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A 73-Year-Old Man Comes to the Office Due to Increasing

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A 73-year-old man comes to the office due to increasing forgetfulness over the past 6 months.  He says, "My mind used to be quite sharp, but now I can't even concentrate to read a book or newspaper.  I'm afraid I'm developing dementia like my father."  The patient reports he has been losing sleep and has little energy and motivation.  He recently took a leave of absence from work because he could no longer concentrate on details and complete his paperwork.  His medical history includes hypertension, hypercholesterolemia, diabetes, benign prostatic hyperplasia, and transient ischemic attack.  Family history is significant for hypertension and diabetes (mother) and Alzheimer disease (father) .  The patient does not smoke and drinks wine only occasionally.  Vital signs are unremarkable, and physical examination is normal except for slowed speech and movements.  The patient declines to perform a serial sevens assessment and says, "I just can't do it."  CT scan of the head is normal.  Which of the following is the most likely cause of this patient's cognitive impairment?


Definitions:

Suppression Circuit

A circuit designed to inhibit or reduce unwanted signals or noise in an electrical system.

AC Loads

Electrical loads that operate with alternating current, commonly found in household and industrial applications.

Metal Oxide Surge Suppressor

A device that protects electrical equipment from voltage spikes by shunting excess voltage to the ground through a metal oxide varistor.

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