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John Stirling Meyer, MD; Brian W. Judd, MS; Talat Tawaklna, MD; Robert L. Rogers, PhD; Karl F. Mortel, PhD

JAMA. 1986;256(16):2203-2209.

Abstract
A cohort of 52 patients (30 men and 22 women) with multi-infarct dementia (MID) has been followed up prospectively for a mean interval of 22.2 months. Clinical course has been documented by serial history taking and interviews and neurological, medical, and psychological examinations, and correlated with measurements of cerebral blood flow. The clinical course and cognitive performance have been compared with those of age-matched normal volunteers and patients with Alzheimer's disease. Patients with MID were subdivided into hypertensive and normotensive groups, and also into those displaying stabilized or improved cognition and those whose condition deteriorated. Among hypertensive patients with MID, improved cognition and clinical course correlated with control of systolic blood pressure within upper limits of normal (135 to 150 mm Hg), but if systolic blood pressure was reduced below this level, patients with MID deteriorated. Among normotensive patients with MID, improved cognition was associated with cessation of smoking cigarettes.

(JAMA 1986;256:2203-2209)

Author Affiliations
From the Cerebral Blood Flow Laboratory, Veterans Administration Medical Center, and the Department of Neurology, Baylor College of Medicine (Drs Meyer, Tawaklna, Rogers, and Mortel, and Mr Judd), and the Department of Psychology, University of Houston (Drs Meyer and Rogers and Mr Judd).

Footnotes
Reprint requests to Cerebral Blood Flow Laboratory, Veterans Administration Medical Center, 2002 Holcombe Blvd, Houston, TX 77211 (Dr Meyer).

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