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Can Tiny Strokes Cause Memory Loss?

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By AMANDA GRANT SMITH, MD Tribune correspondent

The Tampa Tribune

Published: May 30, 2008

As a memory disorder specialist, I often see people who worry about developing Alzheimer's disease, since it is the most common cause of dementia in older adults. However, other conditions can cause the progressive loss of memory. One fairly common cause is the brain damage that accompanies strokes.

A stroke is a "brain attack" that causes the loss of blood and oxygen to brain cells. Large strokes can affect many functions of the brain. Symptoms of this medical emergency can include numbness or weakness of the arm, leg or face, unsteadiness, difficulty understanding or speaking, vision changes, and difficulty with thinking and memory.

One-third to one-fifth of people who suffer a stroke will develop a decline in their mental abilities, a condition known as vascular dementia. In some cases, memory problems develop as a result of the buildup of many tiny strokes that caused no symptoms but are visible on a brain scan. These "silent" strokes can go unnoticed for years, until enough have accumulated to cause problems. People who develop these vascular memory problems often have forgetfulness, slow thinking, slow movements and an inability to perform simple tasks.

Some of the biggest risk factors for memory problems caused by these small strokes include age, high blood pressure, diabetes and a condition called left ventricular hypertrophy (a thickening of the heart muscle). Other stroke risk factors include smoking, excessive alcohol use, high cholesterol, obesity and a type of irregular heartbeat called atrial fibrillation.

The best way to avoid developing memory problems due to stroke is to prevent them in the first place. Exercising, eating healthy foods low in fat and cholesterol, controlling blood sugar, and quitting smoking and drinking can all decrease the risk of having a stroke. Make sure to have regular checkups with your doctor to monitor your blood pressure, heartbeat, cholesterol level and blood sugar.

If you experience any symptoms that make you think you are having a stroke, call 911 or seek emergency medical treatment right away. There are treatments that can help, but every minute counts. The longer brain cells go without blood and oxygen, the more likely they are to suffer permanent damage.

Sometimes, stroke symptoms are caused by a condition known as a transient ischemic attack or TIA (also sometimes referred to as a "mini-stroke"). This means that a person experiences the symptoms of a stroke resulting from decreased blood flow to a part of the brain, but the symptoms disappear within 24 hours. A TIA is often a warning sign that a real stroke is not far off, so it should never be ignored.

No specific treatment is available to reverse memory loss that occurs after a large stroke or from the buildup of small ones. That is why prevention is so key - if you avoid having a stroke in the first place, you can avoid the memory problems that often occur as a result. More information can be obtained from the National Stroke Association, 1-800-STROKES, www.stroke.org, and the American Stroke Association, 1-888-4STROKE or www.strokeassociation.org.

Dr. Smith is assistant director of the Suncoast Alzheimer's and Gerontology Center at USF Health.

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