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QID: 210467
A 71-year-old man is brought in by his daughter for forgetfulness. The daughter finds herself repeating things she has already told him and the patient recently missed a lunch date they had scheduled. She is worried that he may have Alzheimer disease because her mother had it, and this is how it started. The patient sometimes forgets where he puts his glasses and has missed appointments if he doesn't write them in his planner. He states “I always remember birthdays.” Since his wife passed, the patient has been responsible for all the finances and pays the bills on time. He cooks for himself, though sometimes he is “lazy” and will order fast food. The patient’s medical history is significant for hypertension, atherosclerosis, and rheumatoid arthritis. His medications include aspirin, lisinopril, atorvastatin, and methotrexate. He was also treated for depression for the first year following his wife's death 3 years ago. He currently denies feelings of depression or suicidal ideation but has been thinking more about death since some of his golfing buddies passed away. He drinks a beer every night with dinner and smokes cigars socially. His temperature is 98.6°F (37°C), blood pressure is 130/83 mmHg, pulse is 86/min, and respirations are 15/min. A physical examination reveals ulnar deviation of the fingers, decreased grip strength, and a slow, steady gait. The patient is able to spell a 5-letter word backward and remembers 3/3 items after 5 minutes. Which of the following diagnoses most likely explains the patient’s symptoms?
  • Neurology
  • - Alzheimer Disease
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