A 56-Year-Old Woman Comes to the Office for a Routine

question 258

Multiple Choice

A 56-year-old woman comes to the office for a routine health maintenance evaluation.  The patient is physically well but reports feeling upset that she had to place her 79-year-old father in a nursing home.  She says, "I've cared for him since he developed Alzheimer disease 5 years ago, but I couldn't manage him at home anymore."  The patient's medical conditions include hypertension and type 2 diabetes mellitus.  She underwent menopause at age 51.  She does not use tobacco or alcohol and takes yoga classes 3 times a week.  Blood pressure is 140/85 mm Hg and pulse is 77/min.  BMI is 32 kg/m².  Physical examination is unremarkable.  The patient expresses concern about developing Alzheimer disease like her father and asks if there is anything to do.  Which of the following is the most appropriate response to the patient?

• A)"Although Alzheimer disease cannot be prevented, family history is only a risk factor if your father had the early-onset form of the disease."
• B)"Although family history is a risk factor, taking supplements like vitamin E can help reduce your risk."
• C)"I imagine it was difficult to watch your father decline, but there is nothing anyone can do to prevent Alzheimer disease from developing."
• D)"I understand your concern and suggest getting an APOE genetic test to determine if you are at risk for Alzheimer disease."
• E)"While family history is a risk factor for developing Alzheimer disease, getting good control of your medical conditions now can help reduce your risk."