The reader will already be aware that there is little one can do in most cases to guarantee the return of the intellectual function that has been lost. Treatment measures fall, in broad terms, into two categories. The first of these of course is the treatment of any underlying cause: making sure that high blood pressure is brought down to normal levels and kept there; that the blood sugar level is kept within normal limits if the patient has a diabetic tendency; or that the blood is thinned if there is a danger of small blood clots entering the circulation from the heart.
In addition to treating any underlying cause it is often possible to try to help a patient regain as much function as possible after having had a stroke. When the stroke affects the limbs it is easier to assist since physiotherapists, occupational therapists, and others can do a lot to help in a practical manner. When the stroke affects a part of the brain that is involved with mental functioning, however, the problems are greater. Nevertheless a speech therapist and an occupational therapist can sometimes assist people with this type of stroke to maximize recovery or to find means of dealing with their difficulties. It is, however, very often difficult to know when another stroke has occurred although it is often easier to help a person with multiple infarct dementia than a person with, say, Alzheimer’s disease.
Since the course of multiple infarct dementia is much more erratic than that of most of the other conditions that cause intellectual decline and since it depends mainly upon the rate at which strokes occur and the structures within the brain that they affect, it is more difficult to give guidance to families as to what the future holds. It is important that families should know, however, that whereas most people with an Alzheimer’s type dementia eventually die of pneumonia, a significant proportion of MID sufferers, because of abnormalities in arteries outside the head, die as a result of heart failure or coronary thrombosis.
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