Диагностика и терапия смешанной (альцгеймеровско-сосудистой) деменции

Alzheimers disease associated with cerebrovascular disease is now considered as the most frequent type of dementia. The aim was to study some clinical characteristics of mixed dementia (Alzheimer-type dementia associated with cerebral atherosclerosis) comparatively with «pure» Alzheimers disease (AD) and vascular dementia (VaD). A sample made up all patients diagnosed as mild/moderate dementia admitted for the first time to the psychogeriatric unit of one of Moscow psychiatric hospital. A total 283patients (81m and 202f) aged 48-93years were evaluated. The main group made up 94patients with a diagnosis of mixed dementia (33,2%). Two control groups included 75patients with VaD (26,5 %) and 114 patients with AD (40,3 %) without clinical and MRI signs of cerebral atherosclerosis. Mean duration of dementia didnt differ in all cases of dementia. Mixed dementia is more frequent in females (m/f 1:3,9); late onset is more common for mixed dementia (90,4%); there is a high risk of delirium-like confusional states in patients with mixed dementia closed to its frequency in vascular dementia; prevalence of vascular risk factors in mixed dementia is closed to its frequency in VaD. Strokes and TIA occurred before dementia as well as in the course of dementia in cases of mixed dementia (35,1%). A high frequency of focal vascular changes in mixed dementia didnt differ from MRI picture in cases of VaD. Due to complex genesis of disorders mixed dementia needs a multimodal therapeutical intervention.