Multi-infarct Dementia

Multi-infarct dementia (MID) is a common cause of memory loss in the elderly mainly affects elderly people with arteriosclerosis (hardening of the arteries). An individual having a silent stroke may not even know it is happening, but over time, as more areas of the brain are damaged and more small blood vessels are blocked, the symptoms of MID begin to appear.  They may be caused by poor diet, lack of sleep, or too many medicines, for example. Feelings of loneliness, boredom, or depression also can cause forgetfulness The term refers to a group of syndromes caused by different mechanisms all resulting in vascular lesions in the brain. The term dementia describes a medical condition that is caused by changes in the normal activity of very sensitive brain cells.

These changes in the way the brain works can affect memory, speech, and the ability to carry out daily activities. Vascular lesions can be the result of diffuse cerebrovascular disease or focal lesions (or a combination of both, which is what is observed in the majority of cases). Since the diseases often occur together, making a single diagnosis of one or the other is even more problematic. 

Multi Infarct Dementia Causes

Multi-infarct dementia is a form of dementia caused by large numbers of small blood clots (emboli) in the brain that starve the brain cells of oxygen. Dementia is caused by degeneration in the cerebral cortex including death of brain cells, conditions that impair the vascular or neurologic structures of the brain. Multi-infarct dementia is not caused directly by the deposits of atherosclerotic plaque in the blood vessels of the brain, but by a series of strokes that leave areas of dead brain cells (infarction). This occurs when atherosclerotic plaques facilitate the formation of blood clots (thrombi) that block off the small blood vessels and prevent localized areas of the brain from receiving nutrients and oxygen from the blood flow that supplies them.

• The vessel walls become less elastic and cannot dilate to allow greater blood flow when needed (such as during exercise).
• These changes in the way the brain works can affect memory, speech, and the ability to carry out daily activities.
• This often progresses in a stepwise manner to delirium , hallucinations, and impaired thinking.
• The root cause of multi-infarct dementia is usually small blood clots that lodge in blood vessels in the brain, which results in the death of brain cells.
• This often progresses to delirium , hallucinations, and thinking problems.
• Evidence for tobacco consumption as a risk factor for VaD is conflicting
• Alcohol consumption may be protective.

Multi Infarct Dementia Symptoms

Here are the list of Multi Infarct Dementia Symptoms :

• confusion and problems with recent memory
• wandering or getting lost in familiar places
• moving with rapid, shuffling steps
• loss of bladder or bowel control
• laughing or crying inappropriately
• difficulty following instructions
• problems handling money

Multi Infarct Dementia treatment

Multi Infarct Dementia can be treatment. If you have cardiac irregularities as well, powerful anticoagulants are necessary such as warfarin or phenindione. The dementia itself is untreatable and the patient may eventually need constant care. The person should be in a pleasant, comfortable, non-threatening, physically safe environment for diagnosis and initial treatment. Hospitalization may be required for a short time. The underlying causes should be identified and treated as appropriate. Currently there is no treatment for MID that can reverse the damage that has already occurred. Treatment focuses on prevention of additional brain damage by controlling high blood pressure. Every condition known to increase the risk of arteriosclerosis or blood clots also increases the risk of multi-infarct dementia. These are:

• smoking
• high blood pressure
• high cholesterol
• Type 1 and 2 diabetes (particularly if badly regulated)
• irregular cardiac action (heart beat)
• occlusion (closing) of blood vessels leading to the brain.

Prevention Tips

• To prevent more strokes, doctors may prescribe medicines to control high blood pressure, high cholesterol, heart disease, and diabetes.
• The person should be in a pleasant, comfortable, non-threatening, physically safe environment for diagnosis and initial treatment.
• Doctors sometimes prescribe aspirin, warfarin, or other drugs to prevent clots from forming in small blood vessels.
• The presence of a rapidly progressive dementia and multiple strokes in a young patient may indicate uncommon causes of stroke such as CADASIL or angiitis.
• Medications may be required to control aggressive or agitated behaviors or behaviors that are dangerous to the person or to others. 
• These problems if they develop tend to be resistant to conventional psychopharmacological treatment and in many cases lead to hospital admission and placement in permanent care.
• Patients with VaD are prominently affected by depression and emotional incontinence.

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