Multi-Infarct Dementia : Causes, Symptoms, Treatment & Management

Multi-infarct dementia is a type of vascular dementia. Vascular dementia occurs after a stroke and multi-infarct dementia occurs due to brain damage after multiple strokes. It occurs as the blood flow to the brain is affected.

Vascular dementia is the most common cause of dementia, the first common cause being Alzheimer’s disease. Multi-infarct dementia is the most common form of vascular dementia and the most common cause of memory loss in older adults.⁽¹⁾

Multi-infarct dementia occurs in people who have had multiple strokes. A stroke occurs when the blood supply to a part of a person’s brain gets affected, which may be due to a blocked or burst artery.

Multi-infarct dementia develops due to a series of small strokes that cause permanent damage. During a stroke, blood and oxygen are not able to reach a small section of the brain causing the cells in the brain to die. This causes brain damage.⁽²⁾

It is known to occur more in people 60-75 years of age.⁽¹⁾ The other risk factors include high blood pressure or hypertension.

According to the American Heart Association, the risk factors for high blood pressure include:⁽³⁾

• Diabetes
• High cholesterol
• Smoking cigarettes
• Physical negativity
• Drinking excess alcohol
• Diet high in sodium and potassium
• Excess body weight

In the case of a small stroke, no symptoms occur and it is referred by doctors as a silent stroke. If there is a temporary block in the blood flow, there may be symptoms that may last for a few minutes to 24 hours. It is a ministroke and still, no treatment may be needed.

Symptoms of multi-infarct dementia start developing as a greater number of areas in the brain start getting damaged.

The early symptoms of multi-infarct dementia include:⁽⁴⁾

• Slowness of thoughts
• Difficulty in concentrating
• Trouble understanding
• Finding it difficult to plan something
• Problem in language and memory
• Changes in mood and behavior

Later on, as multi-infarct dementia worsens, the symptoms also start worsening. These include:

• Confusion
• Trouble with keeping short-term memory
• Losing control over the bladder or bowel while walking
• Laughing or crying inappropriately
• Trouble counting money
• Finding it difficult to follow instructions.
• Difficulty in following the instruction
• Getting lost even in familiar places

The symptoms might improve in some time, but if more strokes occur the symptoms may worsen.

If a person has a history of stroke or is showing signs of dementia, a doctor should be consulted. The doctor enquires about their diet, sleep patterns, medications, stress, recent illness, and past strokes.

Physical examination is done to check for the signs of stroke, weakness of limbs, dizziness, and problems with speech.

Tests including x-rays and blood pressure monitoring are ordered to look for other medical problems.

There are currently no treatments that can reverse multi-infarct dementia. The treatment can focus to prevent future strokes. This can be done by treating the causes of stroke, which include:

• Diabetes: the blood sugar levels can be managed by medications and lifestyle changes including exercising and eating a diet favoring diabetes control.
• High Blood Pressure: The treatment for hypertension includes diuretics, vasodilators, and reducing the salt intake in the diet.
• High Cholesterol: There are medications that can be helpful in reducing the cholesterol level. These can be helpful in preventing cholesterol from forming.
• Cardiovascular Diseases: The doctor can recommend which medication from the many can be useful for a person to control the condition.

The lifestyle changes that can be helpful in the above conditions include:⁽⁵⁾

• Maintaining moderate weight
• Eating a healthy diet
• Physical activity
• Managing stress
• Reducing alcohol intake
• Quitting smoking

Sometimes, carotid endarterectomy may be recommended by the doctor.⁽⁶⁾ It is a surgery done to remove the blockage from the carotid artery, which is the main blood vessel to the brain.

There is no cure for multi-infarct dementia and the outlook is also not very positive. The cause of death of a person with this condition includes additional strokes, pneumonia, infection and heart disease.⁽⁷⁾