Arteriosclerosis, Infarcts, and Dementia

A study was made of 343 elderly mental-hospital patients whose mental disorder had begun late in life. Of the 31 brains examined at autopsy, 14 showed cerebral infarcts without senile brain disease and ten showed senile brain disease without infarcts. The amounts of arteriosclerosis in the two groups were compared. The microscopic evidence was not treated statistically, but the macroscopic evidence was subjected to Fisher's exact test and chi square for comparison of the amounts of arteriosclerosis noted at the base of the brain and the number of plaques on the named arteries within the brain. The results showed an overwhelming preponderance of arteriosclerosis in the infarct patients compared with the senile brain disease patients. It is concluded that in elderly patients with mental disorders, brain infarcts occur in close and causal relationship with cerebral arteriosclerosis. The bearing of this observation upon the concept of multi-infarct dementia is discussed.