Multi-Infarct Dementia
What is Multi-Infarct Dementia?
Multi-infarct dementia is the second most common cause of dementia in
older people. Sometimes it is difficult to distinguish from
Alzheimer’s disease, which is the most common cause of dementia in
older persons. It is possible for a person to have both multi-infarct
dementia and Alzheimer’s disease, making it hard for the doctor to
diagnose either.
Causes Of Multi-Infarct Dementia
Multi-infarct dementia is caused by a series of strokes that damage or
destroy brain tissue. A stroke occurs when blood cannot get to the
brain. A blood clot or fatty deposits (called plaques) can block the
vessels that supply blood to the brain, causing a stroke.
Who is Affected?
Multi-infarct dementia usually affects people between the ages of 60 and
75. Men are slightly more likely than women to have this disease.
However, the most important risk factor for multi-infarct dementia is
high blood pressure. It is rare for a person without high blood pressure
to develop multi-infarct dementia.
Symptoms
Symptoms that begin suddenly may be a sign of multi-infarct dementia. In
addition to confusion and problems with recent memory, symptoms of
multi-infarct dementia may include:
- wandering or getting lost in familiar
surroundings.
- moving with rapid, shuffling steps.
- loss of bladder or bowel control.
- laughing or crying inappropriately.
- difficulty following instructions.
- problems handling money.
Multi-infarct dementia is often a result
of a series of small strokes, called ministrokes or TIAs (transient
ischmic attacks). The symptoms of a TIA often are very slight. They may
include:
- mild weakness in an arm or a leg.
- slurred speech.
- dizziness.
The symptoms generally do not last for more
than a few days. Several TIAs may occur before the person notices any
symptoms of multi-infarct dementia. People with muti-infarct dementia
may improve for short periods, then decline upon having further strokes.
Diagnosis
People who show signs of dementia or who have a history of strokes
should have a complete physical exam. The doctor will ask the patient
and the family about:
- the patient’s diet
- medications
- sleep patterns
- personal habits
- past strokes
- other medical problems
- recent illnesses
- stressful events
To look for signs of stroke, the doctor will
check for weakness or numbness in the arms or legs, difficulty with
speech, or dizziness. To check for other health problems that could
cause symptoms of dementia, the doctor may order office or laboratory
tests. Tests may include:
- blood pressure reading.
- an electroencephalogram (EEG).
- a test of thyroid function.
- blood tests.
- x-rays.
- computerized tomography (CT) scan.
- magnetic resonance imaging (MRI).
Both CT scans and MRI tests take pictures of
sections of the brain. The pictures are then displayed on a computer
screen to allow the doctor to see inside the brain. (CT scans and MRI
tests are painless and do not require surgery.) In addition, the doctor
may send the patient to a psychologist or psychiatrist to test
reasoning, learning ability, memory, and attention span.
Treatment
While no treatment can reverse damage
that has already been done, treatment to prevent additional strokes is
very important. High blood pressure, the primary risk factor for mutli-infarct
dementia, can be treated successfully. Diabetes also is a treatable risk
for stroke. To prevent additional strokes, doctors may prescribe
medicines to control high blood pressure, high cholesterol, heart
disease, and diabetes. They will counsel patients about good health
habits such as exercising, avoiding smoking and drinking alcohol. The
patient may require a special diet.
Doctors sometimes prescribe aspirin or
other drugs to prevent clots from forming in the small blood vessels.
Drugs also can be prescribed to relieve restlessness or depression or to
help the patient sleep better. Sometimes doctors recommend a surgery
known as carotid endartectomy. This surgery is done to remove blockage
in the carotid artery, the main blood vessel to the brain. Studies are
under way to see how well this surgery works in treating patients with
mult-infarct dementia. Some scientists are also studying drugs that
increase the flow of blood to the brain.
Helping Someone with Multi-Infarct
Dementia
Family members and friends can help the patient cope with mental and
physical problems. They can encourage daily routines and regular social
and physical activities. By talking about events and daily activities
they can help reinforce mental abilities. Lists, alarm clocks, and
calendars may help to remind the patient of important times and events.
For More Information:
Contact your local Mental
Health Association, community mental health center, or:
National Mental Health Association
1021 Prince Street
Alexandria, VA 22314
Phone: 800-969-6642
Stigma Watch Line: 800-969-6642
TTY: 800-433-5959
http://www.nmha.org
Alzheimer’s Association
Phone: (800) 272-3900
Alzheimer’s Disease Education
and Referral (ADEAR) Center
Phone: (800) 438-4380
Eldercare Locator Service
Administration on Aging
Phone: (800) 677-1116
National Institute of Neurological Disorders and Stroke
Phone: (301) 496-5751
with permission from:
National Mental Health Association http://www.nmha.org
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