Abstract: Alzheimer’s disease (AD) and cerebrovascular disease (CVD) frequently coexist in the elderly population, forming mixed dementia, which is the most common and clinically complex type of cognitive impairment in late life. The synergistic interaction between cerebrovascular lesions and the core pathology of AD significantly accelerates cognitive decline. Furthermore, elderly patients often present with multiple comorbidities and polypharmacy, further complicating clinical management. With recent advancements in multimodal neuroimaging, plasma biomarkers, and artificial intelligence, precise subtyping and early diagnosis of AD complicated with CVD have become feasible. Comprehensive management should be grounded in the physiological characteristics of the elderly, encompassing the control of vascular risk factors, individualized pharmacological interventions, cognitive rehabilitation, exercise, and nutritional support. A multidisciplinary collaborative approach is essential to establish a holistic management pathway from initial screening to long-term follow-up. This article systematically reviews the pathological interaction mechanisms, stratified diagnostic strategies, and integrated management protocols to provide an evidence-based and actionable clinical framework for elderly patients.

Key words: Alzheimer’s disease, cerebrovascular disease, comorbidity, biomarker, comprehensive management