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

Based on the patient's history and presentation, the likely diagnosis is AD. In the United States, AD has a prevalence of approximately 6.5 million people over the age of 65 years. Further, about 32 million people worldwide have AD dementia. Early-onset AD, which develops before the age of 65 years, occurs in only about 10% of cases.

The distinction between MCI and dementia is based largely on whether the patient experiences significant interference in the ability to function at work or in usual daily activities. This distinction must be made clinically, informed by a report from the patient and their caregiver.

Both AD and FTD cause significant memory loss. However, unlike AD, FTD initially presents as gradually worsening aphasia over several years, with patients eventually exhibiting progressive dementia.

The National Institutes of Health-Alzheimer's Disease and Related Disorders Association criteria for an AD diagnosis require a patient to present with slowly progressive memory loss of insidious onset, as seen in the present case. Symptoms generally have a gradual onset over months to years, but with an obvious history of worsening cognition. It is important to differentiate AD from more abrupt pathologies like vascular dementia.


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