I had an MRI a few months ago. The diagnosis was chronic microvascular disease with moderate leukoencephalopathy.; ventricular system unremarkable. My neurologists was vague on treatments. The reason for the MRI was because of a significant cognitive impairment. It seems to be getting worse. What is your professional opinion and what would you recommend to a patient?
The type of cognitive impairment is essential in making diagnosis and then planing treatment The cognitive domains can roughly divide into six type1. Memory2. Language3. Personality 4. Visuospatial 5. Execution and planing6. Affect We need to find out which are the domains that are mainly affected and the then plan a holistic treatment This includes looking for correctable factors like vitamin deficiency thyroid dysfunction , underlying depression Then we would pay attention to risk factors if present such as control of blood pressure, diabetes.  Treatment includes Chat Doctor.