A 65-Year-Old Woman Recently Diagnosed with Mild Cognitive Impairment Seeks

question 228

Multiple Choice

A 65-year-old woman recently diagnosed with mild cognitive impairment seeks advice about prevention of dementia.  The patient has glaucoma, osteoarthritis, type 2 diabetes mellitus, and osteoporosis.  She lives alone and performs all activities of daily living independently.  The patient is troubled by her memory impairment but compensates by writing things down and making lists.  She has no depression and scores 25/30 on the Mini-Mental Status Examination.  The patient's sister developed dementia at age 69 and was recently admitted to a long-term care facility.  Her aunt suffered from dementia and died of pneumonia at age 78.
Blood pressure is 122/70 mm Hg and pulse is 77/min.  BMI is 26 kg/m².  General physical examination, including neurologic examination, shows no abnormalities.
Complete blood count, comprehensive metabolic panel, serum thyroid-stimulating hormone, and vitamin B₁₂ level are all within normal limits.
Which of the following is the most appropriate recommendation for this patient?

• A)Donepezil
• B)Low-dose ibuprofen
• C)Memantine
• D)Moderate-intensity exercise
• E)Vitamin E supplementation

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Definitions:

Critical Path

The sequence of stages determining the minimum time needed to complete a project, identifying tasks that directly affect the project's duration.

Project Completion

The final phase of a project where all objectives have been achieved, and the project is closed out and handed over.

Repulsion

A force under the influence of which objects tend to move away from each other, often used in physics or to describe a strong dislike or aversion between persons.

Rape

An act of sexual assault usually involving sexual intercourse or other forms of sexual penetration carried out against a person without their consent.