Early-Onset Mixed Dementia: A Multidisciplinary Diagnostic Approach

Early-onset mixed dementia involves a dual etiology: (1) Alzheimer's disease (AD) pathology marked by amyloid deposition and (2) cerebrovascular disease with white matter ischemic changes. Frontal white matter lesions result from both arteriolosclerosis and AD-associated degenerative changes, while posterior lesions may be more predominantly driven by AD pathology. The cognitive profile is typically dominated by AD features, particularly severe amnesia and memory impairment, though the presence of cerebrovascular disease can lower the threshold for clinically overt dementia and influence executive function and processing speed.