Multi-infarct dementia (MID) is a form of dementia caused by a series of small strokes.
Dementia is a loss of brain function that occurs with certain diseases. It affects memory, thinking, language, judgment, and behavior.
MID; Dementia - vascular; Dementia - poststroke
Multi-infarct dementia (MID) is the second most common cause of dementia (after Alzheimer's disease) in people over age 65. MID affects men more often than women. The disorder usually affects people between ages 55 and 75.
MID is caused by a series of small strokes.
A stroke is an interruption in or blockage of the blood supply to any part of the brain. A stroke is sometimes called an infarct. "Multi-infarct" means that many areas in the brain have been injured due to a lack of blood.
If blood flow is stopped for longer than a few seconds, the brain cannot get oxygen. Brain cells can die, causing permanent damage.
When these strokes affect a small area, there may be no symptoms of a stroke. These are often called silent strokes. Over time, as more areas of the brain are damaged, the symptoms of MID begin to appear.
Not all strokes need to be "silent." Larger strokes that have clear affects on strength, sensation, or other brain and nervous system (neurologic) function also can lead to MID.
There is no treatment to turn back damage to the brain caused by small strokes.
An important goal is to control symptoms and correct risk factors such as high blood pressure, smoking, and high cholesterol to prevent future strokes.
Avoid fatty foods. Follow a healthy, low-fat diet.
Do not drink more than 1 - 2 alcoholic drinks a day.
Keep blood pressure less than 130/80 mm/Hg (ask your doctor what your blood pressure reading should be).
Keep LDL "bad" cholesterol lower than 70 mg/dL.
Your doctor may suggest taking aspirin or another drug called clopidogrel (Plavix) to help prevent blood clots from forming in the arteries. These medicines are called antiplatelet drugs. DO NOT take aspirin without talking to your doctor first.
The goals of helping someone with dementia in the home environment are to:
Manage behavior problems, confusion, sleep problems, and agitation
Medications may be needed to control aggressive, agitated, or dangerous behaviors. The health care provider will usually prescribe these medicines in very low doses and adjust the dose as needed. Such medications may include:
Antipsychotics (olanzapine, quetiapine)
Serotonin-affecting drugs (trazodone, buspirone, or fluoxetine)
Medications used to treat Alzheimer's disease have not been shown to work for MID.
Hearing aids, glasses, or cataract surgery may be needed if the person has sensory problems.
Some improvement may occur for short periods of time, but the disorder will generally get worse over time.
Call your health care provider if symptoms of vascular dementia occur. Go to the emergency room or call the local emergency number (such as 911) if there is a sudden change in mental status. This is an emergency symptom of stroke.
Control conditions that increase the risk of hardening of the arteries (atherosclerosis) by:
DeKosky ST, Kaufer Di, Hamilton RL, Wolk DA, Lopez OL. The dementias. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann; 2008:chap 70.
Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Health Solutions, Ebix, Inc.