Skill Checkup: A 71-Year-Old Woman With Signs of Self-Reported Cognitive Impairment and Primarily Short-Term Memory Loss

Shaheen E. Lakhan, MD, PhD, MS, MEd


January 31, 2023

The Skill Checkup series provides a quick, case-style interactive quiz, highlighting key guideline- and evidence-based information to inform clinical practice.

A 71-year-old woman in the United States presents with signs of self-reported cognitive impairment and primarily short-term memory loss. Symptoms have developed over the course of a year or so but have notably worsened in the past 6 months. Her husband explains that she has become very disorganized, a change that has interfered with her daily activities, and she seems to have difficulty handling money. Further questioning reveals that the patient's daughter passed away about 2 years ago, and therefore, her behavioral symptoms to date have been attributed to depression, including lack of motivation, disrupted sleep patterns, and changes in mood and personality. The patient is on selective serotonin reuptake inhibitors (SSRIs) and estrogen for vasomotor symptoms of menopause. Alcohol intake is infrequent. Body mass index is 19.6 kg/m2. Temperature is 98.2°F (36.8°C), respiratory rate is 14 breaths per minute, oxygen saturation is 96% on room air, pulse rate is 86 beats per minute, and blood pressure is 118/76 mmHg. No other abnormalities were noted on the physical exam. Laboratory tests are within the normal range.


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