Explanation of Infarcts

QUESTION: After a long period of testing and examining, our physician has
finally decided that my mother's problems were not caused by Alzheimer's
Disease, but by something he classified as "infarcts". He now feels that
treatment may permit mother to be cared for at home. We are confused and
would appreciate your help in explaining this to us.
------------------------------------------------------------------------------
ANSWER: I realize that you must be in a difficult situation as you try to
understand a complex diagnosis, and the implication it has for you and your
family. A few definitions may help. The condition your mother is suffering
from is called "multi-infarct dementia" (or MID). Dementia is defined as a
decline in intellectual function as seen in the loss of memory, loss of
language, impaired judgement or mathematical abilities, as well as other
mental activities. An "infarct" is an area of dead tissue that results when
the blood circulation to the area has been closed off, or obstructed. As the
number and size of these areas increase, and more brain tissue is lost, the
symptoms become more evident. Alzheimer's disease is certainly the most
common cause of dementia, and is responsible for 25% to 55% of the cases,
while MID is the second most common cause, and is diagnosed in from 10% to 30%
of patients with dementia. If there is a history of small or large strokes,
the chances that the cause of the mental decline is MID increases. High
blood pressure is another risk factor, as are diabetes, high cholesterol
levels and smoking. An important consideration in your mother's case is the
hope that appropriate treatment can stop the progression of the disease by
stopping the development of small clots in her brain that are causing the
condition. If this can be accomplished, than caring for her at home permits
her to remain in familiar surroundings, where she is best able to function.
Another common complication of MID is a mild to serious depression, with loss
of appetite, insomnia, feelings of guilt and suicide. This may occur up to
70% of the time, and requires additional care and treatment. You will need
frequent consultations with your mother's physician, so that each decision
about care may be based upon a thorough understanding of this condition.