Thanks, NS52. Read through my mother's medical records, she does seem to have some of the issues you've described, such as the hypertension (controlled with meds), stenosis, and the presence of that apparent mini-stroke.NF52 wrote: Not to play neurologist, but cardiovascular disease is a major contributing risk factor for people with ApoE4 (as my dad discovered too late.) Your mother's diagnosis of Alzheimer's may be the primary diagnosis, with typical clinical symptoms (seen in observation and testing) of memory and daily living skills impairments, rather than a "typical" post-stroke focal (isolated) difficulty with right or left-sided movements or speech. I've seen presentations and talked with researchers in the field who say that the majority of "Alzheimer's" cases in people over the age of 65 who have ApoE 4 include vascular disease also, with history of hypertension, strokes, carotid artery stenosis, coronary artery disease and white matter hyperintensities on an MRI. Studies of cognitively healthy people with ApoE4 show that many tend to have a more permeable blood-brain barrier starting at about age 60 and that pre-symptomatic vascular disease may need to be more carefully monitored and managed in this population.
During my father's illness, while I was with my dad my brother had taken mom to some appointments (we were in different states, was very difficult) and was there when she got the results of a scan that indicated some level of COPD. The scan for was for a TB test for her move, nothing to do with any breathing difficulties. This was right before my father's passing and so I had not read those notes in detail, but I did right before her appointment this week and was pretty shocked. The scans apparently indicated a "significant change" since a prior scan in 2019, which largely appears to coincide with her cognitive decline. My mom smoked (though not a "heavy" smoker) for several decades before quitting back in the mid-90's, so I was surprised to see "advanced emphysema" described as she does not exhibit any obvious symptoms. Apparently this is a new development... I've seen some articles that there is a correlation between COPD and dementia, but to me the timing of both developments is very alarming.