Multi-infarct dementia is caused by multiple strokes that result in progressive brain damage, leading to a decline in mental abilities. It is more common in males over 65 with high blood pressure, atherosclerosis, and smoking habits. Symptoms include memory loss, confusion, and mood changes. Treatment involves drugs to prevent future strokes and rehabilitation therapy, but the damage is usually irreversible. Early treatment of hypertension and avoiding smoking can reduce the risk of developing the condition.
Patients with multi-infarct dementia have progressive brain damage resulting from multiple strokes. As strokes continue, brain damage worsens, resulting in a pronounced decline in mental abilities. Many of the strokes aren’t large enough to notice, resulting in a lack of medical care. Every small or large stroke prevents the blood from fully oxygenating the brain tissues, which damages the brain, causing an increase in dementia symptoms such as memory loss, confusion and mood changes. When diagnosed, the disease can be treated with drugs to prevent future strokes, although this is not always successful; brain damage is usually not repairable.
Those most likely to have multi-infarct dementia are males over the age of 65, but the condition can occur earlier and can affect females. People at risk for this disease are usually those at high risk of stroke and these include people with high blood pressure, atherosclerosis (narrowing and hardening of the arteries), and lifelong smoking habits. Suffering from multiple strokes and progressive brain damage is a relatively common cause of dementia symptoms, and up to 20% of dementia cases are thought to result from this disease.
As mentioned, strokes may not be noticed or a patient may have one large stroke, which is noticed, and then several small strokes which are not. The condition might first be diagnosed by the presence of symptoms of dementia. A patient might have progressive memory loss, personality changes, loss of language ability, depression, difficulty performing ordinary tasks such as dressing and eating, changes in the ability to move fluidly and, as the dementia worsens, things such as withdrawal from social activities, high levels of confusion and increasing signs of mental distress.
When these symptoms are present, doctors might suspect multiinfarct dementia if the person is at high risk of stroke. Once doctors suspect this, they can confirm the presence of this disease with neurological tests, computed tomography (CT) and magnetic resonance imaging (MRI), and blood tests that rule out other potential causes of dementia. Despite ways to evaluate patients for multi-infarct dementia, many cases are dismissed as Alzheimer’s until continued strokes do no more harm.
If a correct diagnosis of multiinfarct dementia is made, the disease is addressed in several ways. Drugs are given to reduce continuing strokes, although these are not always fully effective. Some medications are used to address some of the symptoms of dementia and these could include antidepressants. Regaining memory or full mental capacity is generally not possible, and the damage can continue to accumulate as strokes continue. However, it may be helpful to offer rehabilitation therapy to improve function.
Unfortunately, many people with multi-infarct dementia become so impaired that they require lifelong care, and because strokes aren’t always stopped, the risk of death from severe brain injury increases. Supportive and rehabilitation care is helpful, but because the disease can be devastating, people are advised to attempt to avoid the condition by reducing their risk factors for stroke. Early treatment of hypertension and avoidance of behaviors such as smoking are highly recommended.
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