An 81-year-old woman with increasing forgetfulness and difficulty with complex tasks

An 81-year-old woman has lived with her daughter for the past 6 years since being widowed. Her daughter has noted steadily increasing forgetfulness and difficulty with complex tasks. At this point, the daughter must handle all of the patient’s bills.

The patient is easily confused and does not remember a television program she watched 1 day ago. She does not know the name of the current president.

Her Mini-Mental Status Examination score is 18. No evidence of delirium or psychiatric illness is present. You tell the daughter that her mother meets the criteria for dementia, and the daughter asks you if it is Alzheimer disease.

According to the 2011 recommendations from the National Institute on Aging and Alzheimer’s Association, if a patient meets the core diagnostic criteria for dementia, which of the following is a core clinical criterion for probable Alzheimer dementia compared with another dementia type?

• insidious onset and marked impairment in memory and learning
• elevated amyloid-beta in serum and cerebrospinal fluid
• score on the Montreal Cognitive Assessment
• abnormal gait
• increased irritability

This question appears in Med-Challenger Family Medicine Exam Review with CME

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