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

question 336

Multiple Choice

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?

• A)Alzheimer disease
• B)Dementia with Lewy bodies
• C)Major depressive disorder
• D)Normal aging
• E)Parkinson disease
• F)Vascular dementia

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Definitions:

Stress-Related Hormones

Bodily chemicals that are produced in response to stress, influencing health and emotional state.

Heart Rate

The number of heartbeats per unit of time, usually expressed in beats per minute (bpm), indicating the heart's activity level and overall health.

Self-Determination

The process by which a person controls their own life, making choices and decisions based on personal preferences and interests.

Resilience

The capacity to recover quickly from difficulties; toughness.