### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My wife was never fully diagnosed with Alzheimer s but the consensus appeared to be the cause of her declining memory problems. This started about 5 years ago with 2 strokes affecting her left brain. There appeared to be little difference between left and right body strength and did not seem to suffer and typical body reactions. She quickly learned how to walk, eat, dress but it took much longer to recover memory and speak. Two years ago I retired to take care of her full time. In the last few weeks, she has had very rapid physical decline. She used to dance with me almost every day, could walk unassisted and mostly could dress, go to the bathroom by herself, brush her own teeth and feed herself. Now she cannot do anything at all without assistance. Her joints are very stiff and she cannot stand, walk or get in and out of bed by herself. She is also almost constantly shaking her hands and arms, sometimes quite violently. Is this a clear symptom or dementia with Lewy? Is there any correlation to stage 7 Alzheimer s. Beginning, middle of late stage 7?

### output:

Hi, I think she has multiple problems which probably stem from the strokes.  You have mentioned that dementia started after stroke. So first and foremost I think it would be better to consider this as post-stroke dementia or multi-infarct dementia, and not Alzheimer's disease. As for the movement problems, this can be stroke related as well. The difficulty in getting out of bed could well be stiffness resulting after the stroke. Similarly, her tremors could possibly be vascular Parkinsonism. I would need the details of the treatment that she's on. But I would recommend a repeat MRI BRAIN scan. This may be followed by a PET scan. If it is indeed found to be due to further multiple small strokes, the medications need to be added and modified. Along with physiotherapy. If however, she doesn't have the multiinfarct state the PET will help confirm the type of dementia. Many centers are into different stages of study with use of PET. Enrolling her in one of the centers may help her further. Hope I have answered your query. Let me know if I can assist you further.