Multi-infarct dementia (MID) is a form of vascular dementia -- damage in mental function caused by strokes .
Causes, incidence, and risk factors:
Multi-infarct dementia (MID) is the most common form of vascular dementia, and the second most common cause of dementia (after Alzheimer's disease ) in people over age 65.
An estimated 10 - 20% of all dementias are caused by strokes. MID affects men more often than women. The disorder usually affects people between ages 55 and 75.
"Multi-infarct" means that many areas in the brain have been injured due to a lack of blood.
Risk factors for MID include a history of:
Some research suggests that MID may cause Alzheimer's disease or make it get worse faster. MID may be misdiagnosed as Alzheimer's, or may be found along with Alzheimer's.
There is no treatment for MID. The goal is to control symptoms and correct risk factors such as high blood pressure and high cholesterol. The health care provider may recommend other treatments.
DIAGNOSIS AND TREATMENT
The diagnosis and treatment environment should be pleasant, comfortable, nonthreatening, and physically safe. Some patients may need to stay in the hospital for a short time. The health care provider will try to find the cause and treat it.
Stopping or changing medications that worsen or cause confusion may improve mental function. Medications that may cause confusion include:
- Anticholinergics (including antidepressants such as amitriptyline or imipramine)
- Central nervous system depressants
- Pain relievers
Disorders that may contribute to confusion include:
Treating medical and mental disorders often greatly improves function.
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)
- Beta blockers
- 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.
The following may be helpful in caring for a person with MID:
- Adult day care
- Adult protective services
- Boarding homes
- Community resources
- Convalescent homes
- Family counseling
- In-home care
- Visiting nurses or aides
- Volunteer services
Other care tips:
- Keep familiar objects and people around.
- Leave lights on at night.
- Stick to a simple schedule of activities.
- Use behavior modification to help control unacceptable or dangerous behaviors.
- Use reality orientation with environmental cues to help reduce disorientation.
Seek legal advice early in the course of the disorder. Advance directives, power of attorney , and other legal actions may make it easier to make ethical decisions regarding the care of the person with MID.
Calling your health care provider:
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.
Treatment that is started within 3 hours after symptoms begin may reduce damage caused by strokes.