Silent strokes causing short term memory loss. Any advice?

Thanks to all of you for your inspirational stories and ideas. I am definitely more at peace in my heart and will continue to implement these new and challenging ideas into her daily routines. We are blessed that my father is still managing well and can be with her full time as necessary. Praying that he can hold out for another year until my retirement.

With all the doctor appointments, I guess it is no longer a short term memory for her because she finally seems to be aware that she does have a 'memory problem'. Although it makes it harder to realize this, she is also more willing to work with the puzzles and new ideas for exercising her mind. I love the missing Bible word idea suggested by Guestshopadmin...I think she will, too. :)

As hard and frustrating as it is for us, it is impossible to imagine how hard it must be for her. We also know that if the tables were turned, she would have no reservations in caring for us with the same love and devotion. Thank you so much blannie, for your wishes. We are blessed in so many ways. I will continue to visit and share and pray for all those here on this awesome site.

Peace and Blessed Be.

I am happy that no change was made to her blood pressure medication as her BP’s appear to be nice & stable now with the current meds & you are so correct to note how important an adequate blood pressure is. Elderly folks are very susceptible to orthostatic BP changes - meaning when the person stands up the blood pressure drops and no one is available at home to monitor them all the time during the day.
If it isn’t broken, don’t fix it!
Push hydration too - 48-64oz daily. 

Best wishes to your mom. I hope she's able to stay stable.

My dad enjoys those Word Find books. He does them daily. I'm not sure how helpful they are, but, he's almost 81 and still managing pretty well. He handles household finances, maintenance, does outdoor work, etc. I just attended a schedule appt with his Cardiologist (he had quadruple bypass in 1999 and several stents since then) and he's fit as a fiddle. He takes his meds and stays active. He hopped up on the table like he was a man of 40. EKG, blood work, blood pressure, and other tests are great. So, it's an inspiration. My dad has been retired for years, but, I swear, I think that he likely works harder (around the house, helping family and friends, helping animals, donating time to church activities), than many people half his age. lol  I'm not kidding. 

Your mom sounds very much like my mom in her symptoms. My mom had Afib (heart condition) and was on medication for that and for previous clots in her legs and lungs. She had no short-term memory and over time (she lived to almost 98) her reasoning ability and initiative declined.

But she was able to live in independent living until the end with a lot of help from me. She had her little routine and never lost her ability to make her breakfast, get to the bathroom, and the other activities of daily living. But she'd forget to put the half-eaten food in the fridge or forget she had a nice leftover lunch from yesterday in the fridge, forget what she asked me two minutes ago, things like that. But she kept her same sweet personality and didn't ever show symptoms of sundowning or classic symptoms of Alzheimers like losing language or swallowing ability or how to use things or what they were for.

Mom worked the newspaper crossword puzzle daily until maybe the last six months of her life. So she was pretty stable in her ability to manage on a day-to-day basis. I talked to her twice daily if I wasn't seeing her and felt like that kept her grounded in the present time. I tried to get her out around others on a regular basis, but she'd forget what we did the next day. But she enjoyed it in the moment and that was what I was after.

Mom was also very sensitive to medications and I tried to keep them to a minimum. I kept a very close eye on her and made sure she was eating well and getting her medications. I wish the same kind of stable condition for your mom and for you. In the overall scheme of things, mom and I were very lucky.

It sounds weird, but my friend's 91 year old mother is an avid Wheel of Fortune watcher. She loves to guess the puzzles. They do have an electronic version that you can make very large on a screen.
Sudoku math puzzles were given to my stepbrother post stroke.
His wife also found a Bible study package somewhere with some of the verses missing words that he could see if he could remember or figure out.
My mother used to work with my grandmother on recipes - look at the ingredients quickly, turn book around, oh gosh I forgot whether it's sugar or flour...if you're a cook, can prompt too.

Now for the update: The cardiologist concurred with the neurologist in that the memory loss was due to silent strokes. However, his observation of the MRI was that they were 'micro strokes' not even 'mini strokes' which would have been building up over her lifetime and finally catching up to her at 86. He ordered an Echocardiogram which she had done this morning. Although the official reading won't be in for about a week, the technician said her arteries looked very clear, especially for "a woman of her wisdom." (I love this term!)

The cardiologist also agreed that we don't need to start her on any new medications right now. We will wait and see whether her memory continues to decline and, if so, then we can try a medication such as Aricept. His Rx: maintain a good bp, no more falling!, healthy diet, physical and mental exercise.

It will be up to her to exercise her mind by doing word puzzles, reading short stories, etc. She is already an avid crossword worker. She is not a computer person and will not be interested in learning to play anything electronic. So...I'd love to hear any ideas from you guys that I could get her involved with that might help.

Breathing easier...Peace.

Definitely going to do some research in to vascular dementia. Countrymouse, yes, the doctor was a diagnostic neurologist referred via her GP. I take her to her cardiologist next week, whom I know and trust, and will see what his opinion on everything is. Meantime, my SIL is a nurse and has been coming by to take her bp every other day. So far it has remained in the normal range, sometimes a bit low or high, but consistent sitting and standing...definitely doesn't need to be any lower...

Again...awesome to have a place to confer with fellow caretakers. It is becoming increasingly obvious that we are the ones who need to do the research and work collectively with the physicians. Afterall, we are the only ones with first and knowledge of our situations.

Peace and Support.

The "damage caused by several mini strokes" is vascular dementia. That's more or less the definition; although over time, as the disease progresses, the mini-strokes stop being identifiable events and morph into a continual process. If your mother's blood pressure is under control that is one line of treatment covered. Is she also on any kind of anti-clotting medication? - I would be surprised if not.

I too am baffled as to why your neurologist? - was it the neurologist, or another doctor? - would prescribe a treatment for a condition he had just ruled out.

But with ALL questions or reservations about medical treatment, take it up with the doctor; don't second-guess professional advice. You have every right to ask for more information and to decide against a recommendation, but it is risky and counterproductive to do so without telling the doctor who made it.

Yes to staaarrr's avice about vascular dementia!!
Many years ago my mom had an MRI due to her having recurring TIAs and her primary doctor told me it "lit up like a christmas tree", of course I asked what that meant and he said it showed signs of bleeds and referred mom to a neurologist who treated her aggressively for stroke prevention. Unfortunately neither one of them ever mentioned vascular dementia, in fact I had never heard of it until I stumbled on to AgingCare while I searched the web trying to figure out what was happening to my mother!
I'm concerned when you mention low blood pressure... when my mom had her sudden decline everyone pointed to her frighteningly low BP (80/20 and even lower) as a sign she was transitioning to the end of life. Her doctor had retired and nobody seemed to be looking at her charts because the poor woman was on several BP meds and the first course of action should have been to reduce them... looking back I'm certain that the chronically low BP contributed significantly to my mom's cognitive decline.
I also did a little searching online for you and there are some articles that mention a benefit in using donepizil in vascular dementia... now that you know what to look for you can perhaps spend time researching more yourself.

Interesting you mentioned the pharmacist. After a severe reaction to a drug (Methotrexate) prescribed by her rheumatologist, I have been diligent when placing her on any new drug. It was the pharmacist who recognized that there would be an interaction with her current medication. Now she is my 'go to' anytime I have questions or concerns about prescription drugs. I do feel that the Rx for Aricept was just an easy 'give her a pill' solution and I will be seeking 2nd and probably 3rd opinions. Thank you for your feed back. Peace.

Normally they call short-term memory loss from mini-strokes or vascular narrowing, vascular dementia. However, you don't need a name to know that the best course of action in your mother's case is to control her blood pressure. It sounds like it is well under control. As for the Aricept, you would really need to weigh the benefits against the risks. It sounds like your mother's doctor has, but please get a second opinion as these types of drugs are often prescribed without enough thought. You can also contact your pharmacist about any concerns with drug interactions. They are normally more knowledgable than the doctor.

Thank you! All good to know. I will continue to do my research and work with the physicians. This is all so new to me, it helps immensely to hear input from those actually experiencing the situations! Peace.

Mamachar,
What you describe does sound familiar. That's how my LO was first diagnosed as well. She had severe short term memory loss, but, also some loss of judgment, reasoning, organizing, focus, etc. She was diagnosed with Vascular Dementia, by regular doctor, neurologist and a psychiatrist. However, as her condition progressed, it was then believed that she MAY also have Alz. or what is called mixed dementia (having two causes.) That has not been confirmed.

I might find a doctor who really focuses on the treatment of patients with dementia, so they can become familiar with your mom and be able to provide you with more information and input into the treatment. I've heard some positive things about the medication you describe, but, my LO has not taken them. Her doctors did not recommend them for her.  There are negatives as well. I'd make the decision after gathering lots of information and discussing it with a doctor about the pros and cons, as well your specific concerns.

I'd also ask what to expect with this condition, because when my LO was first diagnosed, she also got her BP, blood sugar, etc. under control, but, her dementia still increased at an alarming rate, effecting her physically and mentally. While they can't predict all things, I'd inquire into best and worst case scenario, so you know how to plan.

Thanks for your input. The Rx from her neurologist was Dorepezil (generic for Aricept). Alone, this might be okay, but there is an interaction with the Acebutol which she is taking for high blood pressure - that being to lower the bp even further. Her normal bp stays fairly consistant around 111/70 and I have been monitoring it about every other day since the neuroIogist appt. When I called back and asked about the reason, I was told they wanted to see if it would make any difference/if there was any change in 3 months, although he said in the appt there was no repairing the damage already done. From what I've read about the drug, I'm afraid there are more risks than benefits for her. I have set up an appointment next week with her cardiologist who prescribes the Acebutol with a list of questions about the strokes and medication interactions.

My mother is 86 years old and has already suffered from several bad falls, hitting her head on most of them and even puncturing a lung! so I fear lowing her pb could cause her to be less steady on her feet. I'm thinking these incidents could have caused the mini-strokes since there have been no noticeable 'stroke symptoms' at any 'normal' time...after all, wouldn't your bp spike from something like that?

And, you're absolutely right about calling it dementia, although I'm not sure what to call it...you? When talking to my mother about it, I simply say, "your memory loss". It is such therapy for me to have a place to voice my concerns. Thank you again for caring! Peace.

Medications can be used for different things. You can ask the doctor why he put mom on the medication if she doesn’t have Alzheimer’s and share your concerns about her blood pressure. You dont mention the name of the medication, but is one of the side-effects is that it affects blood pressure? You said mom doesn’t have dementia just short-term memory loss, so I’d be hesitant to call it dementia especially when speaking to her.