Memory dysfunction and cognitive impairment following stroke occur commonly that affects the quality of life. Dementia is a syndrome that causes loss of several distinctive but overlapping intellectual abilities.
Among the neurological diseases in adult life, stroke ranks first in frequency and importance. A stroke is a brain attack that is caused either by reducing blood and oxygen flow to the brain or by bleeding. Strokes are broadly classified into hemorrhagic and ischemic strokes. There are two main causes of stroke: a blocked artery (ischemic stroke) or leaking or bursting of a blood vessel (hemorrhagic stroke). Some people may have only a temporary disruption of blood flow to the brain, known as a transient ischemic attack (TIA), that doesn’t cause lasting symptoms.
Stroke affects cognitive domains especially memory, attention, orientation and language. Maximum impact of stroke at the time of diagnosis is on attention and executive functions rather than on memory. Memory problems manifest at various post-stroke intervals. Mild Cognitive Impairment is a transitional stage between early normal cognition and late severe dementia. The severity of cognitive symptoms can be assessed by Clinical Dementia Rating Scale. Also, memory evaluation is associated with memory types like short-term memory, working memory, episodic and semantic long-term memory and procedural memory.
Post-stroke memory assessment analyses different types of memory functions that are related to different parts of the brain according to stroke location. Multi-Infarct dementia is caused by multiple strokes. Disruption of blood flow leads to damaged brain tissue. The best treatment for prevention of multi-infarct dementia are control of blood pressure, diabetes, high cholesterol and cardiovascular diseases. The physician’s advice includes eating a healthy diet, exercising, not smoking, and maintaining a healthy weight.
Sometimes multi infarct dementia is difficult to distinguish from Alzheimer’s disease which is the most common cause of dementia in older patients. Sometimes they coexist. Research shows that African Americans, American Indians, and Alaska Natives have the highest rates of dementia, and that risk factors may differ for women and men.
No behaviour or lifestyle factor has advanced to the point that researchers can confidently state that it will prevent Alzheimer’s and related dementias. But there are promising avenues as medical science advances.
Views expressed by – Dr. Ansu Sen, MD/DM Neurology, Senior Consultant (Neurologist), Ramakrishna Mission Sewa Prathisthan, Manipal Hospitals Kolkata, West Bengal
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