MID; Dementia - vascular; Dementia - poststroke

There is no treatment to turn back damage to the brain caused by small strokes.

An important goal is to control symptoms and correct risk factors such as high blood pressure, smoking, and high cholesterol to prevent future strokes.

• Avoid fatty foods. Follow a healthy, low-fat diet.
• Do not drink more than 1 - 2 alcoholic drinks a day.
• Keep blood pressure less than 130/80 mm/Hg (ask your doctor what your blood pressure reading should be).
• Keep LDL "bad" cholesterol lower than 70 mg/dL.
• Quit smoking.
• Your doctor may suggest taking aspirin or another drug called clopidogrel (Plavix) to help prevent blood clots from forming in the arteries. These medicines are called antiplatelet drugs. DO NOT take aspirin without talking to your doctor first.

The goals of helping someone with dementia in the home environment are to:

• Manage behavior problems, confusion, sleep problems, and agitation
• Modify the home environment
• Support family members and other caregivers

See: Dementia - homecare for information about taking care of a loved one with dementia.

Medications may be needed to control aggressive, agitated, or dangerous behaviors. The health care provider will usually prescribe these medicines in very low doses and adjust the dose as needed. Such medications may include:

• Antipsychotics (olanzapine, quetiapine)
• Serotonin-affecting drugs (trazodone, buspirone, or fluoxetine).

Medications used to treat Alzheimer's disease have not been shown to work for MID.

Hearing aids, glasses, or cataract surgery may be needed if the person has sensory problems.

Some improvement may occur for short periods of time, but the disorder will generally get worse over time.

Complications include the following:

• Future strokes
• Heart disease
• Loss of ability to function or care for self
• Loss of ability to interact
• Pneumonia, urinary tract infections, skin infections
• Pressure sores

Call your health care provider if symptoms of vascular dementia occur. Go to the emergency room or call the local emergency number (such as 911) if there is a sudden change in mental status. This is an emergency symptom of stroke.

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Review Date: 03/22/2010
Reviewed By: Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)