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The disorder is diagnosed based on history, symptoms, signs, and tests, and by ruling out other causes of dementia, including dementia due to metabolic causes. History may include a past stroke or hypertension. History of the dementia often shows stepwise progression of the condition -- periods of abrupt decline alternating with stable periods of minimal decline. Other characteristics that suggest multi-infarct dementia rather than Alzheimer's disease include: abrupt onset, physical complaints, emotional changes, and localized neurologic signs (modified Hachinski ischemia scale).
A neurologic examination shows variable deficits depending on the extent and location of damage. There may be multiple, localized areas with specific loss of function. Weakness or loss of function may occur on one side or only in one area. Abnormal reflexes may be present. There may be signs of cerebellar dysfunction such as loss of coordination.
A head CT scan, and even more likely, MRI of the brain may show changes that suggest multi-infarct dementia because areas of dead tissue may be visible.
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