Is Multi-Infarct Dementia?
Multi-infarct dementia (MID) is a type of vascular dementia.
It occurs when a series of small strokes causes a loss of brain function. A
stroke, or brain infarct, occurs when the blood flow to any part of the brain is
interrupted or blocked. Blood carries oxygen to the brain, and without oxygen,
brain tissue quickly dies.
The location of the stroke damage determines the type of
symptoms that occur. MID can cause a loss of memory and cognitive function and
can initiate psychological problems. Treatment focuses on controlling the
symptoms and reducing the risk for future strokes.
the Symptoms of Multi-Infarct Dementia
The symptoms of MID may appear gradually over time, or they
may occur suddenly after a stroke. Some people will appear to improve and then
decline again after they have more small strokes.
The early symptoms of dementia include:
- getting lost in familiar places
- having difficulty performing routine tasks, such
as paying the bills
- having difficulty remembering words
- misplacing things
- losing interest in things you used to enjoy
- experiencing personality changes
More obvious symptoms appear as dementia progresses. These
- changes in sleep patterns
- difficulty with basic tasks, such as dressing
and preparing meals
- poor judgment
- social withdrawal
- memory loss
Are the Causes of Multi-Infarct Dementia?
MID is caused by a series of small strokes. A stroke, or infarct,
is the interruption or blockage of blood flow to any part of the brain. The
term “multi-infarct” means many strokes and many areas of damage. If blood flow
is stopped for more than a few seconds, brain cells can die from a lack of
oxygen. This damage is usually permanent.
A stroke can be silent, which means it affects such a small
area of the brain that it goes unnoticed. Over time, many silent strokes can
lead to MID. Large strokes that cause noticeable physical and neurological
symptoms can also lead to MID.
Are the Risk Factors for MID?
MID generally occurs in people aged 55 to 75 years and is
more common in men than in women.
Medical conditions that increase the risk of MID include:
- atrial fibrillation, which is an irregular,
rapid heartbeat that creates stagnation that can lead to blood clots
- previous strokes
- heart failure
- cognitive decline prior to a stroke
- high blood pressure
- atherosclerosis, or hardening of the arteries
Lifestyle Risk Factors
The following are lifestyle risk factors for MID:
- a low level of education
- a poor diet
- little to no physical activity
Is MID Diagnosed?
There’s not a specific test that can determine MID. Each
case of MID is different. Memory can be seriously impaired in one person and
only mildly impaired in another person.
Diagnosis is often made based on:
- a neurological exam
- a history of stepwise mental decline
- CT or MRI scans that detail small areas of tissue
that died from a lack of blood supply
- ruling out other organic causes of dementia such
as high cholesterol, diabetes, high blood pressure, or carotid stenosis
Radiological imaging tests can include:
- CT scans of your brain
- MRI scans of your brain
- an electroencephalogram, which is a measure of the
electrical activity of the brain
- a transcranial doppler, which allows your doctor
to measure the velocity of blood flow through your brain’s blood vessels
Ruling Out Other Causes of Dementia
Your doctor may also order tests to rule out other
conditions that may cause or contribute to dementia, such as
- a brain tumor
- a chronic infection
- thyroid disease
- a vitamin deficiency
- drug intoxication
Is MID Treated?
Treatment will be tailored to your individual needs. Most
treatment plans include medication and lifestyle changes.
Medications may include:
- folic acid
serotonin reuptake inhibitors, which are antidepressants that may also
help neurons grow and reestablish connections in the brain
channel blockers for short-term cognitive function
enzyme inhibitors to lower blood pressure
Herbal supplements have grown in popularity as treatments
for MID. However, not enough studies have been done to prove that their use is
successful. Examples of herbal supplements that are currently being studied for
use in treating MID include:
- Artemisia absinthium, or wormwood, which
is used to improve cognitive function
- Melissa officinalis, or lemon balm, which
is used to restore memory
- Bacopa monnieri, or water hyssop, which
is used to improve memory and intellectual function
Be sure to discuss these supplements with your doctor before
taking them, as they can interfere with other medications.
Other options for treatment include regular exercise to
build muscle strength, cognitive training to regain mental function, and rehabilitation
for mobility issues.
Is the Long-Term Outlook for MID?
MID has no cure. Medications and cognitive training may help
preserve mental function. The speed and advance of dementia varies. Some people
die soon after an MID diagnosis, and others survive for years.
Can MID Be Prevented?
There’s no evidence of any effective measure to avoid MID.
As with many conditions, the best prevention method is to take care of your
body. You should:
- Visit the doctor regularly.
- Eat a balanced diet.
- Begin or maintain a regular exercise program.
- Ensure good blood pressure control.
- Maintain diabetic control.