Skill Checkup: A 70-Year-Old Woman With History of Depression and Mild Cognitive Impairment Presents With Memory Lapses

Jasvinder P. Chawla, MD, MBA


December 22, 2022

Given her recent memory lapses and fatigue, as well as increasing difficulties with day-to-day activities and getting lost while on walks as reported by her husband, the patient probably has mild/early-stage AD.

Neuropsychiatric symptoms are most common during the moderate/middle-stage of AD. These symptoms include apathy, social withdrawal, disinhibition, agitation, psychosis, and wandering.

Late-stage AD symptoms typically include difficulty performing learned motor tasks, olfactory dysfunction, sleep disturbances, extrapyramidal motor signs (eg, dystonia), akathisia, and parkinsonian symptoms. Primitive reflexes, incontinence, and complete dependence on caregivers are also common during this stage.

Difficulties with eating, swallowing, and talking, as well as gradual inability to walk, are commonly seen in end-of-life AD, according to the Alzheimer's Association.


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