I’ve been told that WMD shows on cat scans as hyper densities in the brain caused by small vessel atrophy which decreases or prevents blood flow. My 92 year old mother exhibits signs of dementia. Mostly language difficulty that comes and goes (doesn’t finish sentences, can’t find word, loses train of thought, can’t follow a rapid or lengthy conversation), her filter for keeping thoughts and anger to herself is decreased (lashes out at dad and if anyone calls dad out on some inappropriate behavior like interrupting and taking over conversations, she’ll lash out at you in defense if him…no win.

She’s got multiple medical problems (afib, hypertension and hypotension (othostatic), ocular strokes, peripheral neuropathy (PN), arthritis in spine, 2 knee replacements). The neurologist outruled Parkinsons. Ran blood and urine tests that came back normal (no infection, etc). Asked her to have a nerve conduction study done to determine extent of the PN and she agreed. Results were that the neuropathy is not in her brain or spine, but unless they do further tests, they can’t out rule anything else or determine cause of PN. We were told that more tests just continue to outrule problems and there’s likely nothing that can be done even if they did determine cause.

She is tired of doctor appointments (Covid shot appts, her regular PCP, eye & cardio dr appts and extra Neurology, plus a brief hospital stay just before Thanksgiving for fainting—this is more common and she was fine but dad had already called 911) and does not want any more tests. We kids empathize and support that.

A little more background: She still dresses herself (recently though got confused and put her shoes on before her pants), bathes herself and has good general hygiene. Occasionally will sleep in her clothes for the next day appointment (that’s new) because it takes her so long to get ready in the mornings. Quality of life is not great (IMO), yet lots to be grateful for (lives in own house with dad, he can still drive, she’s still somewhat mobile (tires easily and always risk of fainting due to OH) but feels not too much left to live for. No family nearby and can’t travel or stay overnight anywhere (unfamiliarity and mental exhaustion of packing, etc). Recently she could not attend her sole surviving sibling’s funeral in Florida (he was 100! Fortunately I was able to go and “represent” our family). We kids would like for them to have more help in the house (currently housekeeper 1/mth and helper for 4 hours on Saturdays (she counts for mom while she does her PT exercises which is great, but dad nor mom utilize her fully and dad doesn’t really see the need for her)).

After reading a lot about dementia, Alzheimer’s, and WMD, I don’t see much about WMD and what the prognosis is or how it relates to other cognitive impairment diseases. I’m told by her PCP that many of us have hyper densities in our brains that would show up if we had a cat scan. Is anyone familiar with WMD and what it really means in ones life?

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Your mom is 92. The odds that she also has dementia as well as WMD is at least 50%. I don’t think any more testing will benefit her at all since there’s nothing that will reverse the progression of either of those 2 diseases. Hopefully your parents have their legal ducks in a row: assigned PoA, Living Wills, trusts, Last Will, etc. If they are financially well-off they may be able to stay in their home with someone managing the hired aids for them. If not, then Medicaid is the safety-net. I wish you much peace in your heart.
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I always say that dementia is as individual to a person as his or her own fingerprint. I think that whomever you might find on Forum who has any familiarity with WMD would have experiences that are slightly familiar, but likely no more so than any other dementia. All dementias vary.
There is quite a lot of information available if you google "white matter disease".
More importantly, your family now has an elder with this diagnosis. Any PROGnosis of what it might mean for her is best to come from the neuro-psyc who diagnosed her individual case and has the MRI and scans of her own brain, as well as did the cognitive exams.
I am sorry to hear about this diagnosis. It sounds as though you will have now to wade through might be done to help and assist your mother as you move forward.
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