Dementia.
A 76-year-old woman was brought to the memory clinic by her daughter due to increasing concerns about her memory and cognitive function over the past year. The daughter reported that her mother had begun forgetting familiar names and had difficulty following conversations. Additionally, she had experienced episodes of confusion, often misplacing items and struggling to remember the location of her home when out for walks. The patient had a history of hypertension and mild depression, for which she was receiving treatment. There was no significant history of head trauma, and she had no previous psychiatric conditions. A review of her medications indicated that she was taking an antihypertensive and an antidepressant. The patient’s daughter mentioned that her mother had become withdrawn, showing less interest in activities she once enjoyed, such as gardening and reading.During the cognitive assessment, the patient scored poorly on the Mini-Mental State Examination (MMSE), with particular difficulty in memory recall and language tasks. A physical examination revealed no neurological deficits, and blood tests ruled out vitamin deficiencies and thyroid dysfunction. Given the clinical findings and the history provided by her daughter, the neurologist diagnosed the patient with probable Alzheimer's disease, a common form of dementia. The neurologist discussed the diagnosis with the family, emphasizing the importance of supportive care and possible treatment options, including cholinesterase inhibitors to help manage symptoms. A referral to a geriatric care manager was also made to assist with planning for her care needs as the diseaseprogressed. The family was encouraged to engage in activities that would stimulate the patient’s cognitive function and maintain social connections.
a) Severe headaches
b) Increasing memory loss and cognitive decline
c) Frequent falls
d) Difficulty with vision
a) Geriatric Depression Scale (GDS)
b) Montreal Cognitive Assessment (MoCA)
c) Mini-Mental State Examination (MMSE)
d) Clock Drawing Test
a) Hallucinations
b) Misplacing items and confusion about familiar locations
c) Severe mood swings
d) Inability to speak
a) Antidepressants
b) Cholinesterase inhibitors
c) Antipsychotics
d) Physical therapy
Answers
1. b) Increasing memory loss and cognitive decline
2. c) Mini-Mental State Examination (MMSE)
3. b) Misplacing items and confusion about familiar locations
4. b) Cholinesterase inhibitors