Multi-infarct dementia Health Article

Definition

Multi-infarct dementia (MID) is a form of vascular dementia -- damage in mental function caused by strokes.

Alternative Names

MID

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:

• Hardening of the arteries (atherosclerosis)
• High blood pressure (hypertension)
• Smoking
• Stroke

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.

Symptoms

• Confusion at night
• Decreased ability to function independently
• Decreased interest in daily living activities
• Difficulty making judgments
• Extreme emotional disturbance (agitation)
• Frustration, depression, anxiety, stress, and tension from loss of mental function
• Inability to be spontaneous
• Lack of emotion
• Memory loss
• Numbness or tingling
• Slowly worsening memory loss (dementia) and:
  • Confusion, disorientation
  • Decline in many brain functions that gets worse
  • Difficulties with attention, concentration, judgment, and behavior
  • Difficulty thinking
  • False beliefs (delusions)
  • Hearing sounds or seeing things that are not there (hallucinations)
  • Personality changes
  • Problems with language (aphasia)
  • Uncoordinated or weak movements
• Swallowing difficulty
• Sudden involuntary laughing or crying
• Urinary incontinence
• Withdrawal from social interaction
  • Inability to interact in social or personal situations
  • Inability to keep a job

Signs and tests

Diagnosis rules out other causes of dementia, including dementia due to metabolic causes.

Signs of multi-infarct dementia include:

• Abnormal reflexes
• Local nervous system (neurologic) signs (on the modified Hachinski ischemia scale)
• Past stroke or high blood pressure
• Periods of quick worsening alternating with stable periods of very little change
• Quick onset
• Weakness or loss of function on one side, one area, or many areas

Tests may include:

• Head CT scan
• MRI of the brain