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Alzheimer's Disease

Alzheimer`s, Vascular Dementia or Both?



My 80 year-old mother had a CT scan last week. I was told yesterday that the scan revealed "moderately severe cerebral atrophy" and "small vessel disease". The doctor who gave me the information said that this indicated my mother had Alzheimer`s disease, he didn`t mention Vascular Dementia.

Is it possible that my mother has both Alzheimer`s & vascular dementia? What questions should I be asking at the next consultation?


Alzheimer's disease is diagnosed by cognitive tests, history, and examination. CT helps to rule out other potential causes. 80 year- old individuals often have some small vessel disease in their brain. This will not cause a vascular dementia unless it is very extensive (moderate to severe). If it is just mild to moderate in degree, it probably is not enough to cause any significant memory or cognitive loss. It may cause some balance issues.

Her doctor can tell you how severe the small vessel disease is. Most individuals who have cognitive loss due to vascular disease that is severe enough to cause a dementia condition, usually have had both large and small strokes or severe small vessel disease. There are some unfortunate individuals who do have both vascular dementia and Alzheimer's disease.

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Response by:

Douglas W Scharre, MD Douglas W Scharre, MD
Clinical Associate Professor of Neurology
Clinical Associate Professor of Psychiatry
College of Medicine
The Ohio State University