Margaret Thatcher's Battle Against Stroke-Caused Dementia

Monday, 08 Apr 2013 12:54 PM

By Charlotte Libov

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British leader Margaret Thatcher likely suffered a series of small strokes over many years that went unnoticed until her legendary memory started to slip, a top neurologist tells Newsmax Health.
Thatcher had an almost-photographic memory, say aides and family members, who recalled that she could often recite briefing papers and other government documents word for word after one reading.
“Small strokes are a condition known as ‘multi-infract vascular dementia,’ which is a major cause of dementia. Since Margaret Thatcher was known for her ability to recall monumental amounts of information, she probably had a huge reserve capacity of memory, so she might have suffered small strokes for years before it became noticeable,” says Michael Sellman, M.D., chief of the neurology division at Mercy Medical Center in Baltimore.
Thatcher’s death from a stroke on Monday at the age of 87 came following a battle with dementia that lasted more than a dozen years. In recent years, her ill health left her so frail that she was unable to attend important events, such Prince William’s wedding in 2011. Her daughter, Carol, said that she first noticed her mother’s failing memory in the summer of 2000.
Carol recalled having lunch with her mother in a cafĂ© overlooking London’s Hyde Park. In the past, Thatcher’s daughter said she had often found it difficult to converse with her mother, given the older woman’s predilection for launching into monologues on international events.
That day, though, when her mother confused the Falklands conflict with the Yugoslav wars, “I nearly fell off my chair,” Carol Thatcher recalled. “Watching her struggle with her words and her memory, I couldn't believe it. She was in her 75th year, but I had always thought of her as ageless, timeless, and 100 percent cast-iron damage-proof,” she wrote in the Daily Mail.
“The woman who had dominated discussions for so long could no longer lead debates or keep up with the thread of a drinks-party conversation. On bad days, she could hardly remember the beginning of a sentence by the time she got to the end.”
The brain degeneration suffered by Thatcher is known as multi-infarct dementia, said Dr. Sellman. It is a series of small strokes, or “mini-strokes,” that often go unnoticed until the brain becomes damaged to the point that a person has trouble thinking or conversing. It is the leading cause of vascular dementia, which accounts for 40 percent of cases of dementia.
Mini-strokes result in only temporary, partial blockages of blood supply, and most often go unnoticed, but their damage is cumulative, said Dr. Sellman.
“The effects are fairly subtle. Family members know that mom isn’t the same as she was last week. But they are also cumulative, so what happens after time is that routine activities like bathing, dressing, or going out shopping for food become more of a challenge,” he said. “Each time you have a stroke you are killing brain tissue, so eventually memory is also affected.”
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Although the symptoms of vascular dementia and Alzheimer’s disease appear similar, their causes are very different. Vascular dementia is caused by brain damage stemming from small strokes. The culprit in Alzheimer’s disease is the death of brain cells characterized by areas of plaque on the brain. “Vascular dementia can be even more frustrating for the family because Alzheimer’s drugs like Aricept and Namenda don’t work on these patients,” said Dr. Sellman.
The time to prevent vascular strokes occurs in middle age, before they start occurring, Dr. Sellman said. The same risk factors that cause heart attacks and strokes are at play in mini-strokes.
“Keep your blood pressure, blood sugar, and cholesterol as low as possible. Watch what you eat and don’t smoke,” he said. In addition, daily low-dose aspirin therapy, which helps prevent blood clots, is also helpful, he said, adding, “The time to act is now, because once you begin having mini-strokes, it’s too late to prevent them or reverse the damage.”

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