Case history
Case history #1
A 76-year-old white woman is brought to her general practitioner by her children because she is becoming more forgetful. She used to pay her bills independently and enjoyed cooking but has recently received overdue notices from utility companies and found it difficult to prepare a balanced meal. She has lost 3.5 kg in the past 3 months, and left the water running in her bathtub and flooded the bathroom. When her children express their concerns, she becomes irritable and resists their help. Her house has become more cluttered and unkempt. On a past visit to her physician, she had normal laboratory tests for metabolic, haematological, and thyroid function. The current evaluation reveals no depressive symptoms and 2/15 on the Geriatric Depression Scale short-form. Her Mini-Mental State Examination score is 20/30.
Case history #2
A 54-year-old black woman is referred to the neurology clinic by her general practitioner for evaluation of memory problems. The woman is brought to the clinic by family members who are concerned that she has been more forgetful in the past year. They report she has difficulty recalling birthdays and anniversaries and is not managing common household tasks such as cooking and paying bills. Her sister had onset of dementia in her early 40s and was institutionalised because she was unable to care for herself. The woman was last seen by her primary care physician 3 months ago, when she had a routine work-up, which was reported to be unremarkable. Neurological examination revealed no significant abnormalities. Neuropsychological testing demonstrated severe impairment in executive function, deficits in visuo-spatial testing, and delayed speed of processing information. Mini-Mental State Examination score is 20/30.
Use of this content is subject to our disclaimer