Did medication help symptoms of Vascular Dementia?

Thank you for sharing this very interesting information. You both are an inspiration!

Thank you so much for sharing this info!

I feel like I research 24/7 while taking care of my sister. Although she's been sick with multiple issues (uterine fibroids, massive PE, etc.) for over 2 years, the WM issues were news to us after bradycardia and an MRI in April. She suddenly went from being a voracious reader to not reading at all, and having the behavior of a child.

She has a terrible PCP and surprisingly bad PCP, cardiologist and neurologist. The cardiologist has zero interest in understanding why she experienced bradycardia or why she has SVTs (erratic heat beats; she had a ZIO heart monitor for 2 weeks). I've researched it more and learned that this issue needs to be addressed by a cardiac electrophysiologist (cardiologist who diagnoses and treats heart rhythm problems). I found one and am trying to get an appointment. Sadly, it seems like her doctors have given up and are waiting for her to slowly degrade.

I'm so incredibly frustrated and sad! We have another sister (none of us have kids) but I'm the sole caretaker.

This seems like a dumb question, but I'm wondering who orders the generic workup. Did you organize that through the nutritionist or her PCP?

I can't remember and just looked and ours but L just have the reports with no front page for name or address which is odd for me not to have. However. my daughter is a COO of a Health Company and also a nutritionist. So I turn to her for referrals and to get the Brain nutritionist. She is hiking in Colorado with her family and I can't reach her but she will be back Tuesday night and I have made a note to check on that for you. In the mean time I will keep looking around our house. My wife may have put it somewhere. It is so very hard to get docs to pay attention.
For instance, I had to read theMRI results and found my wife's 9mm lesion is in her brocca area , which controls language. Her wernicke area is perfect. That's where comprehension is. So my wife can fully comprehend but because she has trouble forming the words or doing what's called word replacement(one word for another), people think she can't comprehend. If the circumstances allow, I act as her interpreter. Like she says I'm going to the water. I have to ask you mean the pool or the lake to walk? For something or someone going fast she says they're coming hard. See..... she can comprehend but not say the words. One brain deficiency in one area can appear to be or make people think they just don't understand, when that is NOT true. We just came from the Y where I take her 3 or4 times week to get her heartrate at 110 to 120 because of the vascular blood flow problem. She also has Factor V blood disorder, So blood flow is a challenge for us. On the way back I told her at least 4 times,...Karen you're doing great. You're so much better than a year ago. She said really. she doesn't realize so i give her reassurance she's doing what we need to do and it's working, even if I don't notice much improvement in the last few months. I have to keep her hope up. In Tennessee it is a Class D Felony to tell a Vulnerable Person they won't get better. Probably more info than you wanted but it is so hard and we just have to keep pushing because the system will write them off just as fast a anybody else. Even if the person is just sitting looking out the window most of the time....they are in there and we have to speak for them AND advocate for them, even strangers, they're people.... not throw aways. PS. there are no dumb questions!!!

Hi. No rush. I was just curious to know if there was a specific point of contact that you used.
I've already found a nearby in-network nutritionist who lists "Cognitive Behavioral Therapy (CBT)" as a modality that they work with, and I've found some geneticists listed in her healthcare provider search tool. So, it looks like I already have some contacts to reach out to early next week.

Wow, I don't know how you found such detailed info on where the lesions are in your wife's brain, or the size of the lesions. It's amazing what you've done to understand her health issues, and to find natural ways to help improve her quality of life. Kudos to you and your daughter for your advocacy and care. Your wife is lucky to have you both fighting for her! Positive reinforcement is so important.

I'm going through all of my sister's tests again in fine detail to see what else needs to be done. Her MRI has scattered comments about white matter.
2. Possible punctate subacute infarct along the left frontal lobe subcortical white matter.
3. Extensive white matter FLAIR hyperintensities, few scattered foci of chronic parenchymal microhemorrhage, and multiple scattered brainstem and supratentorial white matter chronic infarcts, in concert raising the possibility of underlying vascular dementia/multi-infarct dementia.
And also, "possible moderate right and mild left cervical ICA luminal stenosis just beyond the carotid bulbs, most likely due to underlying of a chronic plaque" and suggests a "nonemergent/routine vascular duplex carotid ultrasound". I'm going to message her PCP and tell her that I want that ultrasound ordered to avoid her having a stroke. We already believe she's had TIAs. It's crazy how much work patients and advocates must do to ensure loved ones receive proper medical care these days.

Unfortunately, there were signs for a long time but I had no idea that other medical issues (gait issues, high blood pressure, incontinence, etc.) were related to dementia. She has not been diagnosed yet (need a new neurologist too) but I believe she has Binswanger dementia. We cared for our father for years before he died from vascular dementia years ago.

Next month we see her neurosurgeon about her pituitary adenoma (operable brain tumor). Looks like that has grown in the last two months and she will need surgery. We were hoping it could wait.

@ritz1, My cousin was diagnosed with Vascular dementia 6 years before her death and her doctors, including her primary and neurologist, said those meds for dementia were not for Vascular dementia, but Alzheimer’s. So, she did not take them. This started in 2014, so there might have been new research since then. I’d get a second opinion. Because, if a med doesn’t help, I’d be hesitant to agree to it. I will add that,

My dad, who has Alzheimer’s, takes both of those meds and they have helped tremendously. His doctor even said we could slowly stop them since he now has severe dementia, but we could see a different for the worse when I decreased his dose, so we returned to regular dose.

That Tennessee law is amazing. Who thought that up? If someone is terminal and getting Hospice, how is it beneficial to tell them they'll get better? Sounds cruel to me. I don't think it's right to lie to patients. If we think our doctors or caregivers are lying to us, how will we ever be able to trust them? It's so condescending. I don't tell my husband everything about his condition, though his neurologist has. We all know the prognosis. It's like answering little kids' questions: answer truthfully and briefly and at a level they can understand. Of course, if your wife really is doing better, by all means tell her so. Good luck to you both.

That law applies to mental conditions because of the distress saying you won't get better can cause. Not to all conditions. It also doesn't say you have to tell them they will get better like you said. Notice this thread is about brain diseases. I think you added that which is understandable with the stress we are all under. You just can't say you won't get better.
The Tennessee Supreme Court in three cases in 2024 said. "From expert testimony from the Neurologists involved in these cases... The court is of the opinion every Vulnerable Person (Brain Capacity) has two underlying emotions and thoughts"....." 1. The hope they will get better and 2. Fear". These were cases of Abuse of Vulnerable Adults, under the Tennessee Vulnerable Adult Protection Act and the Court said. "Any person can tell if they have committed Abuse of a Vulnerable Adult if what they do or say reduces that Vulnerable adults Hope or if what they do or say increases that Vulnerable adults fear". So in my case before I remarried my wife so I could care for her, she lost her Drivers License and she wanted to talk to her son about taking the test again. After about 5 minutes he yelled Mom I'm tired of talking about this. You're not going to get better!!! That destroyed her hope and caused tremendous fear. It was a Class D Felony. He didn't care about her feelings. He just didn't want to fool with her. Actually her Neurologist notes a month earlier said "She seems to be getting better" but her son wouldn't dare tell her that! He always would say... "If you don't stop "Acting Up", I'm going to put you in that place you don't want to go" ( Assisted Living). He is an Orthopedic Physicians Assistant, not uneducated. When she fell, and had 2 fractured ribs and 2 displaced ribs and a Rotator Cuff tear he wouldn't even take her for Medical treatment. By the way "Acting up" was seeing and talking to me. After we remarried we discovered he emptied her bank account and used part of her monthly income to pay his Chase Credit Card. She asked for an accounting 3 times and he said "don't worry mom you've got plenty of money". Her daughter who works in a nursing home "Borrowed" my wife's nice Volvo xc60 SUV and wouldn't return it after a year and my wife asking for it 8 times. So me showing back up was going to blow their schemes of taking all their mother's assets. People, even family write OUR loved ones off and even do things like this. They've punished my wife for remarrying me now by cutting off all contact with the grandchildren she adores.
So I've taken 2 years becoming as much of an expert for my wife's care as I can as a lawyer and absolutely an expert on Vulnerable Adult Persons Protection Act. On the Drivers License; she may never get it back but I got her Volvo back and I take her after church or on Saturdays to vacant school or industrial parking lots and she drives around as long as she likes. It tickles her to death. There are countless things we can do at any stage to lift them up, make them feel as normal as possible, give them joy, though it may be small to us. I cherish every normal and abnormal minute with her. Even the ones that drive me crazy because when I didn't have her I felt crazier. Every time she walks by me I say I love you. She gets so tired of that; LOL.
I didn't mean to come across harsh in the beginning here but I just wanted you to be clear that you are correct about what you said and what the supreme Court said wasn't that we should instill false hope. We just shouldn't dash the hopes the person may have, or increase the fears they have , even secretly from us. This is hard yes, but it's harder on her. God bless every minute you have left!!!

This is very clarifying. Thank you. I know families can do astonishing, dreadful things when money's involved. When I was a child, my uncle was a real problem for my mother and her siblings after my grandmother died. Until I saw him erupt, I had no idea grown ups could behave like that. You are doing an amazing thing for your wife. I'm in awe.

Thank you. You are obviously a good woman!

Statins are terrible for you and can cause both confusion and leg weakness. Our cardiologist took bith my husband and I off of them and now I take rapatha injection and husband takes Nexlizet pill. Better all around.
I think higher doses of B12 are helping too. This getting old and/or ill is like a never ending research project and I appreciate all information.