A 77-year-old man with a history of type 2 Diabetes Mellitus was diagnosed 2 years ago with mild cognitive impairment. At that time a Minimental (Folstein) 28/30, abbreviated Yesavage Test 14/15, a CBC with normal TSH and maturation factors along with negative LUES and HIV serologies and a magnetic resonance imaging (MRI) showing diffuse cortical atrophy predominantly in the posterior area. The patient was accompanied by his wife, who reported a slow progressive evolution of memory impairment (e.g., sometimes confused with insulin doses). There are no hallucinations or behavioral disorder. Current Minimental is 24/30 and Yesavage test 14/15, there is no neurological focality, tremor or tone or gait disorders on physical examination. Two months ago he came to the emergency department after a mild traumatic brain injury due to an accidental fall (the only one in 2 years) and a CT scan was performed which did not provide new information compared to the previous MRI. What is the most likely diagnosis in this patient?
This case describes an Alzheimer's disease with insidious onset of short-term memory problems. Clinically it can be distinguished from other options by the absence of behavioral problems (typical of frontotemporal dementia) and hallucinations (early in Lewy body disease). Vascular dementia is diagnosed by criteria that include deficits in memory and two other cognitive areas with consequent functional impairment, but cerebral vascular disease based on history, examination and/or neuroimaging tests, which are not indicated in the case. Creutzfeldt-Jacob disease is mostly rapidly progressive and usually presents with other clinical, abnormal neurological examination and MRI alterations.
Frontotemporal dementia.
Alzheimer's disease.
Vascular dementia.
Lewy body disease.
Creutzfeldt-Jakob disease.
This case describes an Alzheimer's disease with insidious onset of short-term memory problems. Clinically it can be distinguished from other options by the absence of behavioral problems (typical of frontotemporal dementia) and hallucinations (early in Lewy body disease).
This case describes an Alzheimer's disease with insidious onset of short-term memory problems. Clinically it can be distinguished from other options by the absence of behavioral problems (typical of frontotemporal dementia) and hallucinations (early in Lewy body disease).
Vascular dementia is diagnosed by criteria that include deficits in memory and two other cognitive areas with consequent functional impairment,
This case describes an Alzheimer's disease with insidious onset of short-term memory problems. Clinically it can be distinguished from other options by the absence of behavioral problems (typical of frontotemporal dementia) and hallucinations (early in Lewy body disease).
Creutzfeldt-Jacob disease is mostly rapidly progressive and usually presents with other clinical, abnormal neurological examination and MRI alterations.