diagnoses of Alzheimer’s disease [16], cerebrovascular disease [17], frontotemporal lobar degeneration [18], or neurocognitive disorder due to mixed etiology [19, 20] had been established according to international diagnostic criteria by a psychiatrist or neurologist after an extensive diagnostic workup in the six…”
Method
The Sulfation Code of Tauopathies: Heparan Sulfate Proteoglycans in the Prion Like Spread of Tau Pathology
Mah, D., Zhao, J., Liu, X., Zhang, F., Liu, J., Wang, L., Linhardt, R. J., & Wang, C. (2021) · Frontiers in Molecular Biosciences · doi:10.3389/fmolb.2021.671458 · Cited by 44 · see citing works
A Novel Model of Mixed Vascular Dementia Incorporating Hypertension in a Rat Model of Alzheimer’s Disease
Denver, P., D’Adamo, H., Hu, S., Zuo, X., Zhu, C., Okuma, C., Kim, P., Castro, D., Jones, M. R., Leal, C. D. R., et al. (2019) · Frontiers in Physiology · doi:10.3389/fphys.2019.01269 · Cited by 36 · see citing works
Long-term low-dose acetylsalicylic use shows protective potential for the development of both vascular dementia and Alzheimer’s disease in patients with coronary heart disease but not in other individuals from the general population: results from two large cohort studies
Nguyen, T. N. M., Chen, L., Trares, K., Stocker, H. R., Holleczek, B., Beyreuther, K. T., Brenner, H., & Schöttker, B. (2022) · Alzheimer s Research & Therapy · doi:10.1186/s13195-022-01017-4 · Cited by 36 · see citing works
“What speaks in favor of this hypothesis is that neuropathological studies suggest that this type of mixed dementia is a rather common pathological finding in the elderly with a prevalence of about 22% [31].”
Result
Alzheimer’s Disease and Alzheimer’s Disease-Related Dementias in Hispanics: Identifying Influential Factors and Supporting Caregivers
Rawat, P., Sehar, U., Bisht, J., Reddy, A., & Reddy, P. H. (2023) · Ageing Research Reviews · doi:10.1016/j.arr.2023.102178 · Cited by 29 · see citing works
Emerging Trends: Neurofilament Biomarkers in Precision Neurology
Sharma, P., Giri, A., & Tripathi, P. N. (2024) · Neurochemical Research · doi:10.1007/s11064-024-04244-3 · Cited by 33 · see citing works
Identifying preclinical vascular dementia in symptomatic small vessel disease using MRI
Lambert, C., Zeestraten, E., Williams, O. A., Benjamin, P., Lawrence, A. J., Morris, R. G., MacKinnon, A. D., Barrick, T. R., & Markus, H. S. (2018) · NeuroImage Clinical · doi:10.1016/j.nicl.2018.06.023 · Cited by 33 · see citing works
“However, our results allow this heterogeneous group to be stratified according to the likely predominant pathology, consistent with the latest recommendations (Custodio et al., 2017).”
Relationship between Surgery under General Anesthesia and the Development of Dementia: A Systematic Review and Meta‐Analysis
Lee, J. J., Choi, G. J., Kang, H., Baek, C. W., Jung, Y. H., Shin, H. Y., Park, Y., & Woo, Y. C. (2020) · BioMed Research International · doi:10.1155/2020/3234013 · Cited by 32 · see citing works
“Recently, however, the concept of mixed dementia (mixed vascular–Alzheimer dementia) has been emerging [65], and currently used diagnostic criteria may yield lower incidence rate of AD than the actual value.”
Background
Role of Citicoline in Patients With Mild Cognitive Impairment
Bermejo, P. E., Dorado, R., & Zea‐Sevilla, M. A. (2023) · Neuroscience Insights · doi:10.1177/26331055231152496 · Cited by 31 · see citing works
APOE genotype dependent molecular abnormalities in the cerebrovasculature of Alzheimer’s disease and age-matched non-demented brains
Ojo, J. O., Reed, J. M., Crynen, G. C., Vallabhaneni, P., Evans, J., Shackleton, B., Eisenbaum, M., Ringland, C., Edsell, A., MULLAN, M. J., et al. (2021) · Molecular Brain · doi:10.1186/s13041-021-00803-9 · Cited by 29 · see citing works
Sex hormones, vascular factors and cognition
Szoeke, C. E. I., Downie, S., Parker, A. F., & Phillips, S. (2021) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2021.100927 · Cited by 26 · see citing works
Vascular dementia subtypes, pathophysiology, genetics, neuroimaging, biomarkers, and treatment updates along with its association with Alzheimer's dementia and diabetes mellitus.
Prajjwal, P., Marsool, M. D., Inban, P., Sharma, B., Asharaf, S., Aleti, S., Gadam, S., Sakini, A. A. A., & Hadi, D. D. (2023) · Disease-a-month : DM · doi:10.1016/j.disamonth.2023.101557 · Cited by 30 · see citing works
Neuropsychological differential diagnosis of Alzheimer’s disease and vascular dementia: a systematic review with meta-regressions
Sokolovič, L., Hofmann, M., Mohammad, N., & Kukolja, J. (2023) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2023.1267434 · Cited by 29 · see citing works
“…different patterns of pathology, disease progression, and cognitive impairment (Bowler et al., 1997; Kramer et al., 2004; but see also van de Pol et al., 2011; Smits et al., 2015; Bischof et al., 2016; Dronse et al., 2016; Custodio et al., 2017; Ramirez-Gomez et al., 2017; Richter et al., 2020).”
Background
Cardiovascular Disease, Diabetes Mellitus, and Hypertension in Lewy Body Disease: A Comparison with Other Dementia Disorders
Javanshiri, K., Haglund, M., & Englund, E. M. (2019) · Journal of Alzheimer s Disease · doi:10.3233/jad-190485 · Cited by 25 · see citing works
Strategies for Treatment of Disease-Associated Dementia Beyond Alzheimer's Disease: An Update
Khan, S. S., Khatik, G. L., & Datusalia, A. K. (2022) · Current Neuropharmacology · doi:10.2174/1570159x20666220411083922 · Cited by 25 · see citing works
“Also, the tau tangles are observed in a semi-quantitative amount in the hippocampus and neo-cortex regions [44].”
Influential
Relationship of Psychological Flexibility and Mindfulness to Caregiver Burden, and Depressive and Anxiety Symptoms in Caregivers of People with Dementia
Tan, K. P., Ang, J. K., Koh, E. B. Y., Pang, N. T. P., & Mat Saher, Z. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20054232 · Cited by 23 · see citing works
Identification of Disease-Related Genes That Are Common between Alzheimer’s and Cardiovascular Disease Using Blood Genome-Wide Transcriptome Analysis
Lee, T., Lee, H., & Initiative, T. A. D. N. (2021) · Biomedicines · doi:10.3390/biomedicines9111525 · Cited by 22 · see citing works
“Mixed dementia, which has the characteristics of both AD and VaD, is one of the main issues for dementia [5,6].”
Background
A unidirectional mapping of ICD-8 to ICD-10 codes, for harmonized longitudinal analysis of diseases
Pedersen, M. K., Eriksson, R., Reguant, R., Collin, C. B., Pedersen, H., Sørup, F. K. H., Simon, C., Birch, A. M., Larsen, M., Nielsen, A. P., et al. (2023) · European Journal of Epidemiology · doi:10.1007/s10654-023-01027-y · Cited by 22 · see citing works
“[30, 31] This paper is novel in developing a fine-grained quantitative scoring of the qualitative match.”
Background
Evolución histórica del concepto y criterios actuales para el diagnóstico de demencia.
Custodio, N., Montesinos, R., & Alarcón, J. O. (2019) · Revista de Neuro-Psiquiatría · doi:10.20453/rnp.v81i4.3438 · Cited by 22 · see citing works
Self-citation
Molecular Pathobiology of the Cerebrovasculature in Aging and in Alzheimers Disease Cases With Cerebral Amyloid Angiopathy
Ojo, J. O., Reed, J. M., Crynen, G. C., Vallabhaneni, P., Evans, J., Shackleton, B., Eisenbaum, M., Ringland, C., Edsell, A., MULLAN, M. J., et al. (2021) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2021.658605 · Cited by 21 · see citing works
“Moreover, vascular dementia and AD related dementia both share a significant degree of overlap in their clinical and neuropathological profiles (Kalaria and Ballard, 1999; Kalaria, 2003; Erkinjuntti et al., 2004; Custodio et al., 2017).”
Background
Contribution of Memory Tests to Early Identification of Conversion from Amnestic Mild Cognitive Impairment to Dementia
Vyhnálek, M., Jester, D. J., Andel, R., Horáková, H., Nikolai, T., Laczó, J., Matušková, V., Čechová, K., Sheardová, K., & Hort, J. (2022) · Journal of Alzheimer s Disease · doi:10.3233/jad-215364 · Cited by 21 · see citing works
“In the clinical phenotype, the patients manifested episodic memory impairment and impaired attention/working memory, executive function, and slow processing speed [33].”
Background
A review of neurological health disparities in Peru
Almubaslat, F., Sánchez, S. S., & Diaz, M. M. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1210238 · Cited by 21 · see citing works
“New studies have also investigated the development of Mixed Vascular-Alzheimer Dementia, which occurs when there is evidence of both diseases present in an individual (82).”
Background
Clinical guidelines «Cognitive disorders in the elderly and senile persons»
Tkacheva, O. N., Yahno, N. N., Незнанов, Н. Г., Шпорт, С. В., Shamalov, N. A., Levin, O. S., Kostyuk, G. P., Gusev, E. I., Martynov, M. Y., Si, G., et al. (2025) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro2025125337 · Cited by 20 · see citing works
Hypertension & dementia: Pathophysiology & potential utility of antihypertensives in reducing disease burden
Lyon, M., Fullerton, J. L., Kennedy, S., & Work, L. M. (2023) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2023.108575 · Cited by 21 · see citing works
Corneal nerve loss predicts dementia in patients with mild cognitive impairment
Ponirakis, G., Hamad, H. K. A., Omar, D. A. M., Petropoulos, I. N., Khan, A., Gad, H., Chandran, M., Gadelseed, M., Elsotouhy, A., Ramadan, M., et al. (2023) · Annals of Clinical and Translational Neurology · doi:10.1002/acn3.51747 · Cited by 17 · see citing works
“Furthermore, the prognostic ability of biomarkers for “pure” AD may be compromised by vascular pathologies, that may independently contribute to the development of dementia.(7,10,11) Indeed, the Alzheimer’s Drug Discover Foundation (ADDF) has emphasized the”
BackgroundInfluential
Preclinical models of disease and multimorbidity with focus upon cardiovascular disease and dementia
Shabir, O., Moll, T., Matuszyk, M. M., Eyre, B., Dake, M. D., Berwick, J., & Francis, S. (2020) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2020.111361 · Cited by 17 · see citing works
Physiological separation of Alzheimer’s disease and Alzheimer’s disease with significant levels of cerebrovascular symptomology and healthy controls
Lithgow, B., Dastgheib, Z. A., Anssari, N., Mansouri, B., Blakley, B. W., Ashiri, M., & Moussavi, Z. (2021) · Medical & Biological Engineering & Computing · doi:10.1007/s11517-021-02409-8 · Cited by 16 · see citing works
AI‐based assessments of speech and language impairments in dementia
Parsapoor, M. (2023) · Alzheimer s & Dementia · doi:10.1002/alz.13395 · Cited by 15 · see citing works
Paradigm Shift: Multiple Potential Pathways to Neurodegenerative Dementia
Perna, A., Montine, K. S., White, L. R., Montine, T. J., & Cholerton, B. (2023) · Neurotherapeutics · doi:10.1007/s13311-023-01441-w · Cited by 15 · see citing works
“The co-occurrence of vascular neuropathologic change and/ or LBD and AD neuropathologic change (ADNC) is well-described [113, 114], and it has been shown that LATE-NC frequently overlaps with ADNC, HS, and potentially LBD [115].”
Background
Blood pressure trajectories over 35 years and dementia risk: A retrospective study: The HUNT study
Selbæk, G., Stuebs, J., Engedal, K., Hachinski, V., Hestad, K. A., Trevino, C. S., Skjellegrind, H. K., Wedatilake, Y., & Strand, B. H. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.931715 · Cited by 14 · see citing works
“Comparisons between the AD and VaD group should be interpreted with caution as there probably is considerable overlap with a large group of people with mixed AD and VaD pathology (Custodio et al., 2017).”
Result
The comorbidity and co-medication profile of patients with progressive supranuclear palsy
Greten, S., Wegner, F., Jensen, I., Krey, L., Rogozinski, S., Fehring, M., Heine, J., Doll‐Lee, J., Pötter‐Nerger, M., Zeitzschel, M., et al. (2023) · Journal of Neurology · doi:10.1007/s00415-023-12006-4 · Cited by 14 · see citing works
“Furthermore, the accumulation of tau and β-amyloid in AD can be accelerated in the context of cardio-and cerebrovascular diseases [44, 45].”
Background
Alzheimer’s Disease and Alzheimer’s Disease-Related Dementias in African Americans: Focus on Caregivers
Kopel, J. J., Sehar, U., Choudhury, M., & Reddy, P. H. (2023) · Healthcare · doi:10.3390/healthcare11060868 · Cited by 13 · see citing works
“Multiple Etiology Dementia (MED) - Alzheimer’s disease and cerebrovascular disease coexist - compromised memory - white matter lesions in brain imaging - localized neurological symptoms [47]”
Background
Sleep deprivation in dementia comorbidities: focus on cardiovascular disease, diabetes, anxiety/depression and thyroid disorders
Mukherjee, U., Sehar, U., Brownell, M., & Reddy, P. H. (2024) · Aging · doi:10.18632/aging.206157 · Cited by 16 · see citing works
Viruses and the Brain—A Relationship Prone to Trouble
Mielcarska, M. B., & Rouse, B. T. (2025) · Viruses · doi:10.3390/v17020203 · Cited by 12 · see citing works
“The amyloid and vascular theories are central frameworks that attempt to explain AD and VaD origins [428].”
Dementia epidemiology in Hungary based on data from neurological and psychiatric specialty services
Balázs, N., Ajtay, A., Oberfrank, F., Bereczki, D., & Kovács, T. (2021) · Scientific Reports · doi:10.1038/s41598-021-89179-3 · Cited by 12 · see citing works
Cognition and Health Ageing
Briggs, R., Kennelly, S., & O’Neill, D. J. (2019) · Springer eBooks · doi:10.1007/978-3-030-06200-2_15 · Cited by 11 · see citing works
White matter hyperintensity on MRI and plasma Aβ42/40 ratio additively increase the risk of cognitive impairment in hypertensive adults
de Havenon, A., Gottesman, R. F., Willamson, J. D., Rost, N. S., Sharma, R., Li, V., Littig, L., Stulberg, E. L., Falcone, G. J., Prabhakaran, S., et al. (2024) · Alzheimer s & Dementia · doi:10.1002/alz.14126 · Cited by 11 · see citing works
“8 The least invasive measurement of AD amyloid beta (A β ) pathology is plasma biomarkers.”
Background
Pimavanserin for the treatment of psychosis in Alzheimer’s disease: A literature review
Srinivasan, S., Tampi, R. R., Balaram, K., & Kapoor, A. (2020) · World Journal of Psychiatry · doi:10.5498/wjp.v10.i7.162 · Cited by 11 · see citing works
Disrupted Structural White Matter Network in Alzheimer’s Disease Continuum, Vascular Dementia, and Mixed Dementia: A Diffusion Tensor Imaging Study
Zhang, H., Chau, A. C. M., Shea, Y. F., Chiu, P. K., Bao, Y., Cao, P., & Mak, H. K. (2023) · Journal of Alzheimer s Disease · doi:10.3233/jad-230341 · Cited by 10 · see citing works
Survival, cognitive functions, and brain MRI in patients with cSVD: 5-year observation
Добрынина, Л. А., Gadzhieva, Z. S., Kremneva, E. I., Витальевна, Ш. К., Tsypushtanova, M. M., Геннадьевна, М. А., Trubitsyna, V. V., Bitsieva, E. T., Filatov, A. S., Byrochkina, A. A., et al. (2022) · Annals of Clinical and Experimental Neurology · doi:10.54101/acen.2022.4.3 · Cited by 10 · see citing works
Beneath the Top of the Iceberg: Financial Capacity Deficits in Mixed Dementia with and without Depression
Giannouli, V., & Tsolaki, M. (2023) · Healthcare · doi:10.3390/healthcare11040505 · Cited by 10 · see citing works
“Mixed/multifactorial dementia (MD) is a condition in which a person has more than one type of dementia, and for the present study, it is defined as the combination of the two most prevalent types of dementia (most frequent in the older population), namely Alzheimer’s Disease (AD) and Vascular Dementia (VaD) and seems…”
BackgroundResultInfluential
Differences in pharmacologic and demographic factors in male and female patients with vascular dementia, Alzheimer's disease, and mixed vascular dementia
Stanley, M. C., Poupore, N. S., Knisely, K., Miller, A., Imeh‐Nathaniel, A., Roley, L. T., Nathaniel, S. I., Goodwin, R. L., & Nathaniel, T. I. (2023) · Frontiers in Dementia · doi:10.3389/frdem.2023.1137856 · Cited by 9 · see citing works
“This poses a challenge in the diagnosis and treatment of MVAD to clinicians, and most diagnostic procedures are biased toward AD (Custodio et al., 2017).”
Background
Thyroid Dysfunction, Vitamin B12, and Folic Acid Deficiencies Are Not Associated With Cognitive Impairment in Older Adults in Lima, Peru
Diaz, M. M., Custodio, N., Montesinos, R., Lira, D., Herrera‐Pérez, E., Pintado‐Caipa, M., Cuenca, J., Gamboa, C., & Lanata, S. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.676518 · Cited by 9 · see citing works
“of vascular cognitive impairment (39)]; (2) frontotemporal dementia (40); (3) mixed dementia [requires the existence of a typical AD and dementia related to cerebrovascular disease, as previously described (41, 42)]; (4) Dementia with Lewy bodies (43); or (5) AD (utilizing criteria published by McKhann et al.”
MethodSelf-citation
Neuropathological findings in Down syndrome, Alzheimer’s disease and control patients with and without SARS-COV-2: preliminary findings
Granholm, A., Englund, E. M., Gilmore, A., Head, E., Yong, W. H., Perez, S. E., Guzman, S. J., Hamlett, E. D., & Mufson, E. J. (2024) · Acta Neuropathologica · doi:10.1007/s00401-024-02743-9 · Cited by 9 · see citing works
“For cases obtained from Lund University (AD + COVID and Control + COVID), the diagnosis of AD and of vascular pathology, as well as the exclusion of such pathology in the controls and other pathology, was established in adherence with internationally accepted criteria for AD [15, 40, 60, 76].”
Method
Roles of glutamate receptors in a novel in vitro model of early, comorbid cerebrovascular, and Alzheimer’s diseases
Pires, E. N. S., Ferreira, S. T., & Linden, R. (2020) · Journal of Neurochemistry · doi:10.1111/jnc.15129 · Cited by 9 · see citing works
“Such findings point to a scenario of mixed dementia, of which the prevalence, diagnosis, and treatment remain a challenge for physicians in general (Claus et al., 2016; Custodio et al., 2017; Rahimi & Kovacs, 2014).”
Background
An unbiased algorithm for objective separation of Alzheimer’s, Alzheimer’s mixed with cerebrovascular symptomology, and healthy controls from one another using electrovestibulography (EVestG)
Dastgheib, Z. A., Lithgow, B., & Moussavi, Z. (2022) · Medical & Biological Engineering & Computing · doi:10.1007/s11517-022-02507-1 · Cited by 9 · see citing works
“Criteria for the clinical diagnosis of AD-CVD are variable, whereas the existing diagnostic criteria for AD and VaD are of limited value for the diagnosis of AD-CVD [14].”
Background
Exploring the influence of weather variability and climate change on health outcomes in people living with dementia: A scoping review protocol
Lima, C. A., Alsunaidi, S., Lowe, S. A. J., Hogan, D. B., Dennett, L., Jones, C. A., & Yamamoto, S. S. (2024) · PLoS ONE · doi:10.1371/journal.pone.0304181 · Cited by 7 · see citing works
White matter hyperintensity severity modifies gut metabolite association with cognitive outcomes
Kijpaisalratana, N., Phuah, C., Ament, Z., Bhave, V. M., Guarniz, A. G., Duskin, J. A., Couch, C. A., Irvin, M. R., & Kimberly, W. T. (2025) · The Journal of Prevention of Alzheimer s Disease · doi:10.1016/j.tjpad.2025.100086 · Cited by 7 · see citing works
“The distinction between Alzheimer’s disease and VCID is challenging clinically [18–20].”
The role of arterial, venous blood and cerebrospinal fluid flow disturbances in forming cognitive impairment types in age-related cerebral microangiophathy
Добрынина, Л. А., Gadzhieva, Z. S., Akhmetzyanov, B. M., Kalashnikova, L. A., & Кротенкова, М. В. (2019) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro201911912281 · Cited by 7 · see citing works
Olfactory Bulb Proteomics Reveals Widespread Proteostatic Disturbances in Mixed Dementia and Guides for Potential Serum Biomarkers to Discriminate Alzheimer Disease and Mixed Dementia Phenotypes
Lachén‐Montes, M., Íñigo-Marco, I., Cartas‐Cejudo, P., Fernández‐Irigoyen, J., & Santamaría, E. (2021) · Journal of Personalized Medicine · doi:10.3390/jpm11060503 · Cited by 6 · see citing works
“dences of both AD and vascular disease [2].”
Background
Integrative machine learning approach to risk prediction for dementia and Alzheimer’s disease
Stern, A., & Michal Linial, B. (2025) · GeroScience · doi:10.1007/s11357-025-01828-x · Cited by 5 · see citing works
“Mixed dementias, such as AD coexisting with vascular dementia (VaD), become more prevalent with age [23], with cerebral amyloid angiopathy (CAA) as a major contributor to vascular-related pathology [24].”
Associations of plasma biomarkers with longitudinal co-pathologies in Alzheimer’s disease and cerebral small vessel disease comorbidity
Yang, J., Zhao, X., Liu, Y., Cai, Y., & Fan, Y. (2026) · The Journal of Prevention of Alzheimer s Disease · doi:10.1016/j.tjpad.2025.100449 · Cited by 5 · see citing works
“Alzheimer ’ s disease (AD) and cerebral small vessel disease (CSVD) serve as the principal contributors to dementia in elderly individuals, [3,4] and frequently coexist clinically [5,6].”
Survival analysis of older adults with dementia: predicting factors after unplanned hospitalization in Maharaj Nakorn Chiang Mai Hospital
Yotruangsri, T., Phinyo, P., Buawangpong, N., Nantsupawat, N., Angkurawaranon, C., & Pinyopornpanish, K. (2024) · BMC Geriatrics · doi:10.1186/s12877-023-04558-x · Cited by 5 · see citing works
“Management and treat-ment of mixed dementia pose significant challenges, and existing regimens of medication provide modest clinical benefits [21, 22].”
Background
Increased risk of dementia in patients with primary Sjogren’s syndrome: a nationwide population-based cohort study
Lee, K., Jeon, H., Kim, H.-S., Choi, K., & Seo, G. H. (2025) · The Korean Journal of Internal Medicine · doi:10.3904/kjim.2023.536 · Cited by 5 · see citing works
Uncovering hidden subtypes in dementia: An unsupervised machine learning approach to dementia diagnosis and personalization of care
Campagner, A., Marconi, L., Bianchi, E., Arosio, B., Rossi, P., Annoni, G., Lucchi, T. A., Montano, N., & Cabitza, F. (2025) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2025.104799 · Cited by 5 · see citing works
Comorbidities and comorbidity burden in patients with neurocognitive disorders: findings from the MEMORA Cohort Study
Temedda, M. N., Garnier‐Crussard, A., Moutet, C., Mouchoux, C., & Dauphinot, V. (2025) · European Geriatric Medicine · doi:10.1007/s41999-025-01288-8 · Cited by 5 · see citing works
“According to the vascular theory, hypertension, peripheral vascular diseases and diabetes may contribute to neurovascular dysfunction in patients with AD [42], which may lead to MD.”
Gray and White Matter Voxel-Based Morphometry of Alzheimer’s Disease With and Without Significant Cerebrovascular Pathologies
Saha, C., Figley, C. R., Dastgheib, Z. A., Lithgow, B., & Moussavi, Z. (2024) · Neuroscience Insights · doi:10.1177/26331055231225657 · Cited by 5 · see citing works
“The cerebellar lobules (6, 7b, 8) that showed the GM difference in this study are from the cerebellum’s posterior lobules, engaged in cognitive and sensorimotor tasks.”
Background
Associations among Braak stage, Parkinsonian gait, cognition, and functional status in autopsy‐confirmed dementia with Lewy bodies
Mayo, A. M., & Peavy, G. M. (2019) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5080 · Cited by 5 · see citing works
“Most recently, neuropathological evidence obtained at autopsy is demonstrating multiple coexisting pathologies.(3) However, research to understand the clinical presentation, level, and progression of functional impairment in the context of any”
Background
Emerging nano-derived therapy for the treatment of dementia: a comprehensive review
Ahmad, S., Ahmad, L., Adil, M., Sharma, R., khan, S., Hasan, N., & Aqil, M. (2025) · Drug Delivery and Translational Research · doi:10.1007/s13346-025-01863-3 · Cited by 4 · see citing works
Early Detection of Dementia Using a Large Language Model-Powered Chatbot
Routray, S., Samir, D., Pushya, G., & Srivastava, J. (2024) · International Conference on Parallel, Distributed and Grid Computing (PDGC) · doi:10.1109/pdgc64653.2024.10984295 · Cited by 4 · see citing works
“The most common combination is AD and VaD dementia, which is mainly related to old age, high blood pressure, and damaged blood vessels of the brain [11,27].”
Ginkgo biloba for cognitive impairment and dementia
Wieland, L. S., Ludeman, E. M., Chi, Y., Feinberg, T., Chen, I., Chen, K., Zhu, Y., Wolverson, E., & Amri, H. (2026) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013661.pub2 · Cited by 4 · see citing works
Baseline Profiles of Drug Prescriptions Prior to Diagnosis of Mild Cognitive Impairment (MCI) Obtained by Latent Class Analysis (LCA), and Assessment of Their Association with Conversion to Dementia
Gómez-Gómez, C., Moya-Molina, M. Á., Tey-Aguilera, M. J., Flores-Azofra, J., & González-Caballero, J. L. (2023) · Healthcare · doi:10.3390/healthcare11152219 · Cited by 4 · see citing works
Assessing adherence to National Institute for Health and Care Excellence dementia assessment and diagnosis guidelines in adults with intellectual disability: a retrospective cohort study
Duncan, C., Wilkinson, E., Jaydeokar, S., & Acton, D. (2023) · Advances in Mental Health and Intellectual Disabilities · doi:10.1108/amhid-07-2023-0022 · Cited by 4 · see citing works
Evaluating the Diagnostic Value of Electrovestibulography (EVestG) in Alzheimer’s Patients with Mixed Pathology: A Pilot Study
Dastgheib, Z. A., Lithgow, B., & Moussavi, Z. (2023) · Medicina · doi:10.3390/medicina59122091 · Cited by 4 · see citing works
“While there are accepted criteria to diagnose AD and VaD [2,6,15], there is little consensus for the diagnosis of AD-CVD (mixed pathology) [16].”
Background
How Do Spouses Experience Living Alone After Their Partner With Dementia Moves Into a Care Home?
Pope, B., Gelling, L., Holland, S., & Cox, C. (2025) · Journal of Clinical Nursing · doi:10.1111/jocn.17831 · Cited by 4 · see citing works
Liver Fibrosis and the Risks of Impaired Cognition and Dementia: Mechanisms, Evidence, and Clinical Implications
Jamalinia, M., Weiskirchen, R., & Lonardo, A. (2026) · Medical Science · doi:10.3390/medsci14010044 · Cited by 3 · see citing works
“Several other subtypes of dementia, including dementia with Lewy bodies [41], frontotemporal dementia [42], and mixed dementias, are particularly common in older individuals in whom processes of neurodegeneration and vascular pathology often coexist [43].”
MRS demonstrates elevated brain glutathione in vascular mild cognitive impairment compared to cognitively normal coronary artery disease controls
Chen, J. J., Kang, Y., Gallagher, D., Herrmann, N., Survilla, K., Vieira, D., Mah, E., Graham, S. J., Kiss, A., Black, S. E., et al. (2025) · Alzheimer s & Dementia · doi:10.1002/alz.70230 · Cited by 3 · see citing works
“68 Another strength of the present study is that vMCI participants underwent amyloid PET imaging.”
Five-Word Test, Screening of Mixed Dementia in Older Adults. Validation Study
Mimenza-Alvarado, A. J., Bombón-Albán, P. E., Duarte-Flores, J. O., Gutiérrez-Gutiérrez, L., Ávila‐Funes, J. A., & Aguilar-Navarro, S. G. (2021) · Revista Colombiana de Psiquiatría · doi:10.1016/j.rcp.2021.04.009 · Cited by 3 · see citing works
Nonpharmacological intervention therapies for dementia: potential break-even intervention price and savings for selected risk factors in the European healthcare system
Marešová, P., Rezny, L., Bauer, P., Valko, M., & Kuča, K. (2024) · BMC Public Health · doi:10.1186/s12889-024-18773-7 · Cited by 3 · see citing works
“Custodio et al. reported a 22% share of MD (AD with VaD) among patients with dementia [52].”
Background
Clinical practice guidelines on addressing cognitive impairment in vascular dementias
Singh, S. M., Kathiresan, P., & Gaur, N. (2025) · Indian Journal of Psychiatry · doi:10.4103/indianjpsychiatry.indianjpsychiatry_713_24 · Cited by 2 · see citing works
Alzheimer’s Disease–Thrombosis Comorbidity: A Growing Body of Evidence from Patients and Animal Models
Koch‐Paszkowski, J., Sennett, C., & Pula, G. (2025) · Cells · doi:10.3390/cells14141069 · Cited by 4 · see citing works
“…the number of patients showing both amyloid plaque deposition (i.e., the hallmark of AD) and neurovascular impairment has increased significantly [14], with mixed vascular-Alzheimer dementia (MVAD) becoming the most common forms of mixed dementia (22% of all current dementia diagnoses) [15].”
Automated Advancements and Synergistic Challenges in Multi-Modal Clinical Assessments for Alzheimer’s Disease Diagnosis: A Comprehensive Review and Meta-Analysis
Rajput, M. D., Bawa, P., Kadyan, V., & Sethi, M. (2025) · Archives of Computational Methods in Engineering · doi:10.1007/s11831-025-10427-0 · Cited by 2 · see citing works
Interrelationships of social determinants with cognition, vascular health, and physical functioning
Amofa, P., Fiala, J. A., Levy, S.-A. T., Ross, K. M., Walker, A. F., & Smith, G. E. (2025) · Alzheimer s & Dementia Behavior & Socioeconomics of Aging · doi:10.1002/bsa3.70013 · Cited by 2 · see citing works
Brain morphological characteristics predicting clinical response to selective serotonin reuptake inhibitors or cholinesterase inhibitors: A study of electronic medical records in patients with cognitive disorders
Onda, K., Chotiyanonta, J. S., Cowley, H., Uchida, Y., Nowrangi, M. A., Adams, R., Lyketsos, C. G., Zandi, P. P., & Oishi, K. (2025) · International Psychogeriatrics · doi:10.1016/j.inpsyc.2025.100105 · Cited by 2 · see citing works
Cerebral toxoplasmosis and alcohol abuse in AIDS: dementia with multiple etiologies
de Almondes, K. M., & Lima, N. C. (2020) · Dementia & Neuropsychologia · doi:10.1590/1980-57642020dn14-040014 · Cited by 3 · see citing works
Older Veterans
Little, J. T., Llorente, B. A., & Llorente, M. D. (2019) · Springer eBooks · doi:10.1007/978-3-030-05384-0_17 · Cited by 2 · see citing works
Liposome: A potential drug delivery vector to treat dementia
Agrawal, M., Roy, U., & Alexander, A. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-824331-2.00010-8 · Cited by 2 · see citing works
Tremor in Vascular Cognitive Impairment Raises the Possibility of Mixed Pathology With Lewy Body Disease
Chiu, P., Tzeng, R.-C., Wei, C.-Y., Hung, G., & Hu, C. (2020) · Frontiers in Neuroscience · doi:10.3389/fnins.2020.00781 · Cited by 1 · see citing works
“Mixed dementia have traditionally focused on the coexistence of Alzheimer’s disease (AD) and CVD in the same demented patient (Langa et al., 2004; Custodio et al., 2017).”
Background
Solid lipid nanoparticles-based drug delivery for dementia
Yüksel, N., Bayındır, Z. S., & Amasya, G. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-824331-2.00008-x · Cited by 2 · see citing works
The diagnostic accuracy of CTseg segmentation software for dementia in a New Zealand memory service
Yelanchezian, Y. M. M., González-Prieto, C., Oulaghan, B., Yates, S., Morgan, C., Dobbie, G., Davis, D. H. J., & Cullum, S. J. (2025) · Journal of Alzheimer s Disease Reports · doi:10.1177/25424823251332448 · Cited by 1 · see citing works
“12 For a diagnostic test to be useful, it must be applicable in a real-world clinical setting (for example, in an AI-assisted diagnostic system) and be able to distinguish patients with true dementia from those with without dementia within a full spectrum of brain pathology, while also minimizing…”
EPIDEMIOLOGY OF ALZHEIMER'S DISEASE AND DEMENTIA IN INDIA: A SYSTEMATIC LITERATURE REVIEW
Zafar, M. N. (2025) · Medical Science of Ukraine (MSU) · doi:10.32345/2664-4738.2.2025.14 · Cited by 1 · see citing works
“Diagnosis of vitamin B 12 insufficiency can be made by measuring serum vitamin B 12 levels, along with tests for serum homocysteine levels and complete blood counts [23,24].”
Interactive Effects of Plasma Alzheimer Disease Biomarkers and White Matter Hyperintensities on Cognitive Decline and Clinical Progression in Nondemented Adults
Yang, J., Zhao, X., Liu, Y., Cai, Y., Fan, Y., & Initiative, A. T. A. D. N. (2026) · Journal of the American Heart Association · doi:10.1161/jaha.126.050676 · Cited by 1 · see citing works
Hypertension and Diabetes Mellitus are Features of Vascular Dementia, Not Alzheimer?s Disease
Javanshiri, K., Haglund, M., & Englund, E. M. (2019) · Journal of Neurology & Neurophysiology · doi:10.4172/2155-9562.1000482 · Cited by 1 · see citing works

Authors: Custodio, N., Montesinos, R., Lira, D., Herrera-Pérez, E., Bardales, Y., & Valeriano-Lorenzo, L.
Affiliations: Instituto Peruano de Neurociencias (PE)
Instituto Peruano de Neurociencias, Perú; Instituto Nacional de Salud del Niño, Perú; GESID, Peru
Corresponding author: Custodio, Nilton
ORCID: Custodio, Nilton
Montesinos, Rosa
Lira, David
Venue: Dementia & Neuropsychologia
Publisher: FapUNIFESP (SciELO)
Published: 2017-12
Volume: 11
Issue: 4
Pages: 364-370
ISSN: 1980-5764 (ISSN-L)
DOI: 10.1590/1980-57642016dn11-040005
PMC: PMC5769994
OpenAlex: W2784098514
Cited by: 148
References: 77
Citations by year: 2026: 16 · 2025: 26 · 2024: 15 · 2023: 27 · 2022: 17 · 2021: 14 · 2020: 13 · 2019: 13 · 2018: 7
FWCI: 7.42
Type: journal article
Language: en
Open access: diamond
doi.org
Licence: cc-by
Locations: Dementia & Neuropsychologia (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
Americanae (AECID Library) (submittedVersion, cc-by-nc)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Redalyc (Universidad Autónoma del Estado de México) (submittedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
Keywords: Alzheimer's disease, cerebrovascular disease, vascular dementia, dementia diagnosis, dementia pathogenesis, dementia epidemiology, natural history of dementia, pharmacotherapy, non-pharmacological treatment, cardiovascular risk factors, hypertension, healthy eating, dementia prevention

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Mixed dementia: A review of the evidence

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