multi infarct dementia

8/18/2019 MUlti Infarct Dementia

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Multi-infarct dementia(MID) is loss of brainfunction caused by a series of

small strokes. A stroke (alsocalled a brain infarct) occurswhen the blood flow to any part of the brain is interruptedor blocked. Blood carries

oxygen to the brain, andwithout oxygen, brain tissuequickly dies.


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The location of the stroke damagedetermines the type of symptoms thatoccur. troke increases the risk ofdementia as much as four to twel!etimes. The mechanism of this is not fullyunderstood.

"#$ can cause the loss of memory andcogniti!e function and can initiate psychological problems. Treatmentfocuses on controlling the symptomsand reducing the risk for future strokes.


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%ascular dementia affects different people in different

ways and the speed of the progression !aries from person to

person. ome symptoms may be similar to those of other

types of dementia and usually reflect increasing difficulty to

perform e!eryday acti!ities like eating, dressing, or

shopping.

Beha!ioral and physical symptoms can come on

dramatically or !ery gradually, although it appears in the a

prolonged perio of time.


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Common Signs and Symptoms of Vascular Dementia

Mental and Emotional Signs and Symptoms

§Slowed thinking§Memory problems; general forgetfulness§Unusual mood changes (e.g. depression, irritability)

§Hallucinations and delusions§onfusion, which may get worse at night§!ersonality changes and loss of social skills

Physical Signs and Symptoms

§"i##iness§$eg or arm weakness§%remors

§Mo&ing with rapid, shuffling steps§'alance problems§$oss of bladder or bowel control

Behavioral Signs and Symptoms

§Slurred speech§$anguage problems, such as difficulty finding the right words

for things§etting lost in familiar surroundings§$aughing or crying inappropriately

§"ifficulty planning, organi#ing, or following instructions§"ifficulty doing things that used to come easily (e.g. handling

money, paying bills, or playing a fa&orite card game)§educed ability to function in daily life


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%ascular dementia results from conditions that damage your brain&s blood

!essels, reducing their ability to supply your brain with the amounts of

nutrition and oxygen it needs to perform thought processes effecti!ely.

'ommon conditions that may lead to !ascular dementia includeStroke (infarction) blocking a brain artery. trokes that block a brain

artery usually cause a range of symptoms that may include !ascular

dementia. But some strokes don&t cause any noticeable symptoms. These

silent brain infarctions still increase dementia risk.

*ith both silent and apparent strokes, the risk of !asculardementia increases with the number of infarctions that

occur o!er time. +ne type of !ascular dementia in!ol!ing

many strokes is called multiinfarct dementia.


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The risk factors for !ascular dementia are similar to those

for stroke or heart disease, and include

Increasing age. %ascular dementia is most common in

those o!er the age of -. /isk increases the older you get.

High blood pressure (hypertension). $octors estimate

that about 0 percent of cases of !ascular dementia result

from hypertension. 1igh blood pressure places extra stress

on blood flow throughout the body, including the brain.


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A history of heart attack or strokes may increase the risk of de!eloping

blood flow problems in the brain.

High cholesterol. 1igh 2$2 or bad cholesterol le!els are linked withan increased risk of !ascular dementia.

Atherosclerosis occurs when deposits of cholesterol or plaques build up

in the arteries and narrow blood !essels, reducing blood flow to the

brain.

Diabetes. 1igh glucose le!els can damage blood !essels throughout the body, including the brain.

Smoking directly damages the blood !essels that feed blood to the brain.

Atrial fibrillation. Abnormal heart rhythm can reduce blood flow to the

brain and increase the risk of blood clots forming.


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iochemical !ests

Biochemical tests look for changes in

superoxidase dismutatse (+$) an en3yme that repairs cells

and reduces damage from free radicals malondialdehyde ("$A) a marker for oxidati!e stress

homocysteine (1'4) an amino acid produced as a byproduct

of eating meat. 1igh le!els may be associated with increased

risk for atherosclerosis, heart attack, blood clots, Al3heimer5sdisease, and stroke.

testosterone (T) a steroid hormone

67 betaestradiol (89) an estrogenic hormone


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Mental "unction !ests

Tests of mental ability include

Barthel #ndex assesses functional status

:luid +b;ect "emory 8!aluation looks at shortterm

memory

clock test assesses your ability to recogni3e and set time

cogniti!e (#

which uses a close relati!e to obtain information on a

patient5s cogniti!e status


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There are two main types of medication used for "#$

#holinesterase inhibitors treat memory loss, confusion,and problems thinking and reasoning. These include

donepe3il

galantamine

$oncholinesterase inhibiting medications include

memantine

nimodipine

hydrerginefolic acid


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Alternati%e !herapies

1erbal supplements ha!e grown in popularity as treatments for "#$. 1owe!er, not

enough studies ha!e been done to pro!e a significant amount of success through their

use. 8xamples of herbal supplements that are currently being studies for use in

treating "#$ include Artemisia absinthium (wormwood) used to impro!e cogniti!e function

Melissa officinalis (lemon balm) used to restore memory

Bacopa monnieri (water hyssop) used to impro!e memory and intellectual function

Be sure to discuss these supplements with your doctor before taking them, as they can

interfere with other medications.

?onpharmacological options for treatment include

regular exercise to build muscle strength

cogniti!e training to regain mental function

rehabilitation for mobility issues


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multi infarct dementia

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