MDS and Dementia

[virgswims]

I wonder if anyone has information or experience concerning the onset of dementia in connection with MDS? My mother is 88 and has had MDS that has gotten progressively worse for 3 and a half years. She takes procrit weekly and transfusions about every 6 to 8 weeks. The doctor tried Vidaza with her last month, but she only made it through two days (not even a full cycle) and she passed out at home. She just doesn't have enough strength to take an aggressive treatment like Vidaza. I know that she has had TIA's, at least 2 times in the past 3 months. She is showing very noticeable signs of dementia - not knowing people, having difficulty thinking of what she wants to say, not being able to associate time/place/people, paranoia, imagining things about people or situations, etc. Does dementia accompany MDS with older people as they go into advanced stages? Any information is appreciated.

[Birgitta-A]

Hi virgswims,
As far as I know dementia is not connected with MDS. Do you know your mother's platelet count? Vidaza very often decreases the platelets initially. If her platelets are low she can have had a small bleeding in the brain? If a bleeding has caused the symptoms from the brain she can recover when the bleeding is absorbed.

I am very afraid of that kind of stroke myself because my platelets are very low (last count 32) and don't function well. My blood pressure is low but when we for example are coughing the blood pressure will rise. I am hoping for the new drug Promacta for my low platelets.
Kind regards
Birgitta-A
70 yo, dx MDS Interm-1 May 2006, transfusion dependent, Desferal and Exjade for iron overload, 2 Neupogen injections/week for low white blood cells

[Neil Cuadra]

The onset of dementia isn't surprising for an 88-year-old, but I have a question: Has your mother been routinely anemic (low hemoglobin) despite the MDS treatment?

I spotted a study that found a link between anemia and mental decline in women over 70. They didn't prove cause and effect, just an association, but since oxygen powers our brains it makes sense that being low on oxygenated blood could contribute to problems with mental processing. The problems you describe sound like more than the simple confusion that many patients experience and call "chemo brain" but I think it's worth asking the doctors if anemia could be a contributing factor.

The study was done about 2005 and is described here. There's an easier-to-understand summary here (may require Medscape signup).