Doctor insights on:
Medicine For Multi Infarct Dementia
Many small strokes: Multiple small "lacunar infarcts" can add up and create a picture very similar to alzheimers, and result in significant cognitive problems. Need to treat the dementia with meds, but also prevent further strokes with meds. Complex, so need fairly thorough evaluation and treatments. ...Read more
When the blood supply of a tissue is compromised by whatever mechanism, the tissue will stop working and if blood flow is not restored, the tissue will eventually die ("infarct", both verb and noun). The clinical picture that runs with development of an infarct ("heart attack"; ...Read more
Thorough Evaluation: Tests determine whether other medical problems could be causing dementia, such as anemia, brain tumor, chronic infection, drug and medication intoxication, severe depression, thyroid disease, vitamin deficiency. Neuropsychological testing is helpful to find out what parts of thinking have been affected, and to guide other tests. Tests also can include a head ct scan and MRI of the brain. ...Read more
See below: The safety needs of the patient need to be assessed based on the stages of dementia. This process is continuous. If patient is still at home, home visits should be made to ensure that there is enough food, medication is taken on time, the environment is safe. If person is at the nursing facility, usually facilities have protocols in place to ensure the safety of the patient. ...Read more
Due to strokes: "dementia" is loss of cognitive faculties to less than a person's previous baseline leading to an inability to function independently. "multi-infarct" means multiple strokes, usually caused by blockage of circulation in discrete areas of the brain resulting in dead brain cells and/or their connections to other brain cells. Multi-infarct dementia may be patchy in what works and what doesn't. ...Read more
Two things:: First and foremost, control the underlying contributing factors to the strokes, ie: the high blood pressure or cholesterol or smoking, etc. Secondly is to treat the dementia by increasing acetylcholine in the brain with aricept, etc and to decrease glutamate with namenda (memantine). ...Read more
Stroke is: The cause of multi-infarct dementia. Management is to prevent other strokes from occurring. See doctor regularly to keep blood pressure, cholesterol and diabetes (if you have it) under good control. If abnormal heart rhythm (atrial fibrillation) is present, then would need blood thinner to prevent blood clots in heart which can lead to stroke. ...Read more
See below: Poor safety awareness is due to poor insight, judgment and planning. This person may have a lack of initiation before doing anything. Perhaps a neuropsychological evaluation or geriatric assessment would be helpful. ...Read more
Piracetam: No. Piracetam was one of the first drugs used for dementia and comes from the class of drugs called nootropics, whose actions are still poorly defined. Most of the trials of piracetam were undertaken many years ago and did not use methods which would be currently considered standard. Some of the studies suggested there may be some benefit from piracetam but overall the evidence is not consistent. ...Read more
I have been told I have mild ectasia of the basilar artery. I suffer with migraine and my father has multi infarct dementia. Should I be concerned?
Multi infarct stroke dementia patient, will stopping ssri antidepressant have a negative impact after some time and patient has shown improvement? Is it addictive or have a downer. Any ALT antidep's?
Vascular dementia: These days multi infarct dementia is referred to as vascular dementia. After a stroke there is evidence that ssri antidepressants help prevent post stroke depression. There is a little but not a lot of evidence that ssris help those with vascular dementia. Ssris are not addictive. For specific advice about using any antidepressant it would be best to see a mental health expert. ...Read more
What specifc therapy can be given to multi infarct stroke dementia patient, 67, to improve cognitive functions and part memory loss. Also need tips for the caregiver to understand the patients needs?
Support groups: A support group for caregivers of dementia patients or alzheimer's patients can be very helpful. There you can find out from others what their troubles have been and what they have tried. The alzheimer's association or the alzheimer's foundation of america have good online websites with information that often applies to all types of dementia including multiinfarct or vascular dementia. ...Read more
What tests can we do to check effect of dabigatran on patient with heart problems, multi infarct stroke dementia? Recently moved to d'tran from warfarin after stroke. Any interaction with antideprests
Are there any non standard or special new treatments for multi infarct stroke dementia patient with loss of memory, cognitive functions?
No: At the present time, there is no new or novel treatment in patients who already had a stroke. There is only prevention of future strokes. ...Read more
Will ssri antidepressants work to improve cognitive functions and memory loss of a recent multi infarct stroke dementia patient, age 67. How long should he take them until we see an improvement?
Is recommended for a 93 years patient with vascular dementia take a hipnotic drug with clonazepan for insomnio?
Complex: Sleep problems are common in older adults and even more common in those with dementia. Causes of sleep problems are varied and as dementia progresses they change. Getting enough exercise early in the day is helpful. Many sleeping medications worsen confusion or cause side effects in those with dementia. Melatonin or warm decaf tea have minimal risk. Some antidepressants can help at least for awhil. ...Read more
What is the best prescription drug for a 93 year old patient with vascular dementia? Any natural?
Not reversible: Vascular dementia is considered nonreversible and often medications currently available offer only small amount of benefit at best. There is no best drug--the one that helps without significant side effects, as well as affordable, is best medicine. Treatment is individualized and so consulting doc is advised. Otc gingko may help some people, but effectiveness is minimum at best. Good luck. ...Read more
My father (94 years old an with vascular dementia) is taking haloperidol (0.5 mg) to before bed because he has hallucinations. Is this drug safe?
Remember: There is no drug that is completely safe. Like many of these "neuroleptic" drugs they can affect the heart and movement system of the body. But by the same token, sometimes the benefits outweigh the risks. If this is the only medication that helps your father, then you have to work with its adverse effects too. Best of luck ...Read more
Is risperdal. 5 mg dose safe for an elder patient with alzheimer's and vascular dementia? I read this drug can cause sudden death in elder patients.
No: According to all studies so far, any antipsychotic used for the purpose of treating behavioral problems or psychosis related to dementia is associated with earlier stroke-related death. This occurs regardless of the antipsychotic and the dose. There are some studies that have shown some antipsychotics to be safer than others (like quetiapine) but those studies are small and inconclusive. ...Read more
Possibly: Depending on the level, location, severity of the vascular lesions or cerebral insults, there is a possibility that some sxs will be reversed somewhat or improved; the brain can compensate at times for vascular insults; however, the key element is treating the underlying diseases such as hypertension and weight and removing high risk behaviors such as smoking. ...Read more
Can be hard to know: If dementia occurs in the context of cerebrovascular disease (strokes, tias), especially if the deficits correlate with known anatomical lesions, it is presumed vascular. Neuropsych testing may add evidence (or not). Vascular dementia also tends to progress in discrete steps, rather than continuously. There are many causes of dementia; some can be hard to diagnose in the living patient. ...Read more
Vascular dementia: There are two common reasons - the first is related to not stopping or being able to reverse the vascular damage that has occurred. Often people have uncontrolled hypertension or inflammatory changes that go unchecked. The second reason is that aging does alter other functions in the brain, including health of blood vessels and neurons and supporting cells. Adds to deficits. ...Read more
Vascular dementia: Vascular dementia may overlap with other types of dementia such as alzheimer's, but results from damage to, or blockages in, blood vessels that nourish the brain. This leads to tiny "infarcts" or deaths of nerve cells in the brain. People with hypertension and/or arteriosclerotic narrowing of these blood vessels are vulnerable to such changes, which happen in a stair-step process over time. ...Read more