Expert: Mary Gordon - 7/20/2007

Question
Mary,
Good Morning, First I preivously emailed you on 5/31/07 about my mom who had just turned 80.  I explained her symptoms and past history and medications and you had thought it was more like Vascular Dimentia, well you were 100%right.  We had her evaluated at the Aging Brain Clinic affiliate with Cleveland Clinic and that is what they diagnosed her with.  I had been reading about taking 81mg baby aspirin to open up blood flow, do you think this would help her position or prolong her inevitable stroke which we are well aware of occurs with Vascular Dimentia?

Answer
Hi Karen,
Treatment for multi-infarct/vascular dementias focuses on preventing future strokes by controlling or avoiding the diseases and medical conditions that put people at high risk for stroke:  high blood pressure, obesity, diabetes, high cholesterol, and cardiovascular disease. Blood pressure and cholesterol levels re the biggies that can be treated with drugs, and also with lifestyle changes.  

Doctors sometimes prescribe aspirin or warfarin to prevent clots from forming in small blood vessels. Low dose aspirin doesn't "open up" blood vessels - aspirin reduces the ability of blood to clot, so it can help stop them from forming, and thus reduce the odds of a stroke.  

This is something to discuss with the doctor, since if she is on any blood thinners, aspirin on top of that might not be a good idea. You need to talk to someone who knows all the medications she takes, and who can make sure aspirin won't interact with anything, or make any existing medical condition worse.

Beyond that, some doctors may recommend surgical procedures to improve blood flow or remove blockages in blood vessels, such as carotid endarterectomy, angioplasty, or stenting. Studies are under way to see how well these treatments work for patients with multi-infarct dementia - and thus far, they don't seem very effective, and they can be very high risk.

You will want to have a talk with her doctor about options, now that you have a clearer idea of what is going on with her. You were very smart to make sure she was properly evaluated. She's lucky to have such a great daughter looking out for her!

Mary G.