Case Study TX Plan

A 69-year-old man is brought to the clinic by his wife due to her concern about his memory problems. Over the past several months, the patient has had increasing difficulty remembering the names of friends and family members. On two separate occasions, he has become lost while driving in his own neighborhood. As a retired engineer, he had always been meticulous about his work and appoint- ments. Now, he needs constant reminders about every aspect of his daily affairs, including his medications. His only known medical problems are hypertension and hyperlipidemia.

On mental status examination, the patient is alert and oriented only to person and place. When asked questions, he looks to his wife for assistance in answering. He does not remember his physician’s name, although he has been coming to the same office for several years. When he speaks, he seems to have difficulty find- ing the right words to express himself. On further cognitive testing, the patient is unable to draw a clock as directed and can only recall one of three objects after 3 minutes. The rest of his neurological and other physical examination findings are unchanged in comparison to prior evaluations.

» What is the most likely diagnosis for this patient?

» What is the next step?

» Formulate a treatment plan.

» Include the 3-differential diagnosis