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Atherosclerosis/Altzheimer's Disease - 3rd Post

  This is the third time I have posted this question.  I also posted on April 18 and May 11, 1998.  Is it possible that neurologists do not address atherosclerosis because it is vascular and do not address Altzheimer's Disease?  If so, please let me know so I will not keep bothering you.  I may  just be expecting information from the wrong professionals.  (The Aprill 18 post disappeared after I wrote the May 11th one.)
  Basically, I wanted to know if having diffuse atherosclerosis and bad carotids sets a person up for altzheimer's disease.  I am a 47 yo female.  Can a Diamox SPECT test show Altzheimer's?
  P.S. Again, just tell me if I'm not in the right forum.
Sorry about the late reply. Sometimes we get behind, and then it gets worse when new questions bury the old questions in the list. I'll see if I can help you now.
The term for decline in cognitive (mental) ability is dementia. Medically, "demented" isn't exactly the same as the lay term.
There are several causes of dementia. Most people have heard of Alzheimer's disease, which is a degenerative disorder. That is, there are groups of cells in the brain which die off and no one knows just why. Not all degenerative diseases produce dementia - depends on which populations of cells in the brain are dying. Specific groups of brain cells dying -> specific disease, usually with its own specific name. Not only that, but the rate at which cells are lost depends on the specific disease as well.
Dementia can be caused by processes other than degeneration. For example, chronic alcohol abuse leads to certain metabolic abnormalities which kill or impair the function of certain cells. Certain infectious or inflammatory processes can produce dementia.
The above is just for perspective - many causes. More relevant to your question, chronic lack of oxygen can impair memory and cognitive function. The term is ischemia - just means not enough blood supply. If you suddenly block a large vessel (for example, carotid artery or middle cerebral artery), you get a stroke which is quite impressive, symptoms including weakness on one side, etc. On the other hand, if you block off a tiny artery (look at a mechanical pencil tip to see what half a millimeter looks like), the region of the brain affected is only the size of a pea or less. Often, this goes unnoticed. You can accumulate a few dozen of these "microstrokes" without really noticing much. However, sooner or later, this "microvascular" disease can impair memory (and people also have quite the hard time with walking).
So the answer is: vascular disease doesn't cause Alzheimer's, but small vessel cerebrovascular disease can lead to dementia and some other symptoms. Large vessel cerebrovascular disease (carotids, etc) is more likely to put you at risk for a more typical "stroke."
Cerebrovascular disease and Alzheimer's are very much in the neurologist's "jurisdiction."
I hope this helps. As you know, this information is provided for your general medical education only. Any specific comment regarding your diagnosis, prognosis, and treatment options must come from your doctor after appropriate evaluation. CCF MD mdf.

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