Definition:Multi-infarct dementia (MID) is the second most common form of dementia after Alzheimer's disease. Patients with MID experience periodic strokes that impair their mental abilities. The effects accumulate over time, ultimately resulting in dementia.

Diagnosis: The course of MID differs from that of Alzheimer's. Patients with Alzheimer's disease generally decline slowly and steadily; MID patients get worse all of a sudden (when they have a stroke), then remain stable for a time, then suddenly get worse again (when they have another stroke). This stepwise course distinguishes MID from Alzheimer's. MID patients may also exhibit lesions on MRI scans (particularly in the hippocampus and frontal lobe); they may report dizzy spells, temporary hemiplegia, or other signs and symptoms of minor stroke. Note that patients can suffer from both Alzheimer's and MID at the same time; this syndrome is called "mixed dementia."

Treatment: Physical and behavioral therapy can partially alleviate the physical and cognitive problems that the strokes cause; however, they cannot always return the patient to full health, and if the strokes continue the patient will likely end up demented. Patients can also take steps to reduce the likelihood of stroke by reducing dietary fat and cholesterol, taking appropriate medication, and so forth.

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