Microvascular ischemic disease is a brain condition that commonly affects older people. Untreated, it can lead to dementia, stroke and difficulty walking. Treatment typically involves reducing or managing risk factors, such as high blood pressure, cholesterol level, diabetes and smoking.
Microvascular ischemic disease is an umbrella term that refers to a variety of changes in the small blood vessels of your brain. Depending on the severity of these changes, they can cause a range of complications — from difficulty focusing to a stroke.
Microvascular ischemic disease has many names, such as:
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Microvascular ischemic disease occurs in older adults, affecting both males and females equally. The chances of having the condition increase with age.
Microvascular ischemic disease affects about 5% of people who are 50 years old. But it affects almost 100% of people older than 90.
Microvascular disease results in narrowing of small blood vessels from wall thickening and plaque build-up. Experts aren’t exactly sure what causes microvascular ischemic disease. There are many contributing factors.
Advanced age is the main risk factor. But these health issues also increase your risk for developing microvascular ischemic disease:
Healthcare providers often call microvascular ischemic disease a silent disease. Symptoms may be subtle and often go unnoticed. This is easy to do since people may attribute symptoms to normal signs of aging.
In some older adults, symptoms become moderate or severe. The condition also affects various systems, so symptoms can be wide-ranging, such as:
Healthcare providers typically use magnetic resonance imaging (MRI) to diagnose microvascular ischemic disease. Both are painless imaging tests. It produces clear images of your brain using a large magnet, radio waves and a computer.
Various brain changes occur in microvascular ischemic disease. In your MRI images, healthcare providers may look for these different structural signs:
It may be possible to reverse some of the brain changes in the early stage of microvascular ischemic disease. But they tend to worsen and become irreversible during the normal course of the disease.
There aren’t specific treatments for microvascular ischemic disease. Currently, treatment focuses on reducing risk factors and staving off complications, such as dementia and stroke.
Every person will have different risk factors, so treatment is highly personalized. In general, treatment may include:
It’s important to work with your healthcare provider to pinpoint your specific risk factors and develop a plan.
Some helpful strategies include:
To know if you’re at risk, pay attention to your symptoms. Stay up to date on your regular checkups and have your bloodwork done. Know your cholesterol levels and blood pressure. If you have underlying conditions such as diabetes or kidney disease, make sure you manage them.
Untreated microvascular ischemic disease can lead to serious, life-threatening complications. These include stroke and severe cognitive decline. If you follow your personalized treatment plan, you may be able to slow the progression of the condition and lead a healthy, independent life.
See your healthcare provider for an evaluation if you’re experiencing a dramatic or subtle decline in your ability to:
Microvascular ischemic disease increases your chance of having a stroke. So, it’s important to go to the emergency room immediately if you’re experiencing sudden:
A note from Cleveland Clinic
Microvascular ischemic disease can range from mild to severe. It can lead to mood changes and problems with thinking and walking. By addressing your specific risk factors, you can manage or minimize these complications and live a healthier life. Talk to your healthcare provider about developing a personalized plan for you.
Last reviewed by a Cleveland Clinic medical professional on 05/05/2022.
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