From: deputydog23x@gmail.com   
      
   Multi-Infarct Dementia   
   Overview Causes Risk Factors Symptoms Diagnosis Treatment Outlook   
   PreventionRead This Next   
      
      
   Part 1 of 8   
   What Is Multi-Infarct Dementia?   
   Multi-infarct dementia (MID) is loss of brain function caused by a series of   
   small strokes. A stroke (also called a 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.   
   Stroke increases the risk of dementia as much as four to twelve times. The   
   mechanism of this is not fully understood.   
      
      
   MID can cause the loss of memory and cognitive function and can initiate   
   psychological problems. Treatment focuses on controlling the symptoms and   
   reducing the risk for future strokes.   
      
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   Part 2 of 8   
   What Causes Multi-Infarct Dementia?   
   According to the National Institutes of Health, MID is the second most common   
   cause of dementia in people over age 65 (NIH, 2012). Alzheimer's disease is   
   the most common cause.   
      
   MID is caused by a series of small strokes. A stroke (infarct) is the   
   interruption or blockage of blood flow to any part of the brain.   
   "Multi-infract" means many strokes and many areas of damage. If blood flow is   
   stopped for more than a few seconds,    
   brain cells can die from lack of oxygen. This damage is usually permanent.   
      
   A stroke can be "silent." That 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.   
      
   Part 3 of 8   
   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 (irregular rapid heartbeat that creates stagnation, which   
   can lead to blood clots)   
   previous stroke(s)   
   heart failure   
   cognitive decline prior to stroke   
   high blood pressure   
   diabetes   
   atherosclerosis (hardening of the arteries)   
   Lifestyle risk factors include:   
      
   smoking   
   alcohol abuse   
   low level of education   
   poor diet with little to no physical activity   
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   Part 4 of 8   
   Recognizing the Signs of Multi-Infarct Dementia   
   The symptoms of MID may appear gradually over time, or may occur suddenly   
   after a stroke. Some patients will appear to improve then decline again after   
   more small strokes.   
      
   The early symptoms of dementia include:   
      
   getting lost in familiar places   
   difficulty performing routine tasks, such as paying the bills   
   difficulty remembering words   
   misplacing things   
   loss of interest in things you used to enjoy   
   personality changes   
   As dementia progresses, more obvious symptoms appear:   
      
   changes in sleep patterns   
   hallucinations   
   difficulty with basic tasks such as dressing and preparing meals   
   delusions   
   depression   
   poor judgment   
   social withdrawal   
   memory loss   
   Part 5 of 8   
   How Is MID Diagnosed?   
   Doctors diagnose MID with radiological imaging and biochemical and cognitive   
   tests. Each case of MID is different. Memory may suffer serious impairment in   
   one case and only mild impairment in another. To gain an understanding of the   
   damage done, doctors    
   will use multiple tests.   
      
   Imaging Tests   
      
   Radiological imaging tests can include:   
      
   brain computed tomography (CT): a detailed, cross-sectional X-ray of the brain   
   magnetic resonance imaging (MRI) of the brain: a detailed image of the brain   
   obtained using a magnetic field and pulses of radio wave energy   
   electroencephalogram (EEG): measures the electrical activity of the brain   
   transcranial Doppler (TCD): measures the velocity of blood flow through the   
   brain's blood vessels   
   Biochemical Tests   
      
   Biochemical tests look for changes in:   
      
   superoxidase dismutatse (SOD): an enzyme that repairs cells and reduces damage   
   from free radicals   
   malondialdehyde (MDA): a marker for oxidative stress   
   homocysteine (HCY): an amino acid produced as a by-product of eating meat.   
   High levels may be associated with increased risk for atherosclerosis, heart   
   attack, blood clots, Alzheimer's disease, and stroke.   
   testosterone (T): a steroid hormone   
   17 beta-estradiol (E2): an estrogenic hormone   
   Mental Function Tests   
      
   Tests of mental ability include:   
      
   Barthel Index: assesses functional status   
   Fluid Object Memory Evaluation: looks at short-term memory   
   clock test: assesses your ability to recognize and set time   
   cognitive (SS-IQCODE) test: the "Informant Questionnaire on Cognitive Decline   
   in the Elderly," which uses a close relative to obtain information on a   
   patient's cognitive status   
   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   
      
   anemia   
   brain tumor   
   chronic infection   
   depression   
   thyroid disease   
   vitamin deficiency   
   drug intoxication   
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   Part 6 of 8   
   How Is MID Treated?   
   Treatment is tailored to the individual. Both medicinal and nonpharmacological   
   treatments are used.   
      
   Medication   
      
   There are two main types of medication used for MID:   
      
   Cholinesterase inhibitors treat memory loss, confusion, and problems thinking   
   and reasoning. These include   
      
   donepezil   
   rivastigmine   
   galantamine   
   Noncholinesterase inhibiting medications include:   
      
   memantine   
   nimodipine   
   hydrergine   
   folic acid   
   CDP-choline   
   Other medication options include:   
      
   selective serotonin reuptake inhibitors (SSRIs): antidepressants that may also   
   help neurons grow and reestablish connections in the brain   
   calcium channel blockers for short-term cognitive function   
   ACE inhibitor anti-hypertensive therapy to lower blood pressure   
   Alternative Therapies   
      
   Herbal supplements have grown in popularity as treatments for MID. However,   
   not enough studies have been done to prove a significant amount of success   
   through their use. Examples of herbal supplements that are currently being   
   studies for use in treating    
   MID include   
      
   Artemisia absinthium (wormwood): used to improve cognitive function   
   Melissa officinalis (lemon balm): used to restore memory   
   Bacopa monnieri (water hyssop): 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.   
      
   Nonpharmacological options for treatment include:   
      
   regular exercise to build muscle strength   
   cognitive training to regain mental function   
   rehabilitation for mobility issues   
   Part 7 of 8   
   What Is the Long-Term Outlook for MID?   
      
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