I read your question carefully but you must know that something must have gone wrong because the question seems to be unfinished. You start to say he also has been diagnosed with and then the sentence is interrupted. Anyway you can submit the full question again later. As for chronic microvascular ischemic changes confusion is not a common presenting sign, however it depends on the extent of these lesions. If they are only mild then they are not the case, but if they are extended they may lead to dementia and confusion. So the imaging report should be read carefully on that regard. As for treating it, that depends on the cause, the causes can be many. Most common ones are damage to blood vessels from high blood pressure, diabetes, smoking, high cholesterol and those issues should be addressed. I hope to have been of help.