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Her sister has dementia and is starting to loose her sight.

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Are you asking about the dementia or vision loss?
The answer to both is maybe, depending on the type of dementia or cause of vision loss.
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Tsmitty, one way to tell if it is hereditary is to do a family tree and see if there is a pattern. Did your wife's mother or any of your wife's siblings have dementia? How about your wife's grandmothers/aunts/uncles on both sides of the family?

Also age plays a part as our body parts tend to break down, such as our eye sight, hearing, etc. Both my Mom and her sister, both of whom were in their late 90's, seem to have the same age related issues.... almost blind, very hard of hearing, and serious memory issues. My Mom other sister who was in her late 80's, didn't have any of those issues.
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Smitty, there's also a major hereditary factor in terms of diet and food choices, in that children learn from their parents and sometimes continue traditions of poor choices in diet. I've seen this, when more than one member developed Type II diabetes, and in which cancer was prevalent at every level of the family except the current youthful generation.
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My wife had a total blood work-up all was normal had MRI showed more loss on left side than right her sister has more loss on rightthan left but both have visual loss in the family no dementia just heart, and diabetes. That's why I'm asking is it hereditary or could it be perks disease cause both have language problems
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A history of heart disease and diabetes predisposes people to vascular diseases. which over time can cause enough damage to the smallest blood vessels in the brain and lead to vascular dementia. There are some studies that question whether there is a link between age related macular degeneration to an increased risk of vascular dementia, although others dispute, pointing out that both diseases share common risk factors and and the chances of those with AMD developing dementia are no greater than average.
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Tsmitty, to add to my post above, curious if your wife and her sister are fall risks? Were they both doing well then had a serious fall?

Why I asked was because I noticed this with my Mom who was in her late 90's, and another writer's Mom, also in her late 90's, both were doing quite well for their age but both had a serious fall where there was head trauma. Within days dementia showed up in the late stages.

With my Dad, any time he fell, be it not serious, it seemed like the memory got a bit worse with each fall.
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My wife always worked out in the gym 5-7 days a week all her life she holds a lifting record for her age she don't smoke drink and eats chicken fish and veggies
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