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Neurological Function

H.M is a 67-year-old female, who recently retired from being a school teacher for the last 40 years. Her husband died 2 years ago due to complications of a CVA. Past medical history: hypertension controlled with Olmesartan 20 mg by mouth once a day. Family history no contributory. Last annual visits with PCP with normal results. She lives by herself but her children live close to her and usually visit her two or three times a week.
Her daughter start noticing that her mother is having problems focusing when talking to her, she is not keeping things at home as she used to, often is repeating and asking the same question several times and yesterday she has issues remembering her way back home from the grocery store.
Case Study Questions

Name the most common risks factors for Alzheimer’s disease
Name and describe the similarities and the differences between Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies, Frontotemporal dementia.
Define and describe explicit and implicit memory.
Describe the diagnosis criteria developed for the Alzheimer’s disease by the National Institute of Aging and the Alzheimer’s Association
What would be the best therapeutic approach on C.J.

Sample Answer

H.M.’s Case: Understanding Memory Concerns

H.M.’s symptoms raise concerns about possible dementia. Let’s explore the risk factors, different types of dementia, memory functions, and potential approaches for her situation.

Risk Factors for Alzheimer’s Disease:

Age: H.M. at 67 is within the age range where Alzheimer’s risk increases.
Family History: While not mentioned, a family history can be a risk factor.

Types of Dementia:

Alzheimer’s Disease (AD): Most common form, characterized by progressive memory loss, language difficulties, and impaired thinking.
Vascular Dementia (VaD): Caused by reduced blood flow to the brain, leading to problems with memory, thinking, and walking.
Dementia with Lewy bodies (DLB): Marked by movement problems, hallucinations, and fluctuations in alertness along with cognitive decline.
Frontotemporal Dementia (FTD): Affects the frontal and temporal lobes, leading to personality changes, language difficulties, and problems with judgment.

Full Answer Section

Similarities:

All dementias involve a decline in cognitive function, impacting memory, thinking, and daily activities.

Differences:

Feature	Alzheimer’s Disease (AD)	Vascular Dementia (VaD)	Dementia with Lewy bodies (DLB)	Frontotemporal Dementia (FTD)
Cause	Protein deposits in the brain	Reduced blood flow to the brain	Lewy bodies in the brain	Degeneration of frontal/temporal lobes
Onset	Gradual	Can be sudden or gradual	Gradual, with fluctuations	Gradual
Symptoms (besides memory loss)	Language difficulties	Difficulty walking, balance	Movement problems, hallucinations	Personality changes, language issues

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Explicit vs. Implicit Memory:

Explicit Memory:Conscious recall of facts and experiences (e.g., remembering your birthday).
Implicit Memory:Unconscious learning and skills (e.g., riding a bike).

Alzheimer’s Disease Diagnosis Criteria (NIA-AA):

Cognitive symptoms:Memory loss, language difficulties, impaired problem-solving.
Functional decline:Difficulty performing daily activities.
Biomarkers (optional):Brain scans or spinal fluid tests to support the diagnosis.

Best Therapeutic Approach for H.M.:

Comprehensive Evaluation:A neurologist should perform a detailed evaluation, including cognitive testing, brain scans, and blood tests to differentiate dementia types and rule out other causes.
Dementia Diagnosis:Once the type is determined, a treatment plan can be established.
Alzheimer’s Management (if diagnosed):While no cure exists, medications can help manage symptoms and slow progression. Non-drug therapies like cognitive stimulation and social engagement are also beneficial.
Support System:M.’s children can provide emotional support and assist with daily tasks.

Important Notes:

Early diagnosis is crucial for maximizing treatment benefits and planning for the future.
Support groups can be a valuable resource for H.M. and her family.

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Neurological Function

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H.M.’s Case: Understanding Memory Concerns

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