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Suggest Treatment For Vascular Dementia In A Patient With Aortic Stenosis
Question: My mother who is 91 years old has aortic stenosis(echo shows 76% open) and has been told to have minimally invasive valve procedure to repair it. She also has a diagnosis of dementia--better during the day, but sometimes get quite belligerent\confused at night. She recently flooded a bathroom by using too much toilet paper and did not notice the toilet overflowing and flooding 2 rooms. The flooring in her bedroom needs to be replaced.
We were told her dementia is probably vascular in origin (she had a couple TIA's), and the aortic stenosis might be contributing to it. Would she even be a candidate because of her dementia? Would fixing her valve help things or would it just fix her valve leaving her dementia to progress. Would it be better to leave things alone?
We were told her dementia is probably vascular in origin (she had a couple TIA's), and the aortic stenosis might be contributing to it. Would she even be a candidate because of her dementia? Would fixing her valve help things or would it just fix her valve leaving her dementia to progress. Would it be better to leave things alone?
Brief Answer:
Surgery wont slow dementia
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. Vascular dementia is very common and possibility of aortic stenosis alone contributing to it rather than atherosclerosis is less.
2. Fixing the valve would only fix the valve. Dementia progression can only be slowed down with medications, and it will keep progressing. Fixing valve wont solve the problem.
3. Even though minimally invasive, elderly are very much prone to stress due to surgical procedures, hostile environment (hospital), depersonalization and medications. Functional decline will increase.
4. If she has dizziness, difficulty in breathing or chest pain, then she might require surgery at the earliest. Symptoms are more important than echo findings. With these symptoms, if she has, she would survive around two years.
5. Depending on symptoms, the possible further function decline due to surgery, you need to assess the requirement. If she does not have any symptoms, if she were my patient, I would like to leave things alone. You need to discuss with your doctor along with your family to come to a combined opinion.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Surgery wont slow dementia
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. Vascular dementia is very common and possibility of aortic stenosis alone contributing to it rather than atherosclerosis is less.
2. Fixing the valve would only fix the valve. Dementia progression can only be slowed down with medications, and it will keep progressing. Fixing valve wont solve the problem.
3. Even though minimally invasive, elderly are very much prone to stress due to surgical procedures, hostile environment (hospital), depersonalization and medications. Functional decline will increase.
4. If she has dizziness, difficulty in breathing or chest pain, then she might require surgery at the earliest. Symptoms are more important than echo findings. With these symptoms, if she has, she would survive around two years.
5. Depending on symptoms, the possible further function decline due to surgery, you need to assess the requirement. If she does not have any symptoms, if she were my patient, I would like to leave things alone. You need to discuss with your doctor along with your family to come to a combined opinion.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
where is your answer? I received email saying it is posted, but there is no answer
Brief Answer:
Surgery wont slow dementia
Detailed Answer:
My answer already sent is as follows:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. Vascular dementia is very common and possibility of aortic stenosis alone contributing to it rather than atherosclerosis is less.
2. Fixing the valve would only fix the valve. Dementia progression can only be slowed down with medications, and it will keep progressing. Fixing valve wont solve the problem.
3. Even though minimally invasive, elderly are very much prone to stress due to surgical procedures, hostile environment (hospital), depersonalization and medications. Functional decline will increase.
4. If she has dizziness, difficulty in breathing or chest pain, then she might require surgery at the earliest. Symptoms are more important than echo findings. With these symptoms, if she has, she would survive around two years.
5. Depending on symptoms, the possible further function decline due to surgery, you need to assess the requirement. If she does not have any symptoms, if she were my patient, I would like to leave things alone. You need to discuss with your doctor along with your family to come to a combined opinion.
This is my answer which was posted earlier, If you still not able to see then please contact customer care.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Surgery wont slow dementia
Detailed Answer:
My answer already sent is as follows:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. Vascular dementia is very common and possibility of aortic stenosis alone contributing to it rather than atherosclerosis is less.
2. Fixing the valve would only fix the valve. Dementia progression can only be slowed down with medications, and it will keep progressing. Fixing valve wont solve the problem.
3. Even though minimally invasive, elderly are very much prone to stress due to surgical procedures, hostile environment (hospital), depersonalization and medications. Functional decline will increase.
4. If she has dizziness, difficulty in breathing or chest pain, then she might require surgery at the earliest. Symptoms are more important than echo findings. With these symptoms, if she has, she would survive around two years.
5. Depending on symptoms, the possible further function decline due to surgery, you need to assess the requirement. If she does not have any symptoms, if she were my patient, I would like to leave things alone. You need to discuss with your doctor along with your family to come to a combined opinion.
This is my answer which was posted earlier, If you still not able to see then please contact customer care.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
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Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Answered by
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