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Elderly
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.
MHAFC needs your financial
support to continue to improve awareness and understanding of mental illnesses.
Please click here to make a contribution.
This publication is
generously supported by a grant from the William H. Donner Foundation
and Eli Lilly and Company.
Copyright 1996
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