Patient: In December 2008, I took my father to the nearby Department of Neurology of Henan Provincial People’s Hospital for inpatient treatment, initially treated for Alzheimer’s disease, but without much effect. “When he was discharged from the hospital, he had another MRI, and the doctor said that the hippocampus was severely atrophied, so he added “Alzheimer’s disease” to the diagnosis of cerebrovascular amyloidosis, and said that the old man had neurological demyelination disease. The diagnosis of dementia was added to the diagnosis of cerebrovascular amyloidosis. After returning home, one more symptom is that he does not eat when he moves (of course, if he encounters his favorite food such as roast chicken, he eats a lot), I suspect that it is the side effects of “Meperidine” and “Amritsyn”, so I stopped these two drugs, and now just eat 1. glipizide Tablets …………….1 1 time a day, 1 time 1 tablet 2. Metformin Hydrochloride Tablets ………. 3. enalapril maleate tablets ……………1 2 times a day, 1 time 1 tablet I want to ask is 1. the doctor said that you can’t take aspirin because there is a brain hemorrhage, right? The doctor said that it is not necessary to infuse some cerebrovascular medication in the hospital every once in a while, right? I don’t know how to thank the doctor for volunteering to answer the patient’s questions. Patient: Thank you for your patience, I will observe for a few more days and give you a reply, thank you, doctor Patient: My father was hospitalized in Henan Provincial People’s Hospital at the end of 2008 and was diagnosed with cerebrovascular amyloidosis and dementia (along with hypertension level 3, diabetes, coronary heart disease). After discharge from the hospital, he only took Glipizide, Dimethoprim, and Dextran to control his blood pressure and blood sugar, but did not take any other medication. Recently, I found that the old man is not walking as well as before, one push is dragging, can’t lift up, and can’t walk long. In addition, he is not in good spirits. He sleeps all the time, and the amount of food has not decreased, but he is obviously thinner than before. Now I want to ask you, does it make sense to hospitalize this kind of patient, because I live in a small city, please, if hospitalized, what is the effect of the general infusion of fluid, thank you! Patient: Thank you Patient: Hello, my father was hospitalized locally a while ago, and was given some medication to improve brain circulation, as well as cytarabine and vitamins, but the effect was not obvious. He was found to have pneumonia and was given some anti-inflammatory drugs. During the hospitalization, liver, kidney and heart functions were checked normally. Recently, he has lost a lot of weight, and now he can’t swallow the medicine, and he eats less unless he eats more of what he loves, but he can eat more by feeding him. I would like to ask if this is an advanced stage of dysphagia, and what should I do as a family member of the patient? In addition, the patient used to string around at night and did not sleep. Now he doesn’t, and I feel that he has no energy. Does that mean my father is really in the advanced stage? Patient: Thank you Patient: Hello doctor, my father has just been in the local hospital for a while and has been given some drugs to improve brain circulation and nerve nutrition, but recently it has become apparent that he cannot walk, and he has to be assisted at home before he can walk, what is going on, because he used to be able to walk downstairs in the company of others? In addition, when he wets the bed at night, he will get up (put on the diaper, he will tear it off by himself), but because he cannot stand up, he has fallen to the floor several times, and because he cannot call someone, he lies on the floor alone. Also, do you think I should send you the cranial MR film? Aspirin is an anti-platelet clotting agent, mainly used to prevent stroke, but eating it may also cause bleeding. Looking at the medical history you provided, the patient has risk factors for vascular disease such as hypertension and diabetes, and is also prone to stroke, so there is a contradiction in treatment. Hippocampal atrophy is indeed a characteristic manifestation of Alzheimer’s disease – dementia. If your father has significant memory loss and declining abilities in all areas, then indeed he is suffering from dementia. Please provide your father with an MR film of his head. I think your father is not only suffering from Alzheimer’s, but possibly mixed dementia. Meperidine and Advil are the best medications for dementia. Of course, all medications have side effects, usually euphoria, insomnia, nausea, vomiting, constipation and so on. Patients who do not eat at all seem to be less like side effects caused by the drugs (which is certainly not absolute) and more like psychiatric symptoms associated with dementia. Most of them are caused by personality changes. Does your father suffer from insomnia, stay awake at night, mess around? Or see ghosts and gods? Shi Haisan, Department of Neurology, Guangzhou Brain Hospital: You’re welcome. The treatment of dementia is very difficult, and it can be said that there is no cure. Medication can only slow down the progression of the disease. Complications have to be prevented. Haisan Shi, Department of Neurology, Guangzhou Brain Hospital: Hello, please note that the patient may have had a stroke, also known as cerebral infarction. Because the patient has so many vascular risk factors. Hospitalization makes sense. Injections to improve circulation and nerve nutrition can be titrated, and some intravenous nutrition can also be supplemented. Shi Haisan, Department of Neurology, Guangzhou Brain Hospital: You are welcome. Shi Haisan, Department of Neurology, Guangzhou Brain Hospital: There are many complications in the late stage of dementia, such as pneumonia and bed sores. I think your father has a lot of head lesions, which can easily cause cerebrovascular accidents. The progression of dementia is also fast, and most of them are in advanced stages. Pneumonia would have been life threatening and could have killed him at any time if not well controlled. It can also involve the heart, brain and other important organs. In advanced cases of dysphagia, a gastric tube can be inserted. What the family needs to do now is to trust the doctor and cooperate with the treatment. Be prepared psychologically and accept the reality. Take care of the patient, turn and pat the back regularly to prevent bed sores. Prevent choking and coughing caused by feeding and aggravating pneumonia. Of course, there is also financial support. Shi Haisan, Department of Neurology, Guangzhou Brain Hospital: You’re welcome! Shi Haisan, Department of Neurology, Guangzhou Brain Hospital: Hello, your father is currently having difficulty walking, we need to find the cause. In addition, caused by drugs? Secondly, the late stage of dementia aggravation? If it is the first two, it can be treated. The latter is not possible. See if the patient can’t move his arms and legs on one side, or both sides? How is the speech? If the patient does not sleep at night, you can take some oral sleep medication, and pay attention to the dosage. You can send me the cranial MRI film.