Multi-Infarct Dementia versus Alzheimer Disease

What is Alzheimer Disease?

Alzheimer's disease is a very well known condition. It is a progressive, neurodegenerative disease characterized by memory loss, language deterioration, impaired visuospatial skills, poor judgment, and indifferent attitude. However, motor function remains preserved. It usually begins after age 65. But the onset may occur as early as age 40. Alzheimer disease appears first as memory decline and, over several years, it destroys cognition, personality, and ther person's ability to function. Confusion and restlessness may also occur.

Are These Symptoms Unique to Alzheimer Disease?

The answer is, of course, "No." Similar symptoms can also result from fatigue, grief, depression, illness, vision or hearing loss, the use of alcohol or certain medications, or simply the burden of too many details to remember at once. There are also many diseases that can cause similar symptoms to those typical of Alzheimer's. Among the diseases that have to be distinguished from Alzheimer's is Multi-Infarct Dementia.

What is Multi-Infarct Dementia?

Multi-infarct dementia (MID), a common cause of dementia in the elderly, occurs when blood clots block small blood vessels in the brain and destroy brain tissue. Probable risk factors are high blood pressure and advanced age. CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy) is an inherited form of MID. This disease can cause stroke , dementia, migraine-like headaches, and psychiatric disturbances.

What are the symptoms of multi-infarct dementia?

Symptoms of MID, which often develop in a stepwise manner, include:

  • confusion,
  • problems with recent memory,
  • wandering or getting lost in familiar places,
  • loss of bladder or bowel control (incontinence),
  • emotional problems such as laughing or crying inappropriately,
  • difficulty following instructions, and problems handling money.

Usually the damage is so slight that the change is noticeable only as a series of small steps. However over time, as more small vessels are blocked, there is a gradual mental decline. MID, which typically begins between the ages of 60 and 75, affects men more often than women.

Is there any treatment for multi-infarct dementia?

Currently there is no treatment for MID that can reverse the damage that has already occurred. Treatment focuses on prevention of additional brain damage by controlling high blood pressure.

What is the prognosis for multi-infarct dementia?

Prognosis for patients with MID is generally poor. Individuals with the disease may improve for short periods of time, then decline again. Early treatment and management of blood pressure may prevent further progression of the disorder.

For additional information, please visit the following MedicineNet.com areas:

This article is, in part, based on material on both Alzheimer's Disease and Multi-infarct Dementia provided by the National Institute of Neurological Disorders and Stroke (NINDD), part of the National Institutes of Health (NIH).


Last Editorial Review: 9/12/2003