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

### input:
Is microvascular leukoencephalopathy progressive? My mother had an MRI done in 2007 showing white matter disease, subcortical atrophy and small vessel disease. Over the past 6-7 years she had been falling in the house and I noticed after the falling she had been experiencing some forgetfulness. She has been to a neurologist about 5 years ago and he had given her a mini-mental state test, and sent her for neuropsych testing. She also suffers from renal insufficiency due to hypertension (she is in Stage 3). She was in stage 4 but a nephrologist has her in stage 3 due to the right medications. Her mother had died from uremic poisoning over 50 years ago (no dialysis then). Anyway, the neurologist based on his examinations and testing feels that she is in a mild to moderate stage of alzheimer. Her cardiologist told me that she has microvascular leukoencepahlopaty (she also has hardenining of the arteries). Her primary care physician feels that her dementia is microvascular (AKA vascular due to small vessel disease; she also has diabetes, coronary artery disease, hypertension, hypothyroidism, cholesterol.) She was a smoker, but stopped about 17 years ago. She also has perepheral artery disease. She is on many medications including aricept and namenda. She also experiences parkinson-like tremors. She had a eeg showing a slows of speech language done about 4 years ago. Based on what I have told you is this dementia of a vascular origin, or is it a mixed dementia? She is currently 86 years old and resides in a nursing home. I know I witnessed while she was at home some forgetfulness like leaving a stove on, poor hygiene, moods swings (verbally and hitting). Also, she would have auditory & visual hallucinations (hearing music, talking to imaginary people). I thought at this point she would be better in a facility where she is exposed to people her age and mind stimulation would be more available than staying at home with a home health aide. She had a sister who had passed away last year at 83 years old from alzheimer. Could both sisters have the same thing? I know her sister had hypertension and atrial fib.

### output:

Hello, Microvascular leukoencephalopathy is usually progressive, as one ages changes to blood vessels usually add up. Apart from her age (in itself a risk factor), she has all other risk factors like hypertension, diabetes, cholesterol changes etc., so while it is attempted to slow progression by controlling these factors it can't be stopped. As for whether she has Alzheimer's the forgetfulness and the hallucinations you describe are not common with vascular dementia, would go more in the favor of Alzheimer. However, neurological exam, imaging and neuropsychological testing are necessary for a more complete assessment. In addition to that one doesn't exclude the other, it is common to have mixed dementia due to both Alzheimer changes and small blood vessels ones, they are both the most common causes of dementia. Hope I have answered your query. Let me know if I can assist you further. 