DEAR DR. ROACH: I was diagnosed with white matter disease a few months ago, and I was given Depakote 500 mg to take (at bedtime). What exactly is this disease? Does it progress to dementia? My mother suffered from Alzheimer’s disease. I am in my late 60s. Are there any options for my future health care that I need to take care of? I am diabetic and also have high blood pressure and heart problems. All are under control. I take metoprolol and lisinopril. — M.R.
ANSWER: The brain is made up mostly of gray matter and white matter. Gray matter consists of the neurons (nerve cells), while white matter consists of the nerve fibers as well as glial cells, which support the neurons. White matter disease can be caused by many different processes, such as multiple sclerosis or migraine headaches, but one common meaning of “white matter disease” — and the one I think you probably were diagnosed with — is the damage done to the white matter by damages blood vessels.
Apart from smoking, high blood pressure, diabetes, and high cholesterol are the biggest factors in ischemic white matter disease of the brain. Improving the control of these factors can reduce the risk of vascular dementia. Vascular dementia is similar in some respects to Alzheimer’s, and often the two are misdiagnosed by patients and families. Vascular dementia, sometimes called multi-stroke dementia, tends to be stable for a while then suddenly get worse, as opposed to Alzheimer’s disease, which is slowly progressive.
The booklet on Alzheimer’s disease gives a detailed presentation of that common illness. Readers can obtain a copy by writing: Dr. Roach — No. 903, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.