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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
2001 N. Beauregard Street, 12th Floor
Alexandria, VA 22311
Phone 703/684-7722
Fax 703/684-5968
Mental Health Resource Center 800/969-NMHA
TTY Line 800/433-5959
Alzheimer’s Association
919 N. Michigan Ave.
Suite 1000
Chicago, IL 60611
Phone: (800) 272-3900
Alzheimer’s Disease
Education and Referral Center
PO Box 8250
Silver Spring, MD 20907-8250
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
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