A health condition that appears due to multiple small strokes that cause damage to the brain is called multi-infarct dementia (MID). It is also a type of vascular dementia that cannot be cured. However, doctors may recommend some options to prevent further strokes. In general, to prevent MID, you should maintain healthy blood pressure.
The term “multi-infarct” means multiple small strokes that cause damage to the tissue in the brain. Damage occurs due to reduced oxygen-rich blood flow. A mental disorder that causes a decline in mental function is called dementia. The symptoms of this mental disorder are so severe that they interfere with daily activities (such as brushing teeth). People with dementia often experience problems with memory, reasoning, language, mood, behavior, and coordination.
This type of dementia occurs commonly, and it is also a common cause of dementia after Alzheimer’s disease. Sometimes, Alzheimer’s disease and multi-infarct dementia may occur at the same time. Most of the time, MID affects older adults (between the ages of 60 and 75).
Symptoms
Some people with MID begin to experience symptoms suddenly. Check some dementia symptoms below:
- Walking with shuffling steps
- Laughing and crying at inappropriate times
- Inability to follow specific instructions
- Difficulty counting money or making monetary transactions
- Loss of bowel and bladder control
- Confusion
- Memory loss
MID often occurs due to several small strokes or transient ischemic attacks (TIAs). Check some general symptoms of stroke below:
- Walking problems
- Severe headaches
- Dizziness
- Weakness and numbness in the face, arms, or legs
- Vision problems in one or both eyes
- Loss of balance and coordination
- Slurred speech
Immediately call 911 or go to the nearest emergency room (ER) if any of the previous symptoms occur. It is important to visit a doctor even if the symptoms disappear.
Causes and Risk Factors
This type of dementia occurs due to a series of small strokes. When it happens, the brain tissue gets reduced amounts of oxygen-rich blood and nutrients. Reduced blood flow often happens due to a blood clot or fatty deposits (also called plaques) that narrow or block the arteries that supply the brain. Usually, people do not know they have MID because blocked blood vessels often clear within several minutes, and the symptoms are mild (such as temporary weakness on one side of the body). In such cases, it is advised to see a doctor as soon as possible because even these small strokes can lead to dementia.
While anyone can develop MID, physicians have identified some factors that could increase your risk of developing it. Check some examples below:
- Diabetes
- Hyperlipidemia (high LDL cholesterol levels)
- Smoking
- Certain diseases that cause blood clots or other blockages – These include carotid artery disease, heart valve disease, coronary artery disease, atherosclerosis, and others.
- Hypertension (high blood pressure) – This is a major risk factor for MID, and MID occurs rarely in people who do not have hypertension.
- Poor lifestyle habits (including a lack of physical activity, poor diet, misuse of alcoholic drinks, and others)
- Obesity (excessive body weight)
What Happens if MID is Left Untreated?
People who develop this type of dementia may also experience some complications because it is a progressive disorder. Check some examples below:
- Physical decline, including loss of bowel or bladder control, walking problems, and others.
- Cognitive and neurological issues – These include progressive decline in memory, inability to follow instructions, and severe confusion.
- An increased risk for further strokes
- Behavioral and psychiatric problems – For example, depression, emotional volatility (such as laughing or crying inappropriately), hallucinations, and others.
- Infections – People with MID are at increased risk for the following infections due to immobility. These include urinary tract infections (UTIs), pneumonia, skin infections (including pressure sores), and others.
While this article does not contain all possible MID complications, you can consult with your doctor about ways to reduce the risk of developing them.
How to Prevent Multi-Infarct Dementia?
One of the best ways to prevent this disorder is to manage risk factors and chronic health conditions early in life. Check for other examples below:
- Regularly perform physical exercise – You should aim for 30 minutes of physical exercise, at least 5 days a week. It often helps get or maintain a healthy weight.
- Stop smoking – If you face problems with smoking cessation, discuss it with your physician.
- Limit or avoid alcoholic drinks
- Manage stress – You can try relaxation exercises, meditation, yoga, and other options.
- Get treatment for chronic diseases – These include hypertension (high blood pressure), high blood sugar, high cholesterol, and others.
It is also important to administer your medicines exactly as recommended by your physician. Otherwise, it may lead to unpleasant outcomes.
Diagnosis
However, there are no specific tests that can confirm MID. That’s why it is difficult to diagnose this disorder. Moreover, MID symptoms are very similar to Alzheimer’s disease, and these disorders may happen at the same time. Typically, physicians begin the diagnosis with a review of your medical history, questions about the symptoms, and a physical and neurological examination. They may also perform the following tests to exclude other diseases that cause similar symptoms to those of MID. For example:
- MRI (magnetic resonance imaging) scans
- CT (computed tomography) scans
- Neuropsychological testing
- Blood tests
- Electroencephalogram (EEG)
Treatment
Unfortunately, there is no way to cure MID because the damage caused by strokes is permanent. That’s why the treatment goal is to reduce the progression of the disease and relieve symptoms, prevent life-threatening complications, and improve your quality of life. Check below some medicines often recommended for people with MID:
- Anticoagulants (also known as blood thinners) – These medications are used to prevent or treat blood clots.
- Antihypertensives – These medications are used to treat high blood pressure.
- Diabetes medicines – Commonly, doctors prescribe the following medicines for people with diabetes. These include Biguanides (such as Metformin), GLP-1 agonists (such as Ozempic), SGLT2 inhibitors (such as Jardiance), DPP-4 inhibitors (including Januvia), and Sulfonylureas.
- Statins – The following medications are often recommended by doctors to treat high cholesterol (hyperlipidemia). For example, Atorvastatin, Rosuvastatin, and Simvastatin. Sometimes, they may also prescribe PCSK9 inhibitors, selective cholesterol absorption inhibitors, fibrates, nicotinic acid, and others.
Along with the previous medicines, doctors usually recommend lifestyle changes. These include regular physical exercise, dietary changes, quitting smoking, and avoiding alcoholic beverages. Most people with MID also need antidepressants to treat depression due to worsening of the brain function. In more advanced stages, people need physical therapy, cognitive therapy, occupational therapy, and speech therapy.
Frequently Asked Questions
When should I see my healthcare provider?
It is recommended to seek medical help if your symptoms are worsening, you begin to experience new symptoms, or have moderate to severe adverse reactions from medicines.
Is multi-infarct dementia the same as Alzheimer’s disease?
While both of them are progressive neurological disorders that lead to dementia, they have different underlying causes. In general, dementia from MID occurs due to multiple series of strokes, but in people with Alzheimer’s disease, it occurs due to a buildup of proteins in the brain.
What is the prognosis for multi-infarct dementia?
Usually, the prognosis for people with MID is poor because the symptoms start suddenly. If you have any other questions, ask your healthcare provider.
